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<meta name="DC.Title" content="Randomized Assessment of the Safety and Efficacy of Intra-Arterial Infusion of Autologous Stem Cells in Subacute Ischemic Stroke" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5586" />
<meta name="DC.Date" content="2018-05-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2018 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Stroke is a debilitating illness for which treatment window is limited. Most patients present to the healthcare facility beyond that window. Autologous stem cells have shown some promise for this group of patients. This study was performed to evaluate the safety and the efficacy of intra-arterial infusion of bone marrow–derived mononuclear cells in patients with middle cerebral artery ischemic stroke.

MATERIALS AND METHODS: A prospective, randomized, open-label, blinded–end point study was performed from July 2015 to June 2016. Of 229 patients with acute stroke who presented to the hospital during this period, 20 patients who satisfied the inclusion/exclusion criteria were included and randomized into the control and intervention groups. Intra-arterial stem cell infusion into the ipsilateral MCA was performed in the patients in the intervention group at 8–15 days post-stroke ictus. Final analysis at 6 months was performed for primary (safety) and secondary outcomes (efficacy).

RESULTS: When we compared the primary end point of the study, no procedure-related mortality, complication, new infarct, or symptomatic intracranial hemorrhage was seen in the intervention group. When we compared the secondary end point of good clinical outcome, 8 (80%) patients in the intervention group showed good clinical outcome (modified Rankin Scale score &lt; 2) with 4 (40%) patients in the control group achieving this (95% confidence interval for good outcome in patients with stem cell infusion, 49.03–94.3, and without stem cell infusion, 16.82–68.73; P = .068).

CONCLUSIONS: Intra-arterial infusion of stem cells can be carried out safely in the subacute stage of ischemic stroke. Improved clinical outcomes were observed with intra-arterial stem cell therapy; however, studies with larger cohorts are needed to validate the results.

BI
:   Barthel index
BMMNC
:   bone marrow–derived mononuclear cells" />
<meta name="DC.Contributor" content="V. Bhatia" />
<meta name="DC.Contributor" content="V. Gupta" />
<meta name="DC.Contributor" content="D. Khurana" />
<meta name="DC.Contributor" content="R.R. Sharma" />
<meta name="DC.Contributor" content="N. Khandelwal" />
<meta name="article:published_time" content="2018-05-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Randomized Assessment of the Safety and Efficacy of Intra-Arterial Infusion of Autologous Stem Cells in Subacute Ischemic Stroke" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Stroke is a debilitating illness for which treatment window is limited. Most patients present to the healthcare facility beyond that window. Autologous stem cells have shown some promise for this group of patients. This study was performed to evaluate the safety and the efficacy of intra-arterial infusion of bone marrow–derived mononuclear cells in patients with middle cerebral artery ischemic stroke.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;A prospective, randomized, open-label, blinded–end point study was performed from July 2015 to June 2016. Of 229 patients with acute stroke who presented to the hospital during this period, 20 patients who satisfied the inclusion/exclusion criteria were included and randomized into the control and intervention groups. Intra-arterial stem cell infusion into the ipsilateral MCA was performed in the patients in the intervention group at 8–15 days post-stroke ictus. Final analysis at 6 months was performed for primary (safety) and secondary outcomes (efficacy).&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;When we compared the primary end point of the study, no procedure-related mortality, complication, new infarct, or symptomatic intracranial hemorrhage was seen in the intervention group. When we compared the secondary end point of good clinical outcome, 8 (80%) patients in the intervention group showed good clinical outcome (modified Rankin Scale score &amp;lt; 2) with 4 (40%) patients in the control group achieving this (95% confidence interval for good outcome in patients with stem cell infusion, 49.03–94.3, and without stem cell infusion, 16.82–68.73; &lt;i&gt;P&lt;/i&gt; = .068).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Intra-arterial infusion of stem cells can be carried out safely in the subacute stage of ischemic stroke. Improved clinical outcomes were observed with intra-arterial stem cell therapy; however, studies with larger cohorts are needed to validate the results.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2018/05/01" />
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<meta name="citation_issn" content="0195-6108" />
<meta name="citation_issn" content="1936-959X" />
<meta name="citation_doi" content="10.3174/ajnr.A5586" />
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<meta name="citation_volume" content="39" />
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<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="Interventional" />
<meta name="citation_firstpage" content="899" />
<meta name="citation_lastpage" content="904" />
<meta name="citation_author" content="V. Bhatia" />
<meta name="citation_author_institution" content="aFrom the Departments of Radiodiagnosis (V.B., V.G., N.K.)" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0003-3700-8025" />
<meta name="citation_author" content="V. Gupta" />
<meta name="citation_author_institution" content="aFrom the Departments of Radiodiagnosis (V.B., V.G., N.K.)" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-9190-1757" />
<meta name="citation_author" content="D. Khurana" />
<meta name="citation_author_institution" content="bNeurology (D.K.)" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-5379-3089" />
<meta name="citation_author" content="R.R. Sharma" />
<meta name="citation_author_institution" content="cTransfusion Medicine (R.R.S.), Postgraduate Institute of Medical Education and Research, Chandigarh, India." />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-7415-4665" />
<meta name="citation_author" content="N. Khandelwal" />
<meta name="citation_author_institution" content="aFrom the Departments of Radiodiagnosis (V.B., V.G., N.K.)" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-8326-5164" />
<meta name="citation_reference" content="Intercollegiate Stroke Working Party. National Sentinel Stroke Clinical Audit 2010: Public Report for England, Wales and Northern Ireland. London: Royal College of Physicians; 2011. https://www.rcplondon.ac.uk/projects/outputs/national-sentinel-stroke-audit-2010. Accessed on March 20, 2017" />
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<meta name="twitter:title" content="Randomized Assessment of the Safety and Efficacy of Intra-Arterial Infusion of Autologous Stem Cells in Subacute Ischemic Stroke" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/39/5.cover-source.jpg" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Stroke is a debilitating illness for which treatment window is limited. Most patients present to the healthcare facility beyond that window. Autologous stem cells have shown some promise for this group of patients. This study was performed to evaluate the safety and the efficacy of intra-arterial infusion of bone marrow–derived mononuclear cells in patients with middle cerebral artery ischemic stroke.

