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21 results on '"Dalal, Shamsher S."'

3. Tenecteplase versus alteplase before mechanical thrombectomy: experience from a US healthcare system undergoing a system-wide transition of primary thrombolytic.

Author

Hendrix, Philipp, Collins, Malie K., Griessenauer, Christoph J., Goren, Oded, Melamed, Itay, Weiner, Gregory M., Dalal, Shamsher S., Kole, Matthew J., Noto, Anthony, and Schirmer, Clemens M.

Subjects
FIBRINOLYTIC agents, PREOPERATIVE care, DRUG efficacy, GENERIC drug substitution, INTRAVENOUS therapy, CEREBRAL angiography, CONVALESCENCE, COMPARATIVE studies, THROMBECTOMY, DESCRIPTIVE statistics, REPERFUSION, TISSUE plasminogen activator, EVALUATION
Abstract

Background Tenecteplase (TNK) is a genetically modified variant of alteplase (TPA) and has been established as a non-inferior alternative to TPA in acute ischemic stroke (AIS). Whether TNK exerts distinct benefits in large vessel occlusion (LVO) AIS is still being investigated. Objective To describe our first-year experience after a healthcare system-wide transition from TPA to TNK as the primary thrombolytic. Methods Patients with AIS who received intravenous thrombolytics between January 2020 and August 2022 were retrospectively reviewed. All patients with LVO considered for mechanical thrombectomy (MT) were included in this analysis. Spontaneous recanalization (SR) after TNK/TPA was a composite variable of reperfusion >50% of the target vessel territory on cerebral angiography or rapid, significant neurological recovery averting MT. Propensity score matching (PSM) was performed to compare SR rates between TNK and TPA. results A total of 148 patients were identified; 51/148 (34.5%) received TNK and 97/148 (65.5%) TPA. The middle cerebral arteries M1 (60.8%) and M2 (29.7%) were the most frequent occlusion sites. Baseline demographics were comparable between TNK and TPA groups. Spontaneous recanalization was significantly more frequently observed in the TNK than in the TPA groups (unmatched: 23.5% vs 10.3%, P=0.032). PSM substantiated the observed SR rates (20% vs 10%). Symptomatic intracranial hemorrhage, 90-day mortality, and functional outcomes were similar. Conclusions The preliminary experience from a realworld setting demonstrates the effectiveness and safety of TNK before MT. The higher spontaneous recanalization rates with TNK are striking. Additional studies are required to investigate whether TNK is superior to TPA in LVO AIS. [ABSTRACT FROM AUTHOR]

Published
2023
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4. Tenecteplase versus alteplase before mechanical thrombectomy: experience from a US healthcare system undergoing a system-wide transition of primary thrombolytic

Author

Hendrix, Philipp, primary, Collins, Malie K, additional, Griessenauer, Christoph J, additional, Goren, Oded, additional, Melamed, Itay, additional, Weiner, Gregory M, additional, Dalal, Shamsher S, additional, Kole, Matthew J, additional, Noto, Anthony, additional, and Schirmer, Clemens M, additional

Published
2022
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5. Experience With the Pipeline Embolization Device for Posterior Circulations Aneurysms: A Multicenter Cohort Study

Author

Griessenauer, Christoph J, primary, Enriquez-Marulanda, Alejandro, additional, Taussky, Philipp, additional, Biswas, Arundhati, additional, Grandhi, Ramesh, additional, Xiang, Sissi, additional, Hong, Tao, additional, Rinaldo, Lorenzo, additional, Lanzino, Giuseppe, additional, Brinjikji, Waleed, additional, Burkhardt, Jan-Karl, additional, Kan, Peter, additional, Ghuman, Mandeep, additional, Yang, Victor X D, additional, Chen, Karen, additional, Aziz-Sultan, Mohammad A, additional, Ghorbani, Mohammad, additional, Schirmer, Clemens M, additional, Goren, Oded, additional, Dalal, Shamsher S, additional, Killer-Oberpfalzer, Monika, additional, Müller-Thies-Broussalis, Erasmia, additional, Koch, Matthew J, additional, Stapleton, Christopher J, additional, Patel, Aman B, additional, Foreman, Paul M, additional, Cress, Marshall C, additional, Hirschl, Robert A, additional, Krings, Timo, additional, Zhang, Hongqi, additional, and Dmytriw, Adam A, additional

