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348 results on '"Mascitelli, Justin R."'

55. In Reply

Author

Baranoski, Jacob F, primary, Mascitelli, Justin R, additional, and Lawton, Michael T, additional

Published
2021
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58. Determinants of intracranial aneurysm retreatment following embolization with a single flow-diverting stent.

Author

Vranic, Justin E, Harker, Pablo, Stapleton, Christopher J, Regenhardt, Robert W, Dmytriw, Adam A, Alotaibi, Naif M, Gupta, Rajiv, Leslie-Mazwi, Thabele M, Koch, Matthew J, Raymond, Scott B, Mascitelli, Justin R, Patterson, T Tyler, Seinfeld, Joshua, White, Andrew, Case, David, Roark, Christopher, Gandhi, Chirag D, Al-Mufti, Fawaz, Cooper, Jared, and Patel, Aman B

Abstract

Purpose: Flow diverting stents have revolutionized the treatment of intracranial aneurysms through endoluminal reconstruction of the parent vessel. Despite this, certain aneurysms require retreatment. The purpose of this study was to identify clinical and radiologic determinants of aneurysm retreatment following flow diversion. Methods: A multicenter flow diversion database was evaluated to identify patients presenting with an unruptured, previously untreated aneurysm with a minimum of 12 months' clinical and angiographic follow-up. Univariate and multivariate logistic regression modeling was performed to identify determinants of retreatment. Results: We identified 189 aneurysms treated in 189 patients with a single flow-diverting stent. Mean age was 54 years, and 89% were female. Complete occlusion was achieved in 70.3% and 83.6% of patients at six and 12 months, respectively. Aneurysm retreatment with additional flow-diverting stents occurred in 5.8% of cases. Univariate analysis revealed that dome diameter ≥ 10 mm (p = 0.012), pre-clinoid internal carotid artery location (p = 0.012), distal > proximal parent vessel diameter (p = 0.042), and later dual antiplatelet therapy (DAPT) discontinuation (p < 0.001) were predictive of retreatment. Multivariate analysis identified discontinuation of DAPT > 12 months (p = 0.003) as a strong determinant of retreatment with dome diameter ≥ 10 mm trending toward statistical significance (p = 0.064). Large aneurysm neck diameter, presence of aneurysm branch vessels, patient age, smoking history, and hypertension were not determinant of retreatment on multivariate analysis. Conclusions: Prolonged DAPT is the most important determinant of aneurysm retreatment following single-device flow diversion. Abbreviating DAPT duration to only six months should be a consideration in this population, especially for patients with a large aneurysm dome diameter. [ABSTRACT FROM AUTHOR]

Published
2022
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59. Is a picture-perfect thrombectomy necessary in acute ischemic stroke?

Author

Chen, Ching-Jen, primary, Chalhoub, Reda, additional, Ding, Dale, additional, Kumar, Jeyan S, additional, Ironside, Natasha, additional, Kellogg, Ryan T, additional, Worrall, Bradford B, additional, Southerland, Andrew M, additional, Jabbour, Pascal, additional, Wolfe, Stacey Q, additional, Arthur, Adam S, additional, Goyal, Nitin, additional, Fragata, Isabel, additional, Maier, Ilko, additional, Matouk, Charles, additional, Grossberg, Jonathan A, additional, Kan, Peter, additional, Schirmer, Clemens M, additional, Crowley, R Webster, additional, Ares, William J, additional, Ogilvy, Christopher S, additional, Rai, Ansaar T, additional, Levitt, Michael R, additional, Mokin, Maxim, additional, Guerrero, Waldo R, additional, Mascitelli, Justin R, additional, Yoo, Albert J, additional, Williamson, Richard, additional, Grande, Andrew Walker, additional, Crosa, Roberto Javier, additional, Webb, Sharon, additional, Psychogios, Marios N, additional, Starke, Robert M, additional, Spiotta, Alejandro M, additional, and Park, Min S, additional

Published
2021
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60. Alarming downtrend in mechanical thrombectomy rates in African American patients during the COVID-19 pandemic-Insights from STAR

