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7. 316 Acute Ischemic Stroke Presentation Labs and Imaging Can Be Used to Model Thrombus Proteomic Composition

Author

Akkipeddi, Sajal Medha, primary, Rahmani, Redi, additional, Ellens, Nathaniel R., additional, Kohli, Gurkirat S., additional, Houk, Clifton, additional, Schartz, Derrek, additional, Chittaranjan, Siddharth, additional, Jalal, Muhammad Ibrahim, additional, Haber, Sam Jacob, additional, Bhalla, Tarun, additional, Mattingly, Thomas, additional, Morrell, Craig, additional, and Bender, Matthew T., additional

Published
2024
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8. 699 Immune Activation on Stroke Thrombus Proteome Associated With Failed First Pass Recanalization by Thrombectomy

Author

Akkipeddi, Sajal Medha, primary, Rahmani, Redi, additional, Ellens, Nathaniel R., additional, Kohli, Gurkirat S., additional, Houk, Clifton, additional, Schartz, Derrek, additional, Chittaranjan, Siddharth, additional, Jalal, Muhammad Ibrahim, additional, Worley, Logan, additional, Bhalla, Tarun, additional, Mattingly, Thomas, additional, Morrell, Craig, additional, and Bender, Matthew T., additional

Published
2024
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13. Observation versus intervention for Borden type I intracranial dural arteriovenous fistula: A pooled analysis of 469 patients.

Author

Schartz, Derrek, Rahmani, Redi, Gunturi, Aditya, Kohli, Gurkirat Singh, Akkipeddi, Sajal Medha K, Ellens, Nathaniel R, Romiyo, Prasanth, Kessler, Alex, Bhalla, Tarun, Mattingly, Thomas K, and Bender, Matthew T

Subjects
ARTERIOVENOUS fistula, RANDOM effects model, DEATH rate
Abstract

Background: While it is thought that Borden Type I intracranial dural arteriovenous fistula (dAVF) have a benign clinical course, their management remains controversial. Methods: A comparative meta-analysis was completed to evaluate the outcomes of intervention verses observation of Borden Type I intracranial dAVF. Outcome measures included: grade progression, worsening symptoms, death due to dAVF, permanent complications other than death, functional independence (mRS 0–2), and rate of death combined with permanent complication, were evaluated. Risk differences (RD) were determined using a random effects model. Results: Three comparative studies combined with the authors' institutional experience resulted in a total of 469 patients, with 279 patients who underwent intervention and 190 who were observed. There was no significant difference in dAVF grade progression between the intervention and observation arms, 1.8% vs. 0.7%, respectively (RD: 0.01, 95% CI: −0.02 to 0.04, P = 0.49), or in symptom progression occurring in 31/279 (11.1%) intervention patients and 11/190 (5.8%) observation patients (RD: 0.03, CI: −0.02 to 0.09, P = 0.28). There was also no significant difference in functional independence on follow up. However, there was a significantly higher risk of dAVF related death, permanent complication from either intervention or dAVF related ICH or stroke in the intervention group (11/279, 3.9%) compared to the observation group (0/190, 0%) (RD: 0.04, CI: 0.1 to 0.06, P = 0.007). Conclusion: Intervention of Borden Type I dAVF results in a higher risk of death or permanent complication, which should be strongly considered when deciding on management of these lesions. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Safety and efficacy comparison of embolic agents for middle meningeal artery embolization for chronic subdural hematoma.

Author

Ellens, Nathaniel R., Schartz, Derrek, Kohli, Gurkirat, Rahmani, Redi, Akkipeddi, Sajal Medha K., Mattingly, Thomas K., Bhalla, Tarun, and Bender, Matthew T.

Subjects
*SUBDURAL hematoma, *THERAPEUTIC embolization, *ARTERIES, *POLYVINYL alcohol, *ENDOVASCULAR surgery, *CLINICAL trials
Abstract

Objective: To perform a systematic review and meta-analysis evaluating the efficacy of middle meningeal artery embolization in terms of both clinical and radiographic outcomes, when performed with different embolic agents. Methods: A systematic literature review and meta-analysis was performed to evaluate the impact of embolic agents on outcomes for middle meningeal artery (MMA) embolization. The use of polyvinyl alcohol (PVA) with or without (±) coils, N-butyl cyanoacrylate (n-BCA) ± coils, and Onyx alone were separately evaluated. Primary outcome measures were recurrence, the need for surgical rescue and in-hospital periprocedural complications. Results: Thirty-one studies were identified with a total of 1,134 patients, with 786 receiving PVA, 167 receiving n-BCA, and 181 patients receiving Onyx. There was no difference in the recurrence rate (5.5% for PVA, 4.5% for n-BCA, and 6.5% for Onyx, with P=0.71) or need for surgical rescue (5.0% for PVA, 4.0% for n-BCA, and 6.9% for Onyx, with P=0.89) based on the embolic agent. Procedural complications also did not differ between embolic agents (1.8% for PVA, 3.6% for n-BCA, and 1.6% for Onyx, with P=0.48). Conclusions: Rates of recurrence, need for surgical rescue, and periprocedural complication following MMA embolization are not impacted by the type of embolic agent utilized. Ongoing clinical trials may be used to further investigate these findings. [ABSTRACT FROM AUTHOR]

