Avramiotis S. Nikolaos, MD, MSc

Presented at #SVIN25: CREST-2: In high-grade asymptomatic carotid stenosis, addition of stenting to medical therapy led to a lower risk of stroke over a 4-year period. Endarterectomy did not lead to a significant benefit. Full results: nej.md/3LK9kst Editorial: Managing Asymptomatic Carotid Stenosis nej.md/482XjG1 @svinsociety

CREST-2 is out. I had Gemini make an infographic—no errors!

Verdict is out!!!!! #CREST2 RESULTS FAVORING CAS!!! Absolute risk difference = 3.2% (95% Cl, 0.6 to 5.9; P=0.016) Relative risk = 2.13 (95% Cl, 1.15 to 4.39) Happening now at #SVIN25 @svinsociety @MThrombectomy

#STROKE: In a secondary analysis of ARCADIA, randomization to apixaban was associated with a lower risk of recurrent ischemic stroke than aspirin in patients with left ventricular systolic dysfunction. @MitchElkind @hoomankamel @ShadiYaghi2 #AHAJournals ahajrnls.org/42Qu1bM

🚨 Keynote Alert at #ESOC2025! GOLDEN BRIDGE II shows AI-driven clinical decision support can improve stroke recurrence rates without safety hazards in acute ischemic stroke care. 📍22 May | Helsinki 👥 21,600+ patients, 77 hospitals #Stroke #AI #ClinicalTrials

ESTREL trial at #ESOC2025: Levodopa did not boost motor recovery after stroke, but extensive ESTREL data may pave the way for exciting advances in personalized rehabilitation. The awakening of stroke rehabilitation might just be postponed! #Stroke #Rehab

#ESOC2025 🧠Covert Brain Infarction ⬆️Increase risk of Stroke ~2x 📈More CBI, more risk ☝️Inform the patient 🚭Treat risk factors @ErasmusMC

Presented at #ESOC2025: Tirofiban, an IV antiplatelet, given as an adjunct to IVT, improved the odds of excellent functional outcome in patients with AIS, at the cost of an increased risk of intracranial bleeding in the ASSET-IT trial #VoiceOfStroke

New DISTAL Trial sub-analysis: Endovascular therapy boosted chances of saving at least 80% of affected brain tissue in medium distal vessel occlusion stroke. Preservation of ≥80% of at-risk brain tissue significantly improved outcomes. Tissue saved = better recovery #ESOC2025

#ESOC2025 🏃🏻‍♀️ESCAPE MEVO sub analysis 👉🏻 prognosis by image 🧠 👉🏻EVT <12 hs not > good functional outcome 👉🏻 Good collateral status > benefit 👉🏻 ⏱️<180 min > benefit

Presented at #ESOC2025: Among 550 patients with stroke due to large-vessel occlusion who had presented within 4.5 hours after onset, 90-day functional outcomes were better with intravenous tenecteplase before thrombectomy than with thrombectomy alone. Read the full BRIDGE-TNK trial results: nej.md/3GTVKAk @ESOstroke

#ESOC2025 | The OPTIMIST trial suggests low-intensity monitoring after IV thrombolysis in mild to moderate stroke can deliver comparable safety & outcomes to standard protocols—while easing ICU strain & improving patient experience 📍4922 patients | 114 hospitals | 8 countries

BRIDGE TNK trial presented at #ESOC2025 shows superior outcomes with IV Tenecteplase + thrombectomy vs thrombectomy alone in acute LVO stroke within 4.5h 🧠 Functional independence - mRS 0–2 🟦 52.9% with bridging vs 44.1% thrombectomy 🧾 Adjusted RR 1.18 #StrokeTreatment

#ESOC2025 ✅ASSET-IT: early tirofiban after IVT 👉🏻>mRS 0-1 and 0-2 at 90 day in Tirofiban arm 👉🏻 = sICH and mortality al 90 days

🚨Neuroprotective agents in Large Core Strokes 👉🏻 Edaravone + Dexborneol vs usual care 👉🏻 < 14 days of onset ✅ drugs: better functional outcomes at 90 days and trend to lower mortality

🚨EXCOA-CVT trial at #ESOC2025:Extending oral anticoagulation after cerebral vein thrombosis shows no clear benefit vs. short-term use. Both VTE recurrence & bleeding rates low. Individualised treatment decisions are key! #Stroke #CVT #VoiceOfStroke #StrokeTwitter @Diana_A_Sousa

The "first" subanalysis from the @DistalTrial is disclosed by Aikaterini Anastasiou, with results across 447 patients suggesting a higher proportion of brain tissue being saved in the study's EVT group compared to its best medical therapy group #esoc2025 @ESOstroke @MPeyT1

BREAKING from @NEJM In cancer patients w/ Cancer-Associated Venous Thromboembolism, reduced-dose apixaban (2.5 mg BID) is : 🔘Noninferior to full-dose (5 mg BID) for VTE recurrence 🔘Lower bleeding risk (12.1% vs. 15.6%) 🔘Safer extended anticoagulation, same protection. #Thrombosis #cancer @OncoAlert @Cihan_Ay_MD DOI: 10.1056/NEJMoa2416112

A STOP-CAD secondary analysis engineered by @DrDanielMandel : Among high risk features identified in cervical artery dissection, only occlusive dissection seemed to benefit from anticoagulation. Important information for future trials. ahajournals.org/doi/full/10.11… @StrokeAHA_ASA 🛑CAD

Amazing international multi-cohort collaboration just published @JAMANeuro Thanks @mbgoeldlin @DavidSeiffge for the amazing work and opportunity to be part of this great work!