Areas of work
The thread running through it: methodology applied to questions where the standard approach serves the clinician poorly.
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Acute ischaemic stroke
Clinical and outcome research in hyperacute stroke care — patient selection, treatment timing, and the real-world performance of acute pathways. -
Endovascular therapy
Decision-making and outcomes in mechanical thrombectomy, including the harder edges of patient selection where the evidence is still maturing. -
Neurosonology
Ultrasound assessment of the cerebral and cervical vasculature — diagnosis, monitoring, and its role in the stroke work-up. -
Bayesian re-analysis of stroke trials
Revisiting stroke-trial data with Bayesian methods to extract more honest, decision-relevant inference from results that frequentist analysis can leave ambiguous.
Why the methodological angle matters
Stroke trials are expensive, hard to run, and frequently end "negative" or "inconclusive" under a frequentist lens — even when they carry real, usable signal. Bayesian re-analysis asks a different and often more clinically honest question: given this evidence, how probable is benefit, and for whom? That framing is not an academic preference; it changes how the result translates to the bedside. It is the same conviction that runs through Livetextbook — organise the evidence so the decision is better supported.
Full publication record
105 publications indexed in PubMed, 2011–2026 — the complete record, not a selection. Work where Dr. Safouris is first or second author is listed first; the remaining co-authored work follows. Each group runs newest first.
First or second author 42
Work led or co-led by Dr. Safouris. Newest first.
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2025Neurology 105(5):e214015Meta-analysis
Endovascular Treatment in Acute Ischemic Stroke Due to Occlusion of Medium or Distal Vessels: A Systematic Review and Meta-Analysis.
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2025Neurology 105(4):e214060Editorial
Stroke Despite Anticoagulation: Optimizing Rather Than Switching.
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2024J Neurol Sci 466:123231Review
Heart failure and stroke: The underrepresentation of the heart failure with preserved ejection fraction subtype in randomized clinical trials of therapeutic anticoagulation.
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2024Ther Adv Neurol Disord 17:17562864241246938Review
Overview of systematic reviews comparing endovascular to best medical treatment for large-vessel occlusion acute ischaemic stroke: an umbrella review.
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2024J Stroke 26(1):13-25Review
Update of Anticoagulation Use in Cardioembolic Stroke With a Special Reference to Endovascular Treatment.
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2023Stroke 54(9):2265-2275Meta-analysis
Medical Management Versus Endovascular Treatment for Large-Vessel Occlusion Anterior Circulation Stroke With Low NIHSS.
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2022Ther Adv Neurol Disord 15:17562864221139632
Endovascular treatment for anterior circulation large-vessel occlusion ischemic stroke with low ASPECTS: a systematic review and meta-analysis.
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2021Expert Opin Investig Drugs 30(10):1025-1035Review
Emerging agents for the treatment and prevention of stroke: progress in clinical trials.
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2021J Clin Med 10(13)
Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective.
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2021Ther Adv Neurol Disord 14:17562864211021182Review
Acute reperfusion therapies for acute ischemic stroke patients with unknown time of symptom onset or in extended time windows: an individualized approach.
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2021Eur J Neurol 28(6):2106-2110Meta-analysis
Endovascular treatment for basilar artery occlusion: A systematic review and meta-analysis.
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2020Stroke 52(1):308-312Meta-analysis
Intravenous Thrombolysis With Tenecteplase in Patients With Large Vessel Occlusions: Systematic Review and Meta-Analysis.
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2020J Clin Neurol 16(4):696-698
Ultra-Early Remote Intracranial Hemorrhage Complicating Intravenous Thrombolysis with Tenecteplase for Acute Ischemic Stroke.
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2020Front Neurol 11:434Review
A Narrative and Critical Review of Randomized-Controlled Clinical Trials on Patent Foramen Ovale Closure for Reducing the Risk of Stroke Recurrence.
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2019Atherosclerosis 282:75-79Meta-analysis
Association of statin pretreatment with collateral circulation and final infarct volume in acute ischemic stroke patients: A meta-analysis.
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2018Stroke 49(8):1992-1995Meta-analysis
Statin Pretreatment and Microembolic Signals in Large Artery Atherosclerosis.
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2018J Stroke 20(3):417Erratum
Recent Advances in Primary and Secondary Prevention of Atherosclerotic Stroke.
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2018J Stroke 20(2):145-166
Recent Advances in Primary and Secondary Prevention of Atherosclerotic Stroke.