Published
2024
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17. Decision for tPA Administration, Not Response Time, Contributes Most to Variation in Thrombolysis Times Onboard Mobile Stroke Unit

Author

Akkipeddi, Sajal Medha K., primary, Ellens, Nathaniel R., additional, Schartz, Derrek, additional, Rahmani, Redi, additional, Burgett, Jason L., additional, Proper, Diana, additional, Pilcher, Webster H., additional, Kelly, Adam G., additional, Benesch, Curt G., additional, Cushman, Jeremy T., additional, Mattingly, Thomas K., additional, Bhalla, Tarun, additional, and Bender, Matthew T., additional

Published
2022
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18. Observation versus intervention for Borden type I intracranial dural arteriovenous fistula: A pooled analysis of 469 patients

Author

Schartz, Derrek, primary, Rahmani, Redi, additional, Gunturi, Aditya, additional, Kohli, Gurkirat Singh, additional, Akkipeddi, Sajal Medha K, additional, Ellens, Nathaniel R, additional, Romiyo, Prasanth, additional, Kessler, Alex, additional, Bhalla, Tarun, additional, Mattingly, Thomas K, additional, and Bender, Matthew T, additional

Published
2022
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19. Mobile Stroke Unit Operational Metrics: Institutional Experience, Systematic Review and Meta-Analysis

Author

Ellens, Nathaniel R., primary, Schartz, Derrek, additional, Rahmani, Redi, additional, Akkipeddi, Sajal Medha K., additional, Kelly, Adam G., additional, Benesch, Curtis G., additional, Parker, Stephanie A., additional, Burgett, Jason L., additional, Proper, Diana, additional, Pilcher, Webster H., additional, Mattingly, Thomas K., additional, Grotta, James C., additional, Bhalla, Tarun, additional, and Bender, Matthew T., additional

Published
2022
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20. Abstract TMP28: Decision For Tpa Administration, Not Drive Time, Contributes Most To Variance In Thrombolysis Times Onboard Mobile Stroke Unit

Author

Akkipeddi, Sajal Medha K, primary, Ellens, Nathaniel R, additional, Schartz, Derrek, additional, Rahmani, Redi, additional, Kelly, Adam G, additional, Benesch, Curtis G, additional, Burgett, Jason L, additional, Lesperance, Joshua, additional, Proper, Diana, additional, Mattingly, Thomas K, additional, Pilcher, Webster H, additional, Bhalla, Tarun, additional, and Bender, Matthew T, additional

Published
2022
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21. Abstract WP41: Mobile Stroke Unit Operational Performance: A Retrospective Single Institution Analysis And Meta-Analysis

Author

Ellens, Nathaniel R, primary, Schartz, Derrek, additional, Rahmani, Redi, additional, Akkipeddi, Sajal M, additional, Kelly, Adam G, additional, Benesch, Curtis, additional, Burgett, Jason, additional, Lesperance, Joshua, additional, Proper, Diana, additional, Mattingly, Thomas, additional, Pilcher, Webster, additional, Bhalla, Tarun, additional, and Bender, Matthew, additional

Published
2022
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29. Efficacy of transvenous embolization of CSF-venous fistula in spontaneous intracranial hypotension: Case-series

Author

Ellens, Nathaniel R., Schartz, Derrek, Ismail, Rahim, Kessler, Alex, Ellika, Shehenaz, Akkipeddi, Sajal Medha K., Rahmani, Redi, and Bender, Matthew T.

Abstract

Background Spontaneous intracranial hypotension is a debilitating neurological condition which can be caused by a cerebrospinal fluid-venous fistula. Transvenous embolization is a promising technique to provide minimally invasive yet durable treatment.Methods A retrospective single-center case series was performed on all patients who underwent transvenous embolization of a cerebrospinal fluid (CSF)-venous fistula. Clinical and radiographic parameters, including Bern score, were reported preoperatively and at 3-month follow-up.Results Six patients underwent embolization of a CSF-venous fistula. All fistulae were located in the thoracic spine and technical success was achieved in all cases. Three patients had symptom resolution, two had significant improvement, and one had stable symptoms on follow-up. The mean Bern score was 6.83 (SD = 1.47) preoperatively and 1.83 (SD = 1.64) postoperatively with a mean improvement in Bern score of 5.0 (SD = 1.9, p= 0.0013).Conclusions CSF-venous fistulas are an increasingly recognized clinical entity which may be treated with transvenous embolization. This case series serves to further validate this technique and suggests it can be performed with similar outcomes in lower volume centers.

Published
2024
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30. Histone content, and thus DNA content, is associated with differential in vitrolysis of acute ischemic stroke clots

Author

Akkipeddi, Sajal Medha K., Rahmani, Redi, Ellens, Nathaniel R., Kohli, Gurkirat S., Houk, Clifton, Schartz, Derrek A., Chittaranjan, Siddharth, Worley, Logan, Gunturi, Aditya, Bhalla, Tarun, Mattingly, Thomas K., Welle, Kevin, Morrell, Craig N., and Bender, Matthew T.

Abstract

Fibrin, von Willebrand factor, and extracellular DNA from neutrophil extracellular traps all contribute to acute ischemic stroke thrombus integrity.

Published
2024
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