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30 results on '"Sarraj, Amrou"'

1. Mechanical Thrombectomy for Large Ischemic Stroke: A Systematic Review and Meta-analysis.

Author

Li, Qi, Abdalkader, Mohamad, Siegler, James, Yaghi, Shadi, Sarraj, Amrou, Campbell, Bruce, Yoo, Albert, Zaidat, Osama, Kaesmacher, Johannes, Pujara, Deep, Nogueira, Raul, Saver, Jeffrey, Li, Lei, Han, Qin, Dai, Yi, Sang, Hongfei, Yang, Qingwu, Nguyen, Thanh, and Qiu, Zhongming

Subjects
Humans, Stroke, Brain Ischemia, Endovascular Procedures, Thrombectomy, Ischemic Stroke, Treatment Outcome, Randomized Controlled Trials as Topic, Observational Studies as Topic
Abstract

BACKGROUND AND OBJECTIVES: There is growing evidence for endovascular thrombectomy (EVT) in patients with large ischemic core infarct and large vessel occlusion (LVO). The objective of this study was to compare the efficacy and safety of EVT vs medical management (MM) using a systematic review and meta-analysis of observational studies and randomized controlled trials (RCTs). METHODS: We searched the PubMed, Embase, Cochrane Library, and Web of Science databases to obtain articles related to mechanical thrombectomy for large ischemic core from inception until February 10, 2023. The primary outcome was independent ambulation (modified Rankin Scale [mRS] 0-3). Effect sizes were computed as risk ratio (RR) with random-effect or fixed-effect models. The quality of articles was evaluated through the Cochrane risk assessment tool and the Newcastle-Ottawa Scale. This study was registered in PROSPERO (CRD42023396232). RESULTS: A total of 5,395 articles were obtained through the search and articles that did not meet the inclusion criteria were excluded by review of the title, abstract, and full text. Finally, 3 RCTs and 10 cohort studies met the inclusion criteria. The RCT analysis showed that EVT improved the 90-day functional outcomes of patients with large ischemic core with high-quality evidence, including independent ambulation (mRS 0-3: RR 1.78, 95% CI 1.28-2.48, p < 0.001) and functional independence (mRS 0-2: RR 2.59, 95% CI 1.89-3.57, p < 0.001), but without significantly increasing the risk of symptomatic intracranial hemorrhage (sICH: RR 1.83, 95% CI 0.95-3.55, p = 0.07) or early mortality (RR 0.95, 95% CI 0.78-1.16, p = 0.61). Analysis of the cohort studies showed that EVT improved functional outcomes of patients without an increase in the incidence in sICH. DISCUSSION: This systematic review and meta-analysis indicates that in patients with LVO stroke with a large ischemic core, EVT was associated with improved functional outcomes over MM without increasing sICH risk. The results of ongoing RCTs may provide further insight in this patient population.

Published
2023

3. Thrombectomy for the Treatment of Large Core Ischemic Strokes: An Updated Systematic Review and Meta-analysis After the Release of the TESLA and TENSION Trials (P9-5.001)

Author

Dibas, Mahmoud, primary, Almajali, Mohammad, additional, Ghannam, Malik, additional, Galecio-Castillo, Milagros, additional, Al Qudah, Abdullah, additional, Khasiyev, Farid, additional, Vivanco-Suarez, Juan, additional, Calienes, Aaron Rodriguez, additional, Shogren, Sophie, additional, Al Majali, Fawaz, additional, Yoo, Albert, additional, Samaniego, Edgar, additional, Sarraj, Amrou, additional, and Gutierrez, Santiago Ortega, additional

Published
2024
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4. Blood Pressure After Endovascular Thrombectomy and Outcomes in Patients With Acute Ischemic Stroke: An Individual Patient Data Meta-analysis

Author

Katsanos, Aristeidis H., Malhotra, Konark, Ahmed, Niaz, Seitidis, Georgios, Mistry, Eva A., Mavridis, Dimitris, Kim, Joon-Tae, Veroniki, Areti Angeliki, Maier, Ilko, Matusevicius, Marius, Khatri, Pooja, Anadani, Mohammad, Goyal, Nitin, Arthur, Adam S., Sarraj, Amrou, Yaghi, Shadi, Shoamanesh, Ashkan, Catanese, Luciana, Kantzanou, Maria, Psaltopoulou, Theodora, Rentzos, Alexandros, Psychogios, Marios, Van Adel, Brian, Spiotta, Alejandro M., Sandset, Else Charlotte, de Havenon, Adam, Alexandrov, Andrei V., Petersen, Nils H., and Tsivgoulis, Georgios

Published
2022
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5. Thrombectomy Outcomes With General vs Nongeneral Anesthesia

Author

Sarraj, Amrou, Albers, Gregory W., Mitchell, Peter J., Hassan, Ameer E., Abraham, Michael G., Blackburn, Spiros, Sharma, Gagan, Yassi, Nawaf, Kleinig, Timothy J., Shah, Darshan G., Wu, Teddy Y., Hussain, Muhammad Shazam, Tekle, Wondwoseen G., Gutierrez, Santiago Ortega, Aghaebrahim, Amin Nima, Haussen, Diogo C., Toth, Gabor, Pujara, Deep, Budzik, Ronald F., Hicks, William, Vora, Nirav, Edgell, Randall C., Slavin, Sabreena, Lechtenberg, Colleen G., Maali, Laith, Qureshi, Abid, Rosterman, Lee, Abdulrazzak, Mohammad Ammar, AlMaghrabi, Tareq, Shaker, Faris, Mir, Osman, Arora, Ashish, Martin-Schild, Sheryl, Sitton, Clark W., Churilov, Leonid, Gupta, Rishi, Lansberg, Maarten G., Nogueira, Raul G., Grotta, James C., Donnan, Geoffrey Alan, Davis, Stephen M., and Campbell, Bruce C. V.

Subjects
Neurology (clinical), Research Article
Abstract

Background and ObjectivesThe effect of anesthesia choice on endovascular thrombectomy (EVT) outcomes is unclear. Collateral status on perfusion imaging may help identify the optimal anesthesia choice.MethodsIn a pooled patient-level analysis of EXTEND-IA, EXTEND-IA TNK, EXTEND-IA TNK part II, and SELECT, EVT functional outcomes (modified Rankin Scale score distribution) were compared between general anesthesia (GA) vs non-GA in a propensity-matched sample. Furthermore, we evaluated the association of collateral flow on perfusion imaging, assessed by hypoperfusion intensity ratio (HIR) – Tmax > 10 seconds/Tmax > 6 seconds (good collaterals – HIR < 0.4, poor collaterals – HIR ≥ 0.4) on the association between anesthesia type and EVT outcomes.ResultsOf 725 treated with EVT, 299 (41%) received GA and 426 (59%) non-GA. The baseline characteristics differed in presentation National Institutes of Health Stroke Scale score (median [interquartile range] GA: 18 [13–22], non-GA: 16 [11–20],p< 0.001) and ischemic core volume (GA: 15.0 mL [3.2–38.0] vs non-GA: 9.0 mL [0.0–31.0],p< 0.001). In addition, GA was associated with longer last known well to arterial access (203 minutes [157–267] vs 186 minutes [138–252],p= 0.002), but similar procedural time (35.5 minutes [23–59] vs 34 minutes [22–54],p= 0.51). Of 182 matched pairs using propensity scores, baseline characteristics were similar. In the propensity score–matched pairs, GA was independently associated with worse functional outcomes (adjusted common odds ratio [adj. cOR]: 0.64, 95% CI: 0.44–0.93,p= 0.021) and higher neurologic worsening (GA: 14.9% vs non-GA: 8.9%, aOR: 2.10, 95% CI: 1.02–4.33,p= 0.045). Patients with poor collaterals had worse functional outcomes with GA (adj. cOR: 0.47, 95% CI: 0.29–0.76,p= 0.002), whereas no difference was observed in those with good collaterals (adj. cOR: 0.93, 95% CI: 0.50–1.74,p= 0.82),pinteraction: 0.07. No difference was observed in infarct growth overall and in patients with good collaterals, whereas patients with poor collaterals demonstrated larger infarct growth with GA with a significant interaction between collaterals and anesthesia type on infarct growth rate (pinteraction: 0.020).DiscussionGA was associated with worse functional outcomes after EVT, particularly in patients with poor collaterals in a propensity score–matched analysis from a pooled patient-level cohort from 3 randomized trials and 1 prospective cohort study. The confounding by indication may persist despite the doubly robust nature of the analysis. These findings have implications for randomized trials of GA vs non-GA and may be of utility for clinicians when making anesthesia type choice.Classification of EvidenceThis study provides Class III evidence that use of GA is associated with worse functional outcome in patients undergoing EVT.Trial Registration InformationEXTEND-IA: ClinicalTrials.gov (NCT01492725); EXTEND-IA TNK: ClinicalTrials.gov (NCT02388061); EXTEND-IA TNK part II: ClinicalTrials.gov (NCT03340493); and SELECT: ClinicalTrials.gov (NCT02446587).

Published
2022
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7. Intravenous Thrombolysis Initiated Before Transfer for Endovascular Stroke Thrombectomy: A Systematic Review and Meta-analysis

Author

Katsanos, Aristeidis H., primary, Sarraj, Amrou, additional, Froehler, Michael, additional, Purrucker, Jan, additional, Goyal, Nitin, additional, Regenhardt, Robert William, additional, Palaiodimou, Lina, additional, Mueller-Kronast, Nils H, additional, Lemmens, Robin, additional, Schellinger, Peter D., additional, Sacco, Simona, additional, Turc, Guillaume, additional, Alexandrov, Andrei V., additional, and Tsivgoulis, Georgios, additional

Published
2022
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9. Mechanical Thrombectomy for Large Ischemic Stroke.

Author

Qi Li, Abdalkader, Mohamad, Siegler, James E., Yaghi, Shadi, Sarraj, Amrou, Campbell, Bruce C. V., Yoo, Albert J., Zaidat, Osama O., Kaesmacher, Johannes, Pujara, Deep, Nogueira, Raul G., Saver, Jeffrey L., Lei Li, Qin Han, Yi Dai, Hongfei Sang, Qingwu Yang, Nguyen, Thanh N., and Zhongming Qiu

Published
2023
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11. Thrombectomy Outcomes With General vs Nongeneral Anesthesia: A Pooled Patient-Level Analysis From the EXTEND-IA Trials and SELECT Study.

Author

Sarraj, Amrou, Albers, Gregory W., Mitchell, Peter J., Hassan, Ameer E., Abraham, Michael G., Blackburn, Spiros, Sharma, Gagan, Yassi, Nawaf, Kleinig, Timothy J., Shah, Darshan G., Wu, Teddy Y., Hussain, Muhammad Shazam, Tekle, Wondwoseen G., Gutierrez, Santiago Ortega, Aghaebrahim, Amin Nima, Haussen, Diogo C., Toth, Gabor, Pujara, Deep, Budzik, Ronald F., and Hicks, William

Published
2023
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12. Blood Pressure After Endovascular Thrombectomy and Outcomes in Patients With Acute Ischemic Stroke

Author

Katsanos, Aristeidis H., primary, Malhotra, Konark, additional, Ahmed, Niaz, additional, Seitidis, Georgios, additional, Mistry, Eva A., additional, Mavridis, Dimitris, additional, Kim, Joon-Tae, additional, Veroniki, Areti Angeliki, additional, Maier, Ilko, additional, Matusevicius, Marius, additional, Khatri, Pooja, additional, Anadani, Mohammad, additional, Goyal, Nitin, additional, Arthur, Adam S., additional, Sarraj, Amrou, additional, Yaghi, Shadi, additional, Shoamanesh, Ashkan, additional, Catanese, Luciana, additional, Kantzanou, Maria, additional, Psaltopoulou, Theodora, additional, Rentzos, Alexandros, additional, Psychogios, Marios, additional, Van Adel, Brian, additional, Spiotta, Alejandro M., additional, Sandset, Else Charlotte, additional, de Havenon, Adam, additional, Alexandrov, Andrei V., additional, Petersen, Nils H., additional, and Tsivgoulis, Georgios, additional

Published
2021
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21. Transfer Patients and Patients Presenting Directly to Endovascular Capable Centers Achieve Similar Good Outcome Rates with Endovascular Therapy (P5.266)

Author

Sarraj, Amrou, primary, Veznedaroglu, Erol, additional, Budzik, Ronald, additional, English, Joey, additional, Baxter, Blaise, additional, Bartolini, Bruno, additional, Liebeskind, David, additional, Krajina, Antonin, additional, Shields, Ryan, additional, χiang, Bin, additional, Nogueira, Raul, additional, Blackburn, Spiros, additional, Farrell, Christine, additional, Savitz, Sean, additional, McCullough, Louise, additional, and Gupta, Rishi, additional

Published
2017
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22. Uncertainties of Endovascular Therapy Outside the AHA guidelines (P5.261)

Author

Sarraj, Amrou, primary, Budzik, Ronald, additional, Veznedaroglu, Enrol, additional, English, Joey, additional, Baxter, Blaise, additional, Bartolini, Bruno, additional, Liebeskind, David, additional, Krajina, Antonin, additional, Shields, Ryan, additional, Jin, Nancy, additional, Nogueira, Raul, additional, Gupta, Rishi, additional, Farrell, Christine, additional, Savitz, Sean, additional, and McCullough, Louise, additional

Published
2017
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29. Clinical and Neuroimaging Outcomes of Direct Thrombectomy vs Bridging Therapy in Large Vessel Occlusion: Analysis of the SELECT Cohort Study.

Author

Sarraj, Amrou, Grotta, James, Albers, Gregory W., Hassan, Ameer E, Blackburn, Spiros, Day, Arthur, Sitton, Clark, Abraham, Michael, Cai, Chunyan, Dannenbaum, Mark, Pujara, Deep, Hicks, William, Budzik, Ronald, Vora, Nirav, Arora, Ashish, Alenzi, Bader, Tekle, Wondwossen G, Kamal, Haris, Mir, Osman, and Barreto, Andrew D

Published
2021
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30. Thrombolysis After Dabigatran Reversal for Acute Ischemic Stroke: A National Registry-Based Study and Meta-Analysis.

Author

Theodorou A, Melanis K, Bakola E, Chondrogianni M, Kiamili A, Plomaritis P, Psychogios K, Safouris A, Kargiotis O, Ntais E, Stefanou MI, Palaiodimou L, Sarraj A, Seiffge DJ, Giannopoulos S, and Tsivgoulis G

Subjects
Aged, Female, Humans, Male, Intracranial Hemorrhages chemically induced, Intracranial Hemorrhages drug therapy, Intracranial Hemorrhages epidemiology, Treatment Outcome, Antibodies, Monoclonal, Humanized administration & dosage, Antibodies, Monoclonal, Humanized adverse effects, Antithrombins administration & dosage, Antithrombins adverse effects, Dabigatran administration & dosage, Dabigatran adverse effects, Dabigatran antagonists & inhibitors, Ischemic Stroke drug therapy, Registries, Thrombolytic Therapy adverse effects, Thrombolytic Therapy methods
Abstract

Background and Objectives: Limited data exist on the safety of IV thrombolysis (IVT) for acute ischemic stroke (AIS) after dabigatran reversal with idarucizumab. We sought to evaluate the safety and efficacy of idarucizumab pretreatment in patients with AIS receiving IVT., Methods: A national registry-based study evaluated the safety and efficacy of IVT in this specific subgroup. We also conducted a systematic review and meta-analysis of cohort studies and case series, aiming to document the pooled rates of (1) symptomatic intracranial hemorrhage (sICH), (2) any intracranial hemorrhage, (3) 3-month mortality, and (4) the proportion of excellent (modified Rankin Scale [mRS] scores 0-1) and (5) good (mRS scores 0-2) functional outcome at 3 months among patients with AIS, who received IVT after dabigatran reversal with idarucizumab. Moreover, we sought to compare these outcomes between IVT-treated patients after dabigatran reversal with idarucizumab and IVT-treated patients without dabigatran pretreatment., Results: Thirteen cohorts including our nation-wide registry-based cohort and 1 case series comprising 553 patients with AIS (mean age: 75 years; male sex: 65%; median baseline NIH Stroke Scale score: 11 points) receiving idarucizumab before IVT were included in this meta-analysis. The pooled rate of sICH after IVT after idarucizumab administration was 4% (95% CI 1-9; I 2 = 26%), while the pooled rates of any intracranial hemorrhage and 3-month mortality were 10% (95% CI 5-16; I 2 = 24%) and 18% (95% CI 10-27; I 2 = 0%), respectively. The pooled rates of excellent and good functional outcomes at 3 months were 56% (95% CI 27-83; I 2 = 69%) and 70% (95% CI 57-81; I 2 = 40%), respectively. The risk of sICH (risk ratio [RR] 1.86; 95% CI 0.91-3.80; I 2 = 0%), any intracranial hemorrhage (RR 1.76; 95% CI 0.99-3.11; I 2 = 8%), and 3-month mortality (RR 1.50; 95% CI 0.91-2.48; I 2 = 0%) did not differ between patients with AIS receiving IVT with and without idarucizumab. Moreover, idarucizumab administration was associated with higher likelihood of achieving a 3-month good functional outcome (RR 1.35; 95% CI 1.11-1.65; I 2 = 27%)., Discussion: IVT for AIS after dabigatran reversal with idarucizumab seems to be safe and effective in observational studies with limited number of patients. Randomized-controlled clinical trials are warranted to provide robust evidence on the safety and efficacy of IVT in this specific AIS subgroup.

Published
2024
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