Published
2021
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7. Experience With the Pipeline Embolization Device for Posterior Circulations Aneurysms: A Multicenter Cohort Study

Author

Griessenauer, Christoph J, primary, Enriquez-Marulanda, Alejandro, additional, Taussky, Philipp, additional, Biswas, Arundhati, additional, Grandhi, Ramesh, additional, Xiang, Sissi, additional, Hong, Tao, additional, Rinaldo, Lorenzo, additional, Lanzino, Giuseppe, additional, Brinjikji, Waleed, additional, Burkhardt, Jan-Karl, additional, Kan, Peter, additional, Ghuman, Mandeep, additional, Yang, Victor X D, additional, Chen, Karen, additional, Aziz-Sultan, Mohammad A, additional, Ghorbani, Mohammad, additional, Schirmer, Clemens M, additional, Goren, Oded, additional, Dalal, Shamsher S, additional, Killer-Oberpfalzer, Monika, additional, Müller-Thies-Broussalis, Erasmia, additional, Koch, Matthew J, additional, Stapleton, Christopher J, additional, Patel, Aman B, additional, Foreman, Paul M, additional, Cress, Marshall C, additional, Hirschl, Robert A, additional, Krings, Timo, additional, Zhang, Hongqi, additional, and Dmytriw, Adam A, additional

Published
2020
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8. Comparison of PED and FRED flow diverters for posterior circulation aneurysms: a propensity score matched cohort study

Author

Griessenauer, Christoph J, primary, Enriquez-Marulanda, Alejandro, additional, Xiang, Sissi, additional, Hong, Tao, additional, Zhang, Hongqi, additional, Taussky, Philipp, additional, Grandhi, Ramesh, additional, Waqas, Muhammad, additional, Tutino, Vincent M, additional, Siddiqui, Adnan H, additional, Levy, Elad I, additional, Ogilvy, Christopher S, additional, Thomas, Ajith J, additional, Ulfert, Christian, additional, Möhlenbruch, Markus A, additional, Renieri, Leonardo, additional, Limbucci, Nicola, additional, Parra-Fariñas, Carmen, additional, Burkhardt, Jan-Karl, additional, Kan, Peter, additional, Rinaldo, Lorenzo, additional, Lanzino, Giuseppe, additional, Brinjikji, Waleed, additional, Spears, Julian, additional, Müller-Thies-Broussalis, Erasmia, additional, Killer-Oberpfalzer, Monika, additional, Islak, Civan, additional, Kocer, Naci, additional, Sonnberger, Michael, additional, Engelhorn, Tobias, additional, Ghuman, Mandeep, additional, Yang, Victor XD, additional, Salehani, Arsalaan, additional, Harrigan, Mark R, additional, Radovanovic, Ivan, additional, Pereira, Vitor M, additional, Krings, Timo, additional, Matouk, Charles C, additional, Chen, Karen, additional, Aziz-Sultan, Mohammad Ali, additional, Ghorbani, Mohammad, additional, Schirmer, Clemens M, additional, Goren, Oded, additional, Dalal, Shamsher S, additional, Koch, Matthew J, additional, Stapleton, Christopher J, additional, Patel, Aman B, additional, Finkenzeller, Thomas, additional, Holtmannspötter, Markus, additional, Buhk, Jan Hendrik, additional, Foreman, Paul Michael, additional, Cress, Marshall, additional, Hirschl, Robert, additional, Reith, Wolfgang, additional, Simgen, Andreas, additional, Janssen, Hendrik, additional, Marotta, Thomas R, additional, and Dmytriw, Adam A, additional