Author

Al Kasab, Sami, primary, Almallouhi, Eyad, additional, Alawieh, Ali, additional, Jabbour, Pascal, additional, Sweid, Ahmad, additional, Starke, Robert M, additional, Saini, Vasu, additional, Wolfe, Stacey Q, additional, Fargen, Kyle M, additional, Arthur, Adam S, additional, Goyal, Nitin, additional, Pandhi, Abhi, additional, Maier, Ilko, additional, Grossberg, Jonathan A, additional, Howard, Brian M, additional, Tjoumakaris, Stavropoula I, additional, Rai, Ansaar, additional, Park, Min S, additional, Mascitelli, Justin R, additional, Psychogios, Marios N, additional, and Spiotta, Alejandro M, additional

Published
2021
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63. The Glossopharyngo-Cochlear Triangle—Part II: Case Series Highlighting the Clinical Application to High-Riding Posterior Inferior Cerebellar Artery Aneurysms Exposed Through the Extended Retrosigmoid Approach

Author

Baranoski, Jacob F, primary, Koester, Stefan W, additional, Przybylowski, Colin J, additional, Zhao, Xiaochun, additional, Catapano, Joshua S, additional, Gandhi, Sirin, additional, Tayebi Meybodi, Ali, additional, Cole, Tyler S, additional, Lee, Jonathan, additional, Frisoli, Fabio A, additional, Lawton, Michael T, additional, and Mascitelli, Justin R, additional

Published
2020
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64. The Glossopharyngo-Cochlear Triangle—Part I: Quantitative Anatomic Analysis of High-Riding Posterior Inferior Cerebellar Artery Aneurysms Exposed Through the Extended Retrosigmoid Approach

Author

Zhao, Xiaochun, primary, Tayebi Meybodi, Ali, additional, Naeem, Komal, additional, Belykh, Evgenii, additional, Labib, Mohamed A, additional, Baranoski, Jacob F, additional, Catapano, Joshua S, additional, Mascitelli, Justin R, additional, Preul, Mark C, additional, and Lawton, Michael T, additional

Published
2020
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67. International experience of mechanical thrombectomy during the COVID-19 pandemic: insights from STAR and ENRG

Author

Al Kasab, Sami, primary, Almallouhi, Eyad, additional, Alawieh, Ali, additional, Levitt, Michael R, additional, Jabbour, Pascal, additional, Sweid, Ahmad, additional, Starke, Robert M, additional, Saini, Vasu, additional, Wolfe, Stacey Q, additional, Fargen, Kyle M, additional, Arthur, Adam S, additional, Goyal, Nitin, additional, Pandhi, Abhi, additional, Fragata, Isabel, additional, Maier, Ilko, additional, Matouk, Charles, additional, Grossberg, Jonathan A, additional, Howard, Brian M, additional, Kan, Peter, additional, Hafeez, Muhammad, additional, Schirmer, Clemens M, additional, Crowley, R Webster, additional, Joshi, Krishna C, additional, Tjoumakaris, Stavropoula I, additional, Chowdry, Shakeel, additional, Ares, William, additional, Ogilvy, Christopher, additional, Gomez-Paz, Santiago, additional, Rai, Ansaar T., additional, Mokin, Maxim, additional, Guerrero, Waldo, additional, Park, Min S, additional, Mascitelli, Justin R, additional, Yoo, Albert, additional, Williamson, Richard, additional, Grande, Andrew Walker, additional, Crosa, Roberto Javier, additional, Webb, Sharon, additional, Psychogios, Marios N, additional, Ducruet, Andrew F, additional, Holmstedt, Christine A, additional, Ringer, Andrew J, additional, and Spiotta, Alejandro M, additional

Published
2020
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72. Transcirculation approach for stent-assisted coiling of intracranial aneurysms: a multicenter study.

Author

Mascitelli, Justin R., Levitt, Michael R., Griessenauer, Christoph J., Kim, Louis J., Gross, Bradley, Abla, Adib, Winkler, Ethan, Jankowitz, Brian, Grandhi, Ramesh, Goren, Oded, and Schirmer, Clemens M.