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2018J Neuroimaging 28(3):239-251Review
The Role of Neurosonology in the Diagnosis and Management of Patients with Carotid Artery Disease: A Review.
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2017Neurology 89(15):e190-e191Case report
Teaching NeuroImages: Giant cell arteritis presenting with acute ischemic strokes due to diffuse intracranial stenoses.
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2017Stroke 48(7):2031-2033Review
Intravenous Thrombolysis in Acute Ischemic Stroke Patients Pretreated With Non-Vitamin K Antagonist Oral Anticoagulants: An Editorial Review.
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2017Neurologist 22(3):90-91Case report
Early Neurological Deterioration During Alteplase Infusion for Acute Ischemic Stroke: An Uncommon Complication of Intravenous Thrombolysis.
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2017Arterioscler Thromb Vasc Biol 37(7):1415-1422
Statin Pretreatment and Microembolic Signals in Large Artery Atherosclerosis.
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2016J Neurol Sci 366:177-179Letter
Yin-Yang vascular imaging sign in basilar artery dissection.
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2016J Neuroimaging 26(4):377-82Review
Transcranial Color-Coded Duplex in Acute Encephalitis: Current Status and Future Prospects.
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2016Brain Behav 6(2):e00418Meta-analysis
Mechanical thrombectomy for emergent large vessel occlusion: a critical appraisal of recent randomized controlled clinical trials.
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2016Expert Rev Neurother 16(5):527-34Review
Endovascular reperfusion therapies for acute ischemic stroke: dissecting the evidence.
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2015Ther Adv Neurol Disord 8(6):245-54Review
The case for dosing dabigatran: how tailoring dose to patient renal function, weight and age could improve the benefit-risk ratio.
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2015J Neurosci Rural Pract 6(3):401-2
Commentary.
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2015Curr Alzheimer Res 12(8):736-44
Mediterranean Diet and Risk of Dementia.
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2015J Neurol Sci 354(1-2):114-5Letter
Differentiating primary central nervous system (CNS) lymphoma from "butterfly glioma": A case report.
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2015Expert Opin Drug Saf 14(6):845-64Review
Safety of intravenous thrombolysis for acute ischemic stroke in specific conditions.
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2015J Neurol Sci 351(1-2):198-199Letter
Cerebral amyloid angiopathy-associated microbleed mimicking transient ischemic attack.
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2015CNS Neurol Disord Drug Targets 14(2):257-69Review
Vascular risk factors and Alzheimer's disease pathogenesis: are conventional pharmacological approaches protective for cognitive decline progression?
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2015J Alzheimers Dis 43(1):23-7Case report
Chronic brain hypoperfusion due to multi-vessel extracranial atherosclerotic disease: a potentially reversible cause of cognitive impairment.
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2014J Neurol Sci 346(1-2):366-7Letter
Rivaroxaban presents a better pharmacokinetic profile than dabigatran in an obese non-diabetic stroke patient.
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2014J Neurol 261(6):1218-20Letter
Transient and permanent neuroimaging abnormalities due to partial status epilepticus in a patient with corpus callosum agenesis.
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2013Neurology 81(23):e176Case report
Teaching neuroimages: isolated sphenoiditis: an uncommon cause of abducens nerve palsy.
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2013J Neurol 260(11):2911-2Letter
Safety of IV thrombolysis in an acute stroke patient anticoagulated with unfractioned heparin.
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2013Neurol Sci 35(1):135-7Letter
Biopsy-proven fulminant primary angiitis of the central nervous system with normal arteriography: a challenging diagnosis of recurrent ischemic strokes.
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2013Angiology 65(5):372-8Review
Protecting the brain and the heart: antithrombotic treatment in nonvalvular atrial fibrillation.
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2011Rev Med Brux 32(5):473-6Case report
[Frontal syndrome post cerebral malaria. Case report].
Other co-authored work 63
Publications co-authored in a contributing role. Newest first.
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2026Eur J Neurol 33(7):e70689
Blood Pressure Control With Clevidipine Is Associated With Hematoma Volume Reduction in Acute Hypertensive Intracerebral Hemorrhage: A Single-Center Prospective Cohort Study.
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2026Thromb Haemost
Differences in Endothelial Glycocalyx, Arterial Stiffness, and Left Atrial Function Among Ischemic Stroke Types.
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2026Eur J Neurol 33(3):e70550
Clinical Significance of Microembolic Signal Detection in Acute Ischemic Stroke: Insights Into Ongoing Cerebral Embolization and Occult Etiologies.
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2026Eur Stroke J 11(1)Meta-analysis
Prehospital blood pressure lowering in acute hemorrhagic stroke: a systematic review and meta-analysis of randomized controlled clinical trials.
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2025Ther Adv Neurol Disord 18:17562864251406065Review
Safety and efficacy of oral anticoagulation in patients with intracranial hemorrhage and atrial fibrillation: a systematic review and meta-analysis of randomized controlled clinical trials.
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2025J Clin Med 14(21)Review
Serum Biomarkers in Acute Ischemic Stroke: Clinical Applications and Emerging Insights.
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2025Int J Stroke 21(5):688-698
Stroke mortality in Greece (2001-2021): Trends, sex differences, and the impact of population aging.
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2025Neurol Res Pract 7(1):75
Gout flares following acute stroke: a single-center cohort and a systematic review/meta-analysis.
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2025Medicina (Kaunas) 61(9)Review
Tailored Treatment of Acute Ischemic Stroke: A Narrative Review of Evidence-Based Strategies by Imaging Type and Thrombectomy Availability.
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2025J Clin Med 14(18)
Spontaneous Multiple Cervical Artery Dissections Detected with High-Resolution MRI: A Prospective, Case-Series Study.
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2025J Clin Med 14(15)Review
Efficacy and Safety of Intravenous Thrombolysis in the Extended Time Window for Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.
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2025J Clin Med 14(12)Review
Clinical Management of Cerebral Amyloid Angiopathy.
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2025Eur Stroke J 10(4):1364-1372Meta-analysis
Fibrinogen time course in acute ischemic stroke patients treated with intravenous thrombolysis with alteplase or tenecteplase.
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2025J Clin Med 14(9)Review
Lipoprotein(a) as a Stroke Biomarker: Pathophysiological Pathways and Therapeutic Implications.
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2025Eur Stroke J 10(3):655-664Meta-analysis
Endovascular therapy versus best medical treatment for symptomatic intracranial atherosclerotic stenosis: A systematic review and meta-analysis.
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2025Neurol Sci 46(6):2875-2877Letter
Severe respiratory alkalosis in a patient with aphasia: an uncommon stroke mimic?
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2025Eur J Neurol 32(1):e16584Review
Microembolic signal detection in acute ischemic stroke: Clinical relevance and impact on treatment individualization-A narrative review.
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2024Neurol Res Pract 6(1):54Review
Prevalence, diagnosis and management of intracranial atherosclerosis in White populations: a narrative review.
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2024Neurology 103(9):e209903Meta-analysis
Tenecteplase vs Alteplase in Acute Ischemic Stroke Within 4.5 Hours: A Systematic Review and Meta-Analysis of Randomized Trials.
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2024Ther Adv Neurol Disord 17:17562864241281903Review
Risk of major adverse cardiovascular events and all-cause mortality under treatment with GLP-1 RAs or the dual GIP/GLP-1 receptor agonist tirzepatide in overweight or obese adults without diabetes: a systematic review and meta-analysis.
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2024Neurology 103(7):e209862Meta-analysis
Thrombolysis After Dabigatran Reversal for Acute Ischemic Stroke: A National Registry-Based Study and Meta-Analysis.
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2024J Neuroimaging 34(4):430-437
Validation of the transcranial Doppler rescue criteria for mechanical thrombectomy.
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2024Neurol Sci 45(10):4881-4893
Hypoperfusion index ratio and pretreatment with intravenous thrombolysis are independent predictors of good functional outcome in acute ischemic stroke patients with large vessel occlusion treated with acute reperfusion therapies.
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2023J Clin Med 12(17)
Clinical Characteristics, Neuroimaging Markers, and Outcomes in Patients with Cerebral Amyloid Angiopathy: A Prospective Cohort Study.
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2023J Neurol Neurosurg Psychiatry 94(10):781-785Meta-analysis
Endovascular treatment for large-core ischaemic stroke: a meta-analysis of randomised controlled clinical trials.
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2023J Clin Med 12(7)Review
Endovascular Treatment for Acute Basilar Artery Occlusion: A Fragility Index Meta-Analysis.
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2023Stroke 54(5):e207-e208Case report
Floating Carotid Thrombus in a Patient With Essential Thrombocytemia due to Calreticulin Mutation.
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2023Eur Stroke J 8(1 Suppl):5-15
Quality metrics in the management of acute stroke in Greece during the first 5 years of Registry of Stroke Care Quality (RES-Q) implementation.
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2023Stroke 54(3):e104-e108
Computed Tomography Perfusion Imaging in Acute Ischemic Stroke: Accurate Interpretation Matters.
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2022Eur J Neurol 30(3):782-784Case report
Bilateral dural arteriovenous fistula diagnosed with neurovascular ultrasonography.
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2022Ther Adv Neurol Disord 15:17562864221136335Review
Diagnosis and treatment of acute isolated proximal internal carotid artery occlusions: a narrative review.
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2022J Clin Med 11(22)
Cerebral Amyloid Angiopathy-Related Inflammation: A Single-Center Experience and a Literature Review.
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2021Neurologist 27(1):30-33Case report
HSV-Encephalitis Resembling Acute Cerebral Infarction in a Patient With Atrial Fibrillation: Beware of Stroke Mimics.
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2021Eur J Neurol 28(11):3866-3869Case report
Hereditary cerebral amyloid angiopathy mimicking CADASIL syndrome.
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2021J Neuroimaging 31(4):656-664Review
Cervical duplex ultrasound for the diagnosis of giant cell arteritis with vertebral artery involvement.
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2021Ther Adv Neurol Disord 14:1756286421998905Review
Expanding indications for endovascular thrombectomy-how to leave no patient behind.
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2021Ther Adv Neurol Disord 14:1756286421997368Review
Off-label use of intravenous thrombolysis for acute ischemic stroke: a critical appraisal of randomized and real-world evidence.
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2021Neurol Sci 42(6):2591-2594Letter
Perfusion imaging averting intravenous thrombolysis in stroke mimics.
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2021Ther Adv Neurol Disord 14:1756286420986727
Real-world comparative safety and efficacy of tenecteplase versus alteplase in acute ischemic stroke patients with large vessel occlusion.
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2020Medicina (Kaunas) 56(12)Review
Ultrasound Assessment of Extracranial Carotids and Vertebral Arteries in Acute Cerebral Ischemia.
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2020J Stroke 22(1):130-140
Timing of Recanalization and Functional Recovery in Acute Ischemic Stroke.
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2020Neuroradiology 62(6):733-739
Eligibility for intravenous thrombolysis in acute ischemic stroke patients presenting in the 4.5-9 h window.
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2020Hypertension 75(3):730-739Meta-analysis
Association of Blood Pressure With Outcomes in Acute Stroke Thrombectomy.
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2019J Neurol Sci 409:116590
Risk of perioperative neck hematoma in TIA and non-disabling stroke patients with symptomatic carotid artery stenosis undergoing endarterectomy within 14 days from cerebrovascular event.
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2019Neurologist 24(6):180-182Case report
Tenecteplase Averting Mechanical Thrombectomy in Emergent Large Vessel Occlusion.
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2019Neurologist 24(5):146-149Case report
Intravenous Thrombolysis For Acute Ischemic Stroke in Fabry Disease.
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2019J Neuroimaging 29(3):309-322Review
The Role of Transcranial Doppler Monitoring in Patients with Multi-Territory Acute Embolic Strokes: A Review.
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2018Int J Stroke 14(3):NP7Letter
Letter to the Editor for the article "Flat-head positioning increases cerebral blood flow in anterior circulation acute ischemic stroke: A cluster randomized phase IIb trial".
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2018Eur J Neurol 26(4):673-679
Safety of urgent endarterectomy in acute non-disabling stroke patients with symptomatic carotid artery stenosis: an international multicenter study.
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2018Ther Adv Neurol Disord 11:1756286418783578
Intravenous thrombolysis for acute ischemic stroke in Greece: the Safe Implementation of Thrombolysis in Stroke registry 15-year experience.
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2017Neurology 89(15):e188-e189Case report
Teaching NeuroImages: Interferon-induced psoriasis flare in a multiple sclerosis case remits with dimethyl fumarate.
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2017J Neurointerv Surg 10(2):112-117
Admission hyperglycemia and outcomes in large vessel occlusion strokes treated with mechanical thrombectomy.
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2016J Neurol Sci 371:96-99
Eligibility for mechanical thrombectomy in acute ischemic stroke: A phase IV multi-center screening log registry.
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2016J Clin Neurol 13(2):196-198Letter
Mechanical Thrombectomy for Acute Middle Cerebral Artery Occlusion Caused by a Giant, Thrombosed, Extracranial Internal Carotid Artery Aneurysm.
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2016Ther Adv Neurol Disord 9(5):359-68
Novel oral anticoagulants for the secondary prevention of cerebral ischemia: a network meta-analysis.
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2016J Neuroimaging 26(5):473-80Review
Subclavian Steal Syndrome with or without Arterial Stenosis: A Review.
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2016JAMA Neurol 73(6):675-83Meta-analysis
Risk of Symptomatic Intracerebral Hemorrhage After Intravenous Thrombolysis in Patients With Acute Ischemic Stroke and High Cerebral Microbleed Burden: A Meta-analysis.
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2016J Stroke Cerebrovasc Dis 25(6):e74-6Case report
High-Resolution Vessel Wall Magnetic Resonance Imaging in Varicella-Zoster Virus Vasculitis.
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2016Neurology 86(12):1103-11
Statin pretreatment is associated with better outcomes in large artery atherosclerotic stroke.
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2016Epilepsy Behav 55:84-6
Preliminary evidence for gender effects of levetiracetam monotherapy duration on bone health of patients with epilepsy.
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2015J Neurol 262(9):2135-43Meta-analysis
Safety and outcomes of intravenous thrombolysis in dissection-related ischemic stroke: an international multicenter study and comprehensive meta-analysis of reported case series.
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2014Stroke 45(11):3352-9Meta-analysis
Recurrent stroke and patent foramen ovale: a systematic review and meta-analysis.
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2014Eur J Neurol 21(10):1251-7, e75-6
Safety of early endarterectomy in patients with symptomatic carotid artery stenosis: an international multicenter study.
Source: PubMed (National Library of Medicine), author query Safouris A[Author], retrieved 16 July 2026. A point-in-time export, not a live feed. Abstracts are not reproduced here; each entry links to its PubMed record. Live query on PubMed →
Presentations
Selected invited lectures, grouped by theme rather than by date. Each entry describes the argument the talk makes.
Acute reperfusion decisions under uncertainty
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Contraindications of Endovascular Treatment: Where Evidence Ends and Judgment Begins
The pivotal thrombectomy trials never enrolled the patients this lecture is about: the mild deficit with a large-vessel occlusion, the distal M2, the patient already dependent before the stroke. Every stroke neurologist can recite the contraindications to thrombolysis, a discipline built under constraint by bleeding risk and exclusion criteria. Asked for the contraindications to thrombectomy, the same room goes quiet. Working the gray zones the trials left behind, this talk sets his own meta-analysis (Stroke 2023) — equipoise on function in mild stroke, symptomatic haemorrhage up 3.5-fold — against the fallback of waiting to see who deteriorates, which carries far worse outcomes than treating immediately.
This talk is not anti-EVT. It is anti-blindness. Evidence is a map of averages. We treat individuals. When the map is clear, we move fast. When it fades, we must slow down.Apostolos Safouris
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The Acute Stroke Pathway: Where Evidence Ends and Judgment Begins
Nicolab Innovation Workshop keynote, Maastricht, 5 May 2026 (ESOC pre-conference)Ospel's 2020 data show two interventionalists reaching opposite decisions on functionally identical cases, and the variable that separates them is the country they work in. The same 86-year-old with an M1 occlusion is treated by a Monday-morning academic team and watched by a Saturday-night solo operator. Same patient, same images, different system, different decision. This keynote reads that scatter through Kahneman's Noise, maps the biases pushing toward both undertreatment and overtreatment, and asks what artificial intelligence can honestly fix: the imaging-triage layer is real and measurable, and it is strong where the input is pixels and the output is a category. It is largely silent on the layer where frailty, competing risks and goals of care live. The closing question is whether the bottleneck in acute stroke is still the individual tool or the infrastructure that makes tools consistently useful across heterogeneous units.
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Endovascular treatment in frail patients
An 86-year-old, M1 occlusion, ASPECTS 8, NIHSS 18 at five hours. Whether she is treated turns out to depend on how many interventionalists are on the rota, whether it is Monday morning or Saturday night after three thrombectomies, and how many stent retrievers are left. This talk runs the same patient four times to show that the deciding variables are frequently not clinical, then demolishes the idea that outcomes teach us anything reliable here: treat her and she dies of sepsis on day 21, decline and she dies of sepsis on day 21, and the two paths teach opposite lessons. Age does not modify the treatment effect, and pre-stroke disability alone is not a reason to withhold thrombectomy. Frailty is a different variable, the mRS does not measure it, and brain-frailty markers on a routine non-contrast CT mediate 85% of age's association with 90-day outcome. Rationing by frailty “is already happening (nobody knows how often)”.
Imaging in acute stroke
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Πολυπαραμετρική απεικόνιση στην επιλογή υποψηφίων για μηχανική θρομβεκτομή
Multiparametric imaging in the selection of candidates for mechanical thrombectomy — delivered in Greek.
13th Panhellenic Congress of Cerebrovascular Diseases, Thessaloniki, 20 November 2025CT perfusion predicts functional outcome. It does not identify the patients who will fail to benefit from thrombectomy. That distinction — prognostic against predictive — is the spine of this talk, anchored in MR CLEAN data showing a shift toward better outcomes with thrombectomy in patients both with and without mismatch, while collateral status genuinely modifies treatment effect. The argument builds a working CT protocol without perfusion, branching on occlusion site, NIHSS and collaterals rather than core-penumbra thresholds. It concedes the residual role honestly, in frail patients, distal occlusions, low-NIHSS cases where a mismatch under 40 mL signals harm, and presentations beyond 24 hours, then reframes the tool:
Use perfusion to EXclude patients, not to select for thrombectomy.Apostolos Safouris
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CAA Imaging for Neurologists – Beyond Microbleeds
Educational course “MRI in everyday neurological clinical practice”, Attikon Hospital, Athens, 14 June 2025Three patients met the Boston criteria for probable cerebral amyloid angiopathy in life. At autopsy, none had CAA; of the nine microbleed lesions sectioned, two were not microbleeds at all — a microaneurysm and a calcification. This talk takes a practising neurologist through the imaging spectrum of CAA under the Boston criteria 2.0, and puts its centre of gravity on the mimics — CADASIL, Fabry, cavernomatosis, endocarditis, radiation, RCVS, venous thrombosis, vasculitis — because the error that costs patients is over-calling CAA on a lobar pattern. A recurring clinical thread is that transient focal neurological episodes are not TIAs; treating them as such can end in lobar haemorrhage two months later. The topic reaches general neurology now for a specific reason: the ARIA seen when lecanemab clears vascular amyloid is, in imaging terms, the same problem this MRI read is built to catch.
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Perihematomal Edema: Clues from Neuroimaging and Clinical Impact
ESOC 2026, MaastrichtEach additional millilitre of perihaematomal oedema growth at 24 hours raises the odds of a poor outcome by 4%. Whether that makes the oedema a therapeutic target or an epiphenomenon is unsettled, and this talk trichotomises it: culprit, bystander, or consequence. It works through the non-contrast CT expansion markers — the black hole sign, the blend sign, the island sign at 98.2% specificity — and argues them as pragmatically superior to the CTA spot sign, since only a minority of patients with intracerebral haemorrhage receive contrast. Beyond volume it reaches for oedema extension distance and sphericity, then closes on the paradox that the 2025 ESO/EANS guideline recommends against the entire anti-inflammatory list outside trials.
Systems and secondary prevention
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Delays in the pre-hospital phase: how big is the problem in stroke right now?
ESOC 2024, Basel, 15 May 2024Expediting thrombectomy by ten minutes returns an average of 39 additional days of disability-free life. Dutch modelling puts one minute faster, nationally, at 3.5 quality-adjusted life-years a year. This invited faculty talk opened the ESOC session on the pre-hospital gap by walking the delay chain link by link — onset to call, dispatch, extrication, travel, door-in-door-out — and pricing each one. Its argument is that measurement, not technology, is the binding constraint: door-in-door-out times have resisted education and feedback, high-volume centres are no better at them, and most European countries cannot state their own delays. On mothership versus drip-and-ship it declines a single answer, setting RACECAT's null result against the Moravian experience, where a triage change cut secondary transfers from 53 to 21.
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Antithrombotic therapy for lacunar stroke
SPS3 found harm from long-term dual antiplatelet therapy in lacunar stroke, and it randomised patients at a median of 62 days and followed them for a mean of 3.4 years — which means it cannot answer the question anyone actually asks, about the first three weeks. CHANCE-2's subtype analysis points the other way: lacunar stroke took the largest relative risk reduction at 49%, and the benefit concentrated in single small subcortical infarcts without intracranial stenosis, which argues against branch atheroma as the explanation. This talk works the early dual-versus-single question, the choice of long-term single agent including CYP2C19 metaboliser status, and what changes specifically for the lacunar subtype, and closes on the factor XI line.
Current status
- Established peer-reviewed body of work across the areas above
- Ongoing collaborations and active manuscripts
- Complete publication record published — 105 indexed, PubMed/DOI-linked
- Selected invited lectures listed by theme