Published
2020
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15. Pharmacy-Mediated Antiplatelet Management Protocol Compared to One-time Platelet Function Testing Prior to Pipeline Embolization of Cerebral Aneurysms: A Propensity Score-Matched Cohort Study

Author

Griessenauer, Christoph J, primary, Jain, Abhi, additional, Enriquez-Marulanda, Alejandro, additional, Gupta, Raghav, additional, Adeeb, Nimer, additional, Moore, Justin M, additional, Grassi, Stacey A, additional, Dalal, Shamsher S, additional, Ogilvy, Christopher S, additional, Thomas, Ajith J, additional, and Schirmer, Clemens M, additional

Published
2018
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16. Comparison of PED and FRED flow diverters for posterior circulation aneurysms: a propensity score matched cohort study

Author

Griessenauer, Christoph J, Enriquez-Marulanda, Alejandro, Xiang, Sissi, Hong, Tao, Zhang, Hongqi, Taussky, Philipp, Grandhi, Ramesh, Waqas, Muhammad, Tutino, Vincent M, Siddiqui, Adnan H, Levy, Elad I, Ogilvy, Christopher S, Thomas, Ajith J, Ulfert, Christian, Mo¨hlenbruch, Markus A, Renieri, Leonardo, Limbucci, Nicola, Parra-Fariñas, Carmen, Burkhardt, Jan-Karl, Kan, Peter, Rinaldo, Lorenzo, Lanzino, Giuseppe, Brinjikji, Waleed, Spears, Julian, Mu¨ller-Thies-Broussalis, Erasmia, Killer-Oberpfalzer, Monika, Islak, Civan, Kocer, Naci, Sonnberger, Michael, Engelhorn, Tobias, Ghuman, Mandeep, Yang, Victor XD, Salehani, Arsalaan, Harrigan, Mark R, Radovanovic, Ivan, Pereira, Vitor M, Krings, Timo, Matouk, Charles C, Chen, Karen, Aziz-Sultan, Mohammad Ali, Ghorbani, Mohammad, Schirmer, Clemens M, Goren, Oded, Dalal, Shamsher S, Koch, Matthew J, Stapleton, Christopher J, Patel, Aman B, Finkenzeller, Thomas, Holtmannspo¨tter, Markus, Buhk, Jan Hendrik, Foreman, Paul Michael, Cress, Marshall, Hirschl, Robert, Reith, Wolfgang, Simgen, Andreas, Janssen, Hendrik, Marotta, Thomas R, and Dmytriw, Adam A

Abstract

BackgroundFlow diversion is a common endovascular treatment for cerebral aneurysms, but studies comparing different types of flow diverters are scarce.ObjectiveTo perform a propensity score matched cohort study comparing the Pipeline Embolization Device (PED) and Flow Redirection Intraluminal Device (FRED) for posterior circulation aneurysms.MethodsConsecutive aneurysms of the posterior circulation treated at 25 neurovascular centers with either PED or FRED were collected. Propensity score matching was used to control for age, duration of follow-up imaging, adjunctive coiling, and aneurysm location, size, and morphology; previously ruptured aneurysms were excluded. The two devices were compared for the following outcomes: procedural complications, aneurysm occlusion, and functional outcome.ResultsA total of 375 aneurysms of the posterior circulation were treated in 369 patients. The PED was used in 285 (77.2%) and FRED in 84 (22.8%) procedures. Aneurysms treated with the PED were more commonly fusiform and larger than those treated with FRED. To account for these important differences, propensity score matching was performed resulting in 33 PED and FRED unruptured aneurysm pairs. No differences were found in occlusion status and neurologic thromboembolic or hemorrhagic complications between the two devices. The proportion of patients with favorable functional outcome was higher with FRED (100% vs 87.9%, p=0.04).ConclusionComparative analysis of PED and FRED for the treatment of unruptured posterior circulation aneurysms did not identify significant differences in aneurysm occlusion or neurologic complications. Variations in functional outcomes warrant additional investigations.

Published
2021
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