47 results on '"Khatibi K"'
Search Results
2. E-217 Distal mechanical thrombectomy using beveled tip aspiration zoom 0.035’ microcatheters
- Author
-
Nguyen, V, primary, Dallas, J, additional, Sequeiros Chirinos, J, additional, Graham, S, additional, Burns-Martin, J, additional, Goyal, N, additional, and Khatibi, K, additional
- Published
- 2023
- Full Text
- View/download PDF
Catalog
3. O-046 Robotic diagnostic cerebral angiography: a multicenter experience
- Author
-
Beaman, C, primary, Gautam, A, additional, Peterson, C, additional, Kaneko, N, additional, Ponce, L, additional, Saber, H, additional, Khatibi, K, additional, Narsinh, K, additional, Morales, J, additional, Kimball, D, additional, Lipovac, J, additional, Baker, A, additional, Caton, M, additional, Smith, E, additional, Nour, M, additional, Szeder, V, additional, Jahan, R, additional, Colby, G, additional, Cord, B, additional, Cooke, D, additional, Tateshima, S, additional, Duckwiler, G, additional, and Waldau, B, additional more...
- Published
- 2023
- Full Text
- View/download PDF
4. Solidification and microstructure characterizations of eutectic aluminum‐silicon casting alloy with the addition of tin
- Author
-
Khatibi, K., primary, Asmael, M.B.A., additional, Safaei, B., additional, and Zeeshan, Q., additional
- Published
- 2021
- Full Text
- View/download PDF
5. P-016 Association of cerebral microbleeds and clinical outcomes following endovascular stroke therapy
- Author
-
Saber, H, primary, Saver, J, additional, Szeder, V, additional, Nour, M, additional, Khatibi, K, additional, Ponce Mejia, L, additional, Tateshima, S, additional, Colby, G, additional, Kaneko, N, additional, Jahan, R, additional, Duckwiler, G, additional, and Liebeskind, D, additional more...
- Published
- 2021
- Full Text
- View/download PDF
6. P-024 National trends in endovascular and surgical treatment of idiopathic intracranial hypertension
- Author
-
Saber, H, primary, Jahan, R, additional, Tateshima, S, additional, Colby, G, additional, Kaneko, N, additional, Nour, M, additional, Szeder, V, additional, Khatibi, K, additional, Ponce Mejia, L, additional, Liebeskind, D, additional, and Duckwiler, G, additional more...
- Published
- 2021
- Full Text
- View/download PDF
7. E-029 Rescue intracranial angioplasty with or without stenting in acute ischemic stroke
- Author
-
Khatibi, K, primary, Mowla, A, additional, Saber, H, additional, Ponce Mejia, L, additional, Kaneko, N, additional, Duckwiler, G, additional, and Tateshima, S, additional
- Published
- 2021
- Full Text
- View/download PDF
8. E-039 Clinical characteristics of traumatic brain injury patients undergoing endovascular rescue for post-traumatic vasospasm
- Author
-
Khatibi, K, primary, Ponce Mejia, L, additional, Saber, H, additional, Kenoko, N, additional, Jahan, R, additional, Tateshima, S, additional, Nour, M, additional, Colby, G, additional, Duckwiler, G, additional, and Szeder, V, additional more...