MATERIALS AND METHODS: A prospective, randomized, open-label, blinded–end point study was performed from July 2015 to June 2016. Of 229 patients with acute stroke who presented to the hospital during this period, 20 patients who satisfied the inclusion/exclusion criteria were included and randomized into the control and intervention groups. Intra-arterial stem cell infusion into the ipsilateral MCA was performed in the patients in the intervention group at 8–15 days post-stroke ictus. Final analysis at 6 months was performed for primary (safety) and secondary outcomes (efficacy).

RESULTS: When we compared the primary end point of the study, no procedure-related mortality, complication, new infarct, or symptomatic intracranial hemorrhage was seen in the intervention group. When we compared the secondary end point of good clinical outcome, 8 (80%) patients in the intervention group showed good clinical outcome (modified Rankin Scale score &lt; 2) with 4 (40%) patients in the control group achieving this (95% confidence interval for good outcome in patients with stem cell infusion, 49.03–94.3, and without stem cell infusion, 16.82–68.73; P = .068).

CONCLUSIONS: Intra-arterial infusion of stem cells can be carried out safely in the subacute stage of ischemic stroke. Improved clinical outcomes were observed with intra-arterial stem cell therapy; however, studies with larger cohorts are needed to validate the results.

BI
:   Barthel index
BMMNC
:   bone marrow–derived mononuclear cells" />
<meta name="og-title" property="og:title" content="Randomized Assessment of the Safety and Efficacy of Intra-Arterial Infusion of Autologous Stem Cells in Subacute Ischemic Stroke" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/39/5/899" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Stroke is a debilitating illness for which treatment window is limited. Most patients present to the healthcare facility beyond that window. Autologous stem cells have shown some promise for this group of patients. This study was performed to evaluate the safety and the efficacy of intra-arterial infusion of bone marrow–derived mononuclear cells in patients with middle cerebral artery ischemic stroke.

MATERIALS AND METHODS: A prospective, randomized, open-label, blinded–end point study was performed from July 2015 to June 2016. Of 229 patients with acute stroke who presented to the hospital during this period, 20 patients who satisfied the inclusion/exclusion criteria were included and randomized into the control and intervention groups. Intra-arterial stem cell infusion into the ipsilateral MCA was performed in the patients in the intervention group at 8–15 days post-stroke ictus. Final analysis at 6 months was performed for primary (safety) and secondary outcomes (efficacy).

RESULTS: When we compared the primary end point of the study, no procedure-related mortality, complication, new infarct, or symptomatic intracranial hemorrhage was seen in the intervention group. When we compared the secondary end point of good clinical outcome, 8 (80%) patients in the intervention group showed good clinical outcome (modified Rankin Scale score &lt; 2) with 4 (40%) patients in the control group achieving this (95% confidence interval for good outcome in patients with stem cell infusion, 49.03–94.3, and without stem cell infusion, 16.82–68.73; P = .068).

CONCLUSIONS: Intra-arterial infusion of stem cells can be carried out safely in the subacute stage of ischemic stroke. Improved clinical outcomes were observed with intra-arterial stem cell therapy; however, studies with larger cohorts are needed to validate the results.

BI
:   Barthel index
BMMNC
:   bone marrow–derived mononuclear cells" />
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">V. Bhatia</span>, <span class="highwire-citation-author" data-delta="1">V. Gupta</span>, <span class="highwire-citation-author" data-delta="2">D. Khurana</span>, <span class="highwire-citation-author" data-delta="3">R.R. Sharma</span> and <span class="highwire-citation-author" data-delta="4">N. Khandelwal</span></span></div>
  
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<div id="hw-article-author-popups-top-node-60864--61720637433" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">V. Bhatia </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiodiagnosis (V.B., V.G., N.K.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=V.%2BBhatia%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bhatia%20V&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AV.%2BBhatia%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-3700-8025" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for V. Bhatia</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">V. Gupta </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiodiagnosis (V.B., V.G., N.K.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=V.%2BGupta%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Gupta%20V&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AV.%2BGupta%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-9190-1757" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for V. 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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Bhatia</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Gupta</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Khurana</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">R.R.</span> <span class="nlm-surname">Sharma</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Khandelwal</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2018, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">899-904; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5586 </span></div>
  
  
  
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      <div class="highwire-cite-title">Randomized Assessment of the Safety and Efficacy of Intra-Arterial Infusion of Autologous Stem Cells in Subacute Ischemic Stroke</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Bhatia</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Gupta</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Khurana</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">R.R.</span> <span class="nlm-surname">Sharma</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Khandelwal</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2018, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">899-904; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5586 </span></div>
  
  
  
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