Subjects
EVALUATION of medical care, RESEARCH, CEREBRAL angiography, CORONARY artery stenosis, THERAPEUTIC embolization, SURGICAL stents, MEDICAL cooperation, RETROSPECTIVE studies, SURGICAL complications, ENDOVASCULAR surgery, INTRACRANIAL aneurysms
Abstract

Background The transcirculation approach (TCA) for stent-assisted coiling (SAC) of intracranial aneurysms may be useful for certain wide-neck bifurcation aneurysms as well as those with acute-angle efferent branches. Objective To describe a multicenter experience using the TCA for SAC. Methods A multicenter, retrospective study (2016-2020) of aneurysm treatment using SAC via the TCA. Angiographic outcome was scored using the Raymond Scale (adequate occlusion 1 and 2), and clinical outcome was scored using a modified Rankin Scale (good outcome 0-2) Results Twenty-nine patients with 29 aneurysms were included (62.1% female; average age 61; 89.7% unruptured; 13.8% previously treated; average dome size 6.4 mm; average neck 4.4 mm). Aneurysm locations included internal carotid artery-fetal posterior cerebral artery (n=4), internal carotid artery terminus (n=4), anterior communicating artery (n=8), vertebral artery-posterior inferior cerebellar artery (n=2), and basilar tip (n=11). The TCA used communicating arteries (93.1%; average 1.6 mm), intermediate catheters (51.7%), jailing technique (62.1%), and staged procedures (10.3%). The most common stent was the Neuroform Atlas (Stryker; 69%). Immediate adequate occlusion was obtained in 75.9%, and five patients with inadequate occlusion progressed to adequate occlusion at follow-up. One (3.4%) procedural complication occurred: a watershed stroke in the setting of baseline four-vessel extracranial disease. Two patients had a poor outcome unrelated to the TCA. The majority of patients (86.4%) had a good clinical outcome. One case of in-stent stenosis due to non-compliance with medication was seen, which resolved with medication resumption. Conclusions The TCA for SAC can be performed for a variety of aneurysms with a low complication rate and good clinical outcomes. [ABSTRACT FROM AUTHOR]

Published
2021
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74. Contributors