- Published
- 2020
- Full Text
- View/download PDF
9. Interleaved Flow-sensitive Dephasing (iFSD) for Enhanced Blood Flow Suppression and Preserved t1-weighted Contrast and Overall Signals in 3D TSE Imaging
- Author
-
Qingle Kong, PhD, Jiayu Xiao, MD, Junzhou Chen, MSc, Yang Chen, MSc, Khatibi Kasra, PhD, Mack William, PhD, Steven Cen, PhD, E Kim Paul, PhD, and Zhaoyang Fan, PhD
- Subjects
Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2024
- Full Text
- View/download PDF
10. E-175 Effect of intra-arterial verapamil treatment on brain tissue oxygenation in the setting of cerebral vasospasm
- Author
-
Khatibi, K, primary, Szeder, V, additional, Blanco, M Buitrago, additional, Tateshima, S, additional, Jahan, R, additional, Duckwiler, G, additional, and Vespa, P, additional
- Published
- 2018
- Full Text
- View/download PDF
11. O-032 Role of bedside multi-modality monitoring in detection of cerebral vasospasm following subarachnoid hemorrhage
- Author
-
Khatibi, K, primary, Szeder, V, additional, Korbakis, G, additional, Blanco, M Buitrago, additional, Tateshima, S, additional, Jahan, R, additional, Duckwiler, G, additional, and Vespa, P, additional
- Published
- 2017
- Full Text
- View/download PDF
12. E-045 cerebral vascular findings in papa syndrome: cerebral arterial vasculopathy or vasculitis and a posterior cerebral artery dissecting aneurysm
- Author
-
Khatibi, K, primary, Heit, J, additional, Telischak, N, additional, Elbers, J, additional, and Do, H, additional
- Published
- 2015
- Full Text
- View/download PDF
13. Parental consanguinity among parents of neonates with congenital hypothyroidism in Isfahan
- Author
-
Hashemipour, M., Amini, M., Talaie, M., Kelishadi, R., Hovespian, S., Ramin Iranpour, Salek, M., Haghigh, S., and Khatibi, K. H.
14. O-032 Role of bedside multi-modality monitoring in detection of cerebral vasospasm following subarachnoid hemorrhage
- Author
-
Khatibi, K, Szeder, V, Korbakis, G, Blanco, M Buitrago, Tateshima, S, Jahan, R, Duckwiler, G, and Vespa, P
- Abstract
Introduction/PurposeAfter aneurysmal subarachnoid hemorrhage (SAH) patients are at risk for delayed ischemic neurologic deficits (DIND), that is thought to be secondary to vasospasm. DIND is suspected in the setting of depressed arousal or focal neurologic deficits and confirmed radiographically. Implanted brain monitors facilitate the detection of DIND and the assessment of treatment effectiveness when unable to follow neurologic examination. In this study we evaluated the efficacy of (1) continuous brain tissue oxygenation (PBTO2) monitoring, (2) glucose, and (3) lactate to pyruvate ratio (LPR) in detecting local vasospasm when confirmed by digital subtraction angiography (DSA).Materials and methodsThis retrospective observational study that includes 10 patients with high grade SAH, assessed over multiple time points. The extent of angiographic vasospasm for each vessel was subjectively graded by 5 different neuro-interventionalists. The grading then was quantified as 0 (no spasm) to 6 (severe spasm). The intracranial probes were placed at the Kochers point which lies at the watershed area between the anterior cerebral artery (ACA) and middle cerebral artery (MCA) on corresponding side closest focus to the pathology. The extent of vasospasm was estimated by the weighted average of (1 × ACA +2 × MCA+3 × internal carotid artery (ICA))/6. Presence of clinically significant spasm was defined to be equal or greater than 2 (mild spasms). PBTO2, glucose, and LPR measurements were averaged over the 24 hour period prior to each DSA. The bedside measurements from all patients were divided in the two groups with and without spasm and were compared in between patients using a two-tailed non-paired student T-test. ResultsSixteen time intervals were evaluated for PBTO2 and 18 intervals for glucose and LPR. The average PBTO2 during spasm was significantly lower (17.6+/-5.5 versus 23.8+/-3.73, p=0.003). Glucose was non-significantly lower during spasm: 0.6 versus 1.1, p=0.15). LPR was also non-significantly higher in spasm (34.5 versus 28.6, p=0.24). In the subjects with multiple time intervals PbtO2 negatively correlates with degree of vasospasm (r=−0.97±0.05).ConclusionMulti-modality monitoring (MMM) of comatose patients with SAH yields potentially useful but difficult to interpret information in the setting of vasospasm, and clear diagnostic thresholds have yet to be determined. Quantitative comparison of MMM and DSA in the setting of vasospasm would be more reliable with more accurate approach to quantifying cerebral blood flow from angiography.DisclosuresK. Khatibi:None. V. Szeder:None. G. Korbakis:None. M. Buitrago Blanco:None. S. Tateshima:None. R. Jahan:None. G. Duckwiler:None. P. Vespa:None. more...
- Published
- 2017
- Full Text
- View/download PDF
15. Interleaved flow-sensitive dephasing (iFSD): Toward enhanced blood flow suppression and preserved T 1 weighting and overall signals in 3D TSE-based neuroimaging.
- Author
-
Kong Q, Xiao J, Shiroishi MS, Sheikh-Bahaei N, Cen SY, Khatibi K, Mack WJ, Ye JC, Kim PE, Bi X, Saloner D, Yang Q, Chang E, and Fan Z
- Abstract
Purpose: To develop and validate a 3D turbo spin-echo (TSE)-compatible approach to enhancing black-blood (BB) effects while preserving T
1 weighting and overall SNR., Methods: Following the excitation RF pulse, a 180° RF pulse sandwiched by a pair of flow-sensitive dephasing (FSD) gradient pulses in the phase- (y) and partition-encoding (z) directions, respectively, is added. The polarity of FSD gradients in z direction is toggled every TR, achieving an interleaved FSD (iFSD) configuration in y-z plane. The technique was optimized and evaluated in 18 healthy volunteers and 32 patients with neurovascular disease or brain metastases. Comparisons were made among TSE with and without one of BB preparations: iFSD, delay alternating with nutation for tailored excitation, and motion-sensitized driven equilibrium., Results: iFSD-TSE achieved the best blood flow suppression indicated by venous sinus SNR and parenchyma-to-sinus contrast-to-noise ratio (CNR). iFSD-TSE yielded slightly lower white matter SNR (106.6 ± 32.9) and white-to-gray matter CNR (27.3 ± 8.1) compared to TSE (111.4 ± 31.5 and 28.6 ± 8.8), which were significantly higher than those of delay alternating with nutation for tailored excitation-prepared TSE (84.3 ± 25.0 and 16.8 ± 4.8) and motion-sensitized driven equilibrium-prepared TSE (77.3 ± 26.6 and 15.9 ± 5.3). At the neurovascular wall lesions, iFSD-TSE yielded the highest wall-to-lumen CNR among the three sequences with a BB preparation, all of which significantly outperformed TSE. iFSD-TSE effectively suppressed slow-flow artifacts that otherwise mimicked an atherosclerotic lesion or strongly contrast-enhancing vessel wall. In diagnosing brain metastases, iFSD allowed for highest inter-reader agreement (κ 0.75) and shortest reading time., Conclusion: iFSD is a promising approach compatible with 3D TSE for robust blood flow suppression and preserved T1 weighting and overall SNR., (© 2024 The Author(s). Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.) more...- Published
- 2024
- Full Text
- View/download PDF
16. Clinical and radiographic characteristics of traumatic brain injury patients undergoing endovascular rescue for posttraumatic vasospasm.
- Author
-
Khatibi K, Mejia LLP, Saber H, Kaneko N, Tateshima S, Nour M, Colby GP, Jahan R, Buitrago-Blanco M, Vespa P, Duckwiler G, and Szeder V
- Abstract
Background: Cerebral vasospasm is a serious sequela of traumatic brain injury (TBI) which leads to further neurologic injury subsequent to the initial trauma. The natural history and associated risk factors are not well understood. The objective of this study is to evaluate the clinical and radiographic characteristics of patients with TBI., Methods: This is a descriptive case series of all patients with TBI who underwent cerebral angiogram for evaluation and rescue therapy for posttraumatic arterial vasospasm (PTV) between October 2017 and November 2019. The association of clinical and radiographic characteristics with cumulative severity of angiographic vasospasm was evaluated. The clinical characteristics comprised of age, sex, Glascow Coma Scale (GCS) and need for surgery. The radiographic characteristics were presence of subarachnoid hemorrhage (SAH), location of SAH, presence of contusion, presence of subdural hemorrhage (SDH), and presence of pseudoaneