Peter Panagos Research

Contributions to Science

Stroke and neurovascular emergencies have always been my clinical and research passion. Since the approval of IV thrombolysis in 1996 followed by the endovascular revolution of 2015, organization and coordination of stroke care has been my focus. As the Co-Director of one of largest regional stroke networks, Chair of AHA Mission: Lifeline Stroke and the Leadership Committees, as well as serving on regional and state EMS committees, I have developed and tremendous knowledge and perspective on the unique challenges of integration and coordination of prehospital and emergency department care for all diseases. While barriers exist, opportunities are unlimited to improve the emergency care of our sickest patients. My lessons learned and relationships forged have placed me in the position to implement and coordinate system wide emergency research.

  1. Gropen T, Schwamm L, Panagos PD, et al. Regional Implementation of the Stroke Systems of Care Model: Recommendations of the Northeast Cerebrovascular Consortium. Stroke. 2009; 40: 1793-1802. PMID19299641
  2. Nguyen TN, Abdalkader M, Jovin TG, Nogueira RG, Jadhav AP, Haussen DC, Hassan AE, Novakovic R, Sheth SA, Ortega-Gutierrez S, Panagos PD. Mechanical thrombectomy in the era of the COVID-19 pandemic: emergency preparedness for neuroscience teams: a guidance statement from the Society of Vascular and Interventional Neurology. Stroke. 2020 Jun;51(6):1896-901.
  3. Jauch EC, Schwamm LH, Panagos PD, Barbazzeni J, Dickson R, Dunne R, Foley J, Fraser JF, Lassers G, Martin-Gill C, O’Brien S. Recommendations for regional stroke destination plans in rural, suburban, and urban communities from the prehospital stroke system of care consensus conference: a consensus statement from the American Academy of Neurology, American Heart Association/American Stroke Association, American Society of Neuroradiology, National Association of EMS Physicians, National Association of State EMS Officials, Society of NeuroInterventional Surgery, and Society of Vascular and Interventional Neurology: endorsed by …. Stroke. 2021 May;52(5):e133-52.
  4. Yu CY, Blaine T, Panagos PD, Kansagra AP. Demographic disparities in proximity to certified stroke care in the United States. Stroke. 2021 Aug;52(8):2571-9.

Clinical Trial Design

Clinical trial design, implementation and recruitment of the acute stroke patient presenting to the emergency department has been my primary research focus. I have been fortunate to collaborate with some of the leading vascular neurologists and emergency physicians in developing more efficient and effective therapies in the hyper-acute window of ischemic and hemorrhagic brain injury. Population analysis and comfort with large databases was the focus of my stroke fellowship and early academic years. Much of this work has led to local, regional and national change in the acute clinical practice in the acute setting:

  1. Ford AL, Williams JA, Spencer M, McCammon C, Khoury N, Sampson TR, Panagos PD, Lee JM Reducing door-to-needle times using Toyota’s lean manufacturing principles and value stream analysis. Stroke. 2012 Dec;43(12):3395-8.
  2. Broderick JP, Palesch YY, Demchuk AM, et al, IMS III Investigators. Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. N Engl J. Med. 2013 Mar 28;368(13):1265. PMCID: PMC365187
  3. An H, Ford AL, Chen Y, Zhu H, Ponisio R, Kumar G, Shanechi AM, Khoury N, Vo KD, Williams J, Derdeyn CP, Diringer MN, Panagos PD, Powers WJ, Lee JM, Lin W. Defining the ischemic penumbra using magnetic resonance oxygen metabolic index. Stroke. 2015 Apr;46(4):982-8. PMCID: PMC4533116
  4. Goyal MS, Hoff BG, Williams J, Khoury N, Wiesehan R, Heitsch L, Panagos PD, Vo KD, Benzinger T, Derdeyn CP, Lee JM, Ford AL. Streamlined Hyperacute Magnetic Resonance Imaging Protocol Identifies Tissue-Type Plasminogen Activator-Eligible Stroke Patients When Clinical Impression Is Stroke Mimic. Stroke. 2016 Apr;47(4):1012-7. PMCID: PMC4811697


Early in my career, under the guidance of mentors such as Drs. Arthur Pancioli, Edward Jauch, Joe Broderick and William Barsan, I was encouraged to serve on national and regional committees in order to develop the skills required to lead the implementation of stroke care on a system level. I’ve used this advice to participate in important policy statements/guidelines that affect the practice of stroke care across the world.

  1. Biller J, Sacco RL, Albuquerque FC, Demaerschalk BM, Fayad P, Long PH, Noorollah LD, Panagos PD, Schievink WI, Schwartz NE, Shuaib A, Thaler DE, Tirschwell DL; American Heart Association Stroke Council Cervical arterial dissections and association with cervical manipulative therapy: a statement for healthcare professionals from the american heart association/american stroke association. Stroke. 2014 Oct;45(10):3155-74. PMID: 25104849.
  2. Levine SR, Weingast SZ, Weedon J, Stefanov DG, Katz P, Hurley D, Kasner SE, Khatri P, Broderick JP, Grotta JC, Panagos PD, Feldmann E. To treat or not to treat? Exploring factors influencing intravenous thrombolysis treatment decisions for minor stroke. Stroke. 2018 Aug;49(8):1933-8.
  3. Adeoye O, Nyström KV, Yavagal DR, Luciano J, Nogueira RG, Zorowitz RD, Khalessi AA, Bushnell C, Barsan WG, Panagos PD, Alberts MJ. Recommendations for the establishment of stroke systems of care: a 2019 update: a policy statement from the American Stroke Association. Stroke. 2019 Jul;50(7):e187-210.
  4. Amin HP, Madsen TE, Bravata DM, Wira CR, Johnston SC, Ashcraft S, Burrus TM, Panagos PD, Wintermark M, Esenwa C, American Heart Association Emergency Neurovascular Care Committee of the Stroke Council and Council on Peripheral Vascular Disease. Diagnosis, Workup, Risk Reduction of Transient Ischemic Attack in the Emergency Department Setting: A Scientific Statement From the American Heart Association. Stroke. 2023.