Author

Aalbers, Marlien W., Abou-El-Hassan, Hadi, Acosta, Frank, Adelson, P. David, Adler, John R., Jr., Agarwal, Vijay, Aghi, Manish K., Ahluwalia, Manmeet S., Ahmed, A. Karim, Ajler, Pablo, Akinduro, Oluwaseun O., Albuquerque, Felipe C., Aldana, Philipp R., Alluri, Ram K., Alvi, Mohammed Ali, Amendola, Luca, Amin-Hanjani, Sepideh, Ammerman, Joshua M., Anderson, William, Andrade-Barazarte, Hugo, Appelboom, Geoff, Arnold, Paul M., Asthagiri, Ashok, Aulakh, Sonikpreet, Aziz, Khaled M., Aziz, Tipu, Bakhsheshian, Joshua, Ball, Perry A., Bandiera, Stefano, Barbaro, Nicholas M., Barnard, Zachary R., Barrow, Daniel L., Beaumont, Thomas L., Bederson, Joshua, Beier, Alexandra D., Bellabarba, Carlo, Bello, Lorenzo, Belzberg, Alan J., Ben-Haim, Sharona, Ben-Shalom, Netanel, Bender, Matthew T., Bendok, Bernard R., Benes, Ludwig, Benzel, Edward C., Bertalanffy, Helmut, Bettegowda, Chetan, Bhagat, Priyal Vinod, Bi, Wenya Linda, Bijanki, Kelly, Bishop, Allen T., Bisson, Erica F., Black, Keith L., Blondel, Benjamin, Boahene, Kofi, Bohnen, Angela M., Bollo, Robert J., Bookland, Markus, Borghei, Alireza, Borghei-Razavi, Hamid, Boriani, Stefano, Borkar, Sachin A., Bova, Frank J., Brahimaj, Bledi C., Brandt, Ryan J., Bransford, Richard J., Brotchi, Jacques, Brown, Benjamin L., Bruce, Jeffrey N., Bruneau, Michael, Buchanan, Ian A., Burchiel, Kim J., Burke, Timothy G., Bydon, Ali, Bydon, Mohamad, Byrne, Richard W., Cabral, Gustavo Augusto Porto Sereno, Cacciola, Francesco, Campos, Jessica K., Caplan, Justin M., Caputy, Anthony J., Cardinale, Francesco, Carlstrom, Lucas P., Carrau, Ricardo L., Carter, Bob S., Castana, Laura, Castillo-Velazquez, Gabriel, Chaichana, Kaisorn L., Chanan-Khan, Asher, Chang, Edward F., Chang, Steven D., Chari, Aswin, Chen, Ching-Jen, Chen, Douglas, Chen, James, Chen, Selby, Chern, Joshua J., Chi, John H., Chiocca, E. Antonio, Chitale, Rohan, Chitnavis, Bhupal, Choudhri, Omar A., Chu, Ray M., Clifton, William, Cohen, Alan R., Cohen, Salomon, Colby, Geoffrey P., Cole, Tyler S., Consales, Alessandro, Coon, Alexander L., Cooper, Jared B., Copeland, William R., Coric, Domagoj, Corl, Frank M., Corliss, Brian M., Corti, Marcelo, Cossu, Massimo, Currier, Bradford L., Curry, William T., Dabus, Guilherme, Dahdaleh, Nader S., Dailey, Andrew T., Daniels, David J., Dardis, Ronan M., Das, Sunit, Dasenbrock, Hormuzdiyar H., Day, Arthur L., Biase, Gaetano De, Garza Ramos, Rafael De la, Deen, H. Gordon, Deletis, Vedran, Detsky, Jay, Dlouhy, Brian J., Domingo, Ricardo A., Domino, Joseph, Donaldson, Angela M., Dornbos, David, Dorsi, Michael J., Reis, Cassius Vinicius Corrêa Dos, Ducker, Thomas B., Duffau, Hugues, Dunn, Ian F., D’Amico, Randy S., Eggenberger, Eric R., Ehresman, Jeff, El Naga, Ashraf N., Elarjani, Turki, Elder, Benjamin D., Elsharkawy, Ahmed, Epstein, Nancy E., Erkmen, Kadir, Errico, Thomas J., Eskey, Clifford J., Evans, Linton, Everson, Megan C., Fei, Naomi, Fessler, Richard G., Filler, Aaron G., Flores, Bruno C., Foley, Kevin T., Foroni, Roberto I., Forte, Antonio J., Fountas, Kostas N., Fox, W. Christopher, Freeman, William David, Friedman, William Alan, Frim, David M., Frisoli, Fabio, Fujimura, Miki, Ganaha, Sara, Gandhi, Dheeraj, Gandhi, Sirin, Garrett, Mark, Garzon-Muvdi, Tomas, Gasbarrini, Alessandro, Gassie, Kelly, Geisler, Fred H., Georgoulis, George, Gill, Brian J.A., Goehre, Felix, Goel, Atul, Goel, Gunjan, Gokaslan, Ziya L., Gold, Katherine G., Gomez, Diego F., Gonzalez, L. Fernando, Goodwin, C. Rory, Gordon, Chad R., Goyal, Anshit, Graffeo, C.S., Grande, Andrew W., Grandhi, Ramesh, Green, Alexander L., Greenfield, Jeffrey P., Grewal, Sanjeet S., Groves, Mari L., Guan, Jian, Guinto, Gerardo, Gullan, Richard, Gupta, Gaurav, Gupta, Nalin, Gupta, Vivek, Hah, Raymond J., Hakim, Fernando, Halalmeh, Dia Radi, Haldeman, Clayton L., Haranhalli, Neil, Hardesty, Douglas A., Hardigan, Trevor, Harrop, James S., Hartnett, Sara, Heinze, Stefan, Hernesniemi, Juha, Hersh, David S., Hidalgo, Joaquin, Hill, Travis, Hindoyan, Kevork N., Ho, Olivia, Hoh, Brian L., Hopkins, L. Nelson, Hsu, Wesley, Huang, Judy, Huang, Michael, Huff, Wei X., Huq, Sakibul, Hussain, Zain, Ironside, Natasha, Iyer, Rajiv R., Jabbour, Pascal M., Jackson, Christina, Jackson, Christopher M., Jahromi, Behnam Rezai, Jallo, George I., Jaume, Alejandra, Javadpour, Mohsen, Jea, Andrew, Jentoft, Mark, Jho, David H., Jho, Diana H., Jho, Hae-Dong, Jiang, Bowen, Joyce, Evan, Kalani, M. Yashar S., Kapsalaki, Eftychia Z., Kaplitt, Michael G., Karas, Patrick, Karatayli-Ozgursoy, Selmin, Kawase, Takeshi, Kehler, Uwe, Kerezoudis, Panagiotis, Kern, Drew S., Khan, Farhan A., Khan, Nickalus R., Khu, Kathleen, Kim, Daniel H., Kirsch, Matthias, Klinge, Petra, Koch, Matthew J., Kogan, Michael, Kolcun, John Paul G., Kondziolka, Douglas, Korinth, Marcus Christopher, Kotecha, Rupesh, Krex, Dietmar, Krishna, Chandan, Krishnan, Kartik G., Krishnaney, Ajit, Kshettry, Varun R., Lacy, Maureen, Ladner, Travis R., Landeiro, Jose Alberto, Lang, Frederick F., Lang, Michael J., Larsen, Alexandra Giantini, Laurent, Dimitri, Lawton, Michael T., Lee, Bryan S., Levi, Allan, Levivier, Marc, Levy, Elad I., Lim, Michael, Lin, Li-Mei, Lin, Michelle, Erland Lind, Göran, Linderoth, Bengt, Link, Michael J., Lo Russo, Giorgio, Loftus, Christopher M., Longhi, Michele, Lonser, Russell R., Louie, Christopher E., Lu, Daniel C., Ludtka, Christopher, Lundy, Larry B., Magge, Subu N., Malessy, Martijn J.A., Maniker, Allen H., Manley, Geoffrey T., Maralani, Peiman, Marenco-Hillembrand, Lina, Martinez-Sosa, Meleine, Mascitelli, Justin R., Mazur, Marcus D., McCormick, Paul C., Mena-Bernal, José Hinojosa, Menezes, Arnold H., Meyer, Fredric B., Middlebrooks, Erik H., Midha, Rajiv, Mikula, Anthony, Miller, David, Miller, Jonathan P., Mirza, Bilal, Mirzadeh, Zaman, Mocco, J., Molina, Camilo A., Montaser, Alaa S., Morcos, Jacques J., Morgan, Chad J., Mostofi, Abteen, Muftuoglu, Yagmur, Myrehaug, Sten, Nabavi, Arya, Nanaszko, Michael J., Nanda, Pranav, Naragum, Varun, Nasser, Rani, Nathal, Edgar, Nguyen, Timothy K., Nibali, Marco Conti, Nicolato, Antonio, Nimmagadda, Anitha, North, Richard B., Nottmeier, Eric, Noureldine, Mohammad Hassan A., Oakes, W. Jerry, Ogilvy, Christopher S., Ojemann, Jeffrey G., Ojemann, Steven, Okonkwo, David O., Olivi, Alessandro, Olomu, Osarenoma U., Orlev, Alon, Osburn, Brooks, Ota, Nakao, Otto, Bradley A., Pang, Dachling, Parney, Ian, Pascual, José María, Patel, Aman B., Patel, Anoop, Patel, Smruti K., Patir, Rana, Penn, Richard D., Pennington, Zachary, Pepa, Giuseppe Maria Della, Perdomo-Pantoja, Alexander, Pereira, Erlick A.C., Perez-Cruet, Mick J., Peris-Celda, Maria, Perry, A., Perry, Avital, Pessina, Federico, Peterson, Jennifer L., Pham, Martin H., Pichelmann, Mark, Pinheiro-Neto, Carlos D., Pirgousis, Phillip, Pitts, Lawrence H., Placide, Rick J., Plaha, Puneet, Polifka, Adam J., Pondaag, Willem, Post, Kalmon D., Potts, Matthew B., Poulsgaard, Lars, Prete, Alessandro, Prevedello, Daniel M., Prieto, Ruth, Puffer, Ross C., Quevedo-Valdes, Pablo A., Quiñones-Hinojosa, Alfredo, Quintana, Leonidas M., Sr., Rahmathulla, Gazanfar, Rahme, Rudy J., Ramhmdani, Seba, Ramon, Juan F., Ramos-Fresnedo, Andres, Ramos-Zuniga, Rodrigo, Sr., Ranalli, Nathan J., Ranjan, Manish, Rapp, Aaron, Ravindra, Vijay M., Recinos, Pablo F., ReFaey, Karim, Régis, Jean, Relyea, Katherine, Resnick, Daniel K., Richardson, Angela M., Rigamonti, Daniele, Riva, Marco, Riva, Matteo, Rizzi, Michele, Rochkind, Shimon, Rolston, John D., Rosenberg, William S., Rosenwasser, Robert H., Roser, Florian, Rossi, Marco, Rowland, Nathan C., Rutka, James T., Rymarczuk, George N., Sahgal, Arjun, Sala, Francesco, Salle, Federico, Sani, Sepehr, Santiago, Gabriel F., Salvatori, Roberto, Martinez Santos, Jaime L., Sarris, Christina E., Savastano, Luis E., Saxena, Amar, Schackert, Gabriele, Prof, Schmidt, Meic H., Schroeder, Henry W.S., Prof, Schwab, Joseph, Schwartz, Theodore H., Sciortino, Tommaso, Sciubba, Daniel M., Scott, Kyle W., Scoville, Jonathan P., See, Alfred P., Sekula, Raymond F., Jr., Shad, Amjad, Shah, Jugal, Shaibani, Ali, Shaikhouni, Ammar, Sharma, Manish S., Sheehan, Jason, Sheehy, John Paul, Sheth, Sameer, Shi, Changbin, Shimony, Nir, Shin, Alexander Y., Siddiqui, Adnan H., Silveira, Roberto Leal, Simmons, Nathan, Sindou, Marc, Sinisi, Marco, Smith, Edward R., Smith, Joseph R., Smith, Kyle A., Smyth, Matthew D., Soliman, Hany, Souweidane, Mark M., Spagnuolo, Edgardo, Spetzler, Robert F., Spinner, Robert J., Stapleton, Christopher J., Stein, Rachel, Steinmetz, Michael P., Stone, Scellig, Stricsek, Geoffrey P., Suarez-Meade, Paola, Sughrue, Michael E., Suk, Ian, Sun, Daniel Q., Sur, Samir, Sure, Ulrich, Sweid, Ahmad, Tafel, Ian, Tamargo, Rafael J., Tawk, Rabih G., Tew, John M., Jr., Theodore, Nicholas, Thompson, B. Gregory, Jr., Thompson, John A., Tian, Fucheng, Tirakotai, Wuttipong, Tjoumakaris, Stavropoula, Todnem, Nathan, Tominaga, Teiji, Trifiletti, Daniel M., Tripathi, Shashwat, Tseng, Eric, Tubbs, R. Shane, Tulamo, Riikka, Tuleasca, Constantin, Turkmani, Ali H., Vakharia, Kunal, Van Gompel, Jamie J., Vasudeva, Viren S., Velasco, Ana Luisa, Velasco, Francisco, Velat, Gregory J., Venur, Vyshak Alva, Verlicchi, Angela, Vivas-Buitrago, Tito, Vlasak, Alexander L., Vrionis, Frank D., Wainwright, John Varmaa, Wallace, M. Christopher, Waqas, Muhammad, Watridge, Clarence B., Weiss, Nirit, Welz, Matthew E., Westbroek, Erick M., Wharen, Robert E., Wildrick, David M., Wilkinson, D. Andrew, Winfree, Christopher J., Witham, Timothy, Wolff, Amir, Wolinsky, Jean-Paul, Wu, Kyle C., Xavier, Shaun, Yaeger, Kurt, Yampolsky, Claudio, Yassari, Reza, Yolcu, Yagiz Ugur, Yu, Alexander K., Zager, Eric L., Zanotti, Bruno, Zileli, Mehmet, and Zivelonghi, Emanuele

Published
2022
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81. Is a picture-perfect thrombectomy necessary in acute ischemic stroke?

Author

Chen, Ching-Jen, Chalhoub, Reda, Ding, Dale, Kumar, Jeyan S, Ironside, Natasha, Kellogg, Ryan T, Worrall, Bradford B, Southerland, Andrew M, Jabbour, Pascal, Wolfe, Stacey Q, Arthur, Adam S, Goyal, Nitin, Fragata, Isabel, Maier, Ilko, Matouk, Charles, Grossberg, Jonathan A, Kan, Peter, Schirmer, Clemens M, Crowley, R Webster, Ares, William J, Ogilvy, Christopher S, Rai, Ansaar T, Levitt, Michael R, Mokin, Maxim, Guerrero, Waldo R, Mascitelli, Justin R, Yoo, Albert J, Williamson, Richard, Grande, Andrew Walker, Crosa, Roberto Javier, Webb, Sharon, Psychogios, Marios N, Starke, Robert M, Spiotta, Alejandro M, and Park, Min S

Abstract

BackgroundThe benefit of complete reperfusion (modified Thrombolysis in Cerebral Infarction (mTICI) 3) over near-complete reperfusion (≥90%, mTICI 2c) remains unclear. The goal of this study is to compare clinical outcomes between mechanical thrombectomy (MT)-treated stroke patients with mTICI 2c versus 3.MethodsThis is a retrospective study from the Stroke Thrombectomy and Aneurysm Registry (STAR) comprising 33 centers. Adults with anterior circulation arterial vessel occlusion who underwent MT yielding mTICI 2c or mTICI 3 reperfusion were included. Patients were categorized based on reperfusion grade achieved. Primary outcome was modified Rankin Scale (mRS) 0–2 at 90 days. Secondary outcomes were mRS scores at discharge and 90 days, National Institutes of Health Stroke Scale score at discharge, procedure-related complications, and symptomatic intracerebral hemorrhage.ResultsThe unmatched mTICI 2c and mTICI 3 cohorts comprised 519 and 1923 patients, respectively. There was no difference in primary (42.4% vs 45.1%; p=0.264) or secondary outcomes between the unmatched cohorts. Reperfusion status (mTICI 2c vs 3) was also not predictive of the primary outcome in non-imputed and imputed multivariable models. The matched cohorts each comprised 191 patients. Primary (39.8% vs 47.6%; p=0.122) and secondary outcomes were also similar between the matched cohorts, except the 90-day mRS which was lower in the matched mTICI 3 cohort (p=0.049). There were increased odds of the primary outcome with mTICI 3 in patients with baseline mRS ≥2 (36% vs 7.7%; p=0.011; pinteraction=0.014) and a history of stroke (42.3% vs 15.4%; p=0.027; pinteraction=0.041).ConclusionsComplete and near-complete reperfusion after MT appear to confer comparable outcomes in patients with acute stroke.

Published
2022
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89. Wide-neck bifurcation aneurysms of the middle cerebral artery and basilar apex treated by endovascular techniques: a multicentre, core lab adjudicated study evaluating safety and durability of occlusion (BRANCH)

Author

De Leacy, Reade A, primary, Fargen, Kyle M, additional, Mascitelli, Justin R, additional, Fifi, Johanna, additional, Turkheimer, Lena, additional, Zhang, Xiangnan, additional, Patel, Aman B, additional, Koch, Matthew J, additional, Pandey, Aditya S, additional, Wilkinson, D Andrew, additional, Griauzde, Julius, additional, James, Robert F, additional, Fortuny, Enzo M, additional, Cruz, Aurora, additional, Boulos, Alan, additional, Nourollah-Zadeh, Emad, additional, Paul, Alexandra, additional, Sauvageau, Eric, additional, Hanel, Ricardo, additional, Aguilar-Salinas, Pedro, additional, Novakovic, Roberta L, additional, Welch, Babu G, additional, Almardawi, Ranyah, additional, Jindal, Gaurav, additional, Shownkeen, Harish, additional, Levy, Elad I, additional, Siddiqui, Adnan H, additional, and Mocco, J, additional

Published
2018
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92. The Glossopharyngo-Cochlear Triangle-Part I: Quantitative Anatomic Analysis of High-Riding Posterior Inferior Cerebellar Artery Aneurysms Exposed Through the Extended Retrosigmoid Approach.

Author

Zhao, Xiaochun, Tayebi Meybodi, Ali, Naeem, Komal, Belykh, Evgenii, Labib, Mohamed A, Baranoski, Jacob F, Catapano, Joshua S, Mascitelli, Justin R, Preul, Mark C, and Lawton, Michael T

Abstract

An extended retrosigmoid approach can offer sufficient space for clip reconstruction of some high-riding posterior inferior cerebellar artery (PICA) aneurysms.

Published
2021
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93. The Glossopharyngo-Cochlear Triangle-Part II: Case Series Highlighting the Clinical Application to High-Riding Posterior Inferior Cerebellar Artery Aneurysms Exposed Through the Extended Retrosigmoid Approach.

Author

Baranoski, Jacob F, Koester, Stefan W, Przybylowski, Colin J, Zhao, Xiaochun, Catapano, Joshua S, Gandhi, Sirin, Tayebi Meybodi, Ali, Cole, Tyler S, Lee, Jonathan, Frisoli, Fabio A, Lawton, Michael T, and Mascitelli, Justin R

Abstract

Use of the far lateral transcondylar (FL) approach and vagoaccessory triangle is the standard exposure for clipping most posterior inferior cerebellar artery (PICA) aneurysms. However, a distal PICA origin or high-lying vertebrobasilar junction can position the aneurysm beyond the vagoaccessory triangle, making the conventional FL approach inappropriate.

Published
2021
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96. Novel and emerging technologies for endovascular thrombectomy

Author

Chartrain, Alexander G., primary, Awad, Ahmed J., additional, Mascitelli, Justin R., additional, Shoirah, Hazem, additional, Oxley, Thomas J., additional, Feng, Rui, additional, Gallitto, Matthew, additional, De Leacy, Reade, additional, Fifi, Johanna T., additional, and Kellner, Christopher P., additional

Published
2017
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100. Wide-neck bifurcation aneurysms of the middle cerebral artery and basilar apex treated by endovascular techniques: a multicentre, core lab adjudicated study evaluating safety and durability of occlusion (BRANCH).

Author

De Leacy, Reade A., Fargen, Kyle M., Mascitelli, Justin R., Fifi, Johanna, Turkheimer, Lena, Xiangnan Zhang, Patel, Aman B., Koch, Matthew J., Pandey, Aditya S., Wilkinson, D. Andrew, Griauzde, Julius, James, Robert F., Fortuny, Enzo M., Cruz, Aurora, Boulos, Alan, Nourollah-Zadeh, Emad, Paul, Alexandra, Sauvageau, Eric, Hanel, Ricardo, and Aguilar-Salinas, Pedro

Subjects
INTRACRANIAL aneurysm surgery, ENDOVASCULAR surgery, CEREBRAL angiography, CEREBRAL arteries, CONFIDENCE intervals, DISEASES, INTRACRANIAL aneurysms, MEDICAL cooperation, RESEARCH, SELF-evaluation, TREATMENT effectiveness, BASILAR artery, ODDS ratio
Abstract

Background and purpose BRANCH (wide-neck bifurcation aneurysms of the middle cerebral artery and basilar apex treated by endovascular techniques) is a multicentre, retrospective study comparing core lab evaluation of angiographic outcomes with self-reported outcomes. Materials and methods Consecutive patients were enrolled from 10 US centres, aged between 18 and 85 with unruptured wide-neck middle cerebral artery (MCA) or basilar apex aneurysms treated endovascularly. Patient demographics, aneurysm morphology, procedural information, mortality and morbidity data and core lab and self-reported modified Raymond Roy (RR) outcomes were obtained. Results 115 patients met inclusion criteria. Intervention-related mortality and significant morbidity rates were 1.7% (2/115) and 5.8% (6/103) respectively. Core lab adjudicated RR1 and 2 occlusion rates at follow-up were 30.6% and 32.4% respectively. The retreatment rate within the follow-up window was 10/115 (8.7%) and in stent stenosis at follow-up was 5/63 (7.9%). Self-reporting shows a statistically significant direction to angiographic RR one outcomes at follow-up compared with core lab evaluation, with OR 1.75 (95% CI 1.08 to 2.83). Conclusion Endovascular treatment of wide-neck MCA and basilar apex aneurysms resulted in a core lab adjudicated RR1 occlusion rate of 30.6%. Self-reported results at follow-up favour better angiographic outcomes, with OR 1.75 (95% CI 1.08 to 2.83). These data demonstrate the need for novel endovascular devices specifically designed to treat complex intracranial aneurysms, as well as the importance of core lab adjudication in assessing outcomes in such a trial. [ABSTRACT FROM AUTHOR]

Published
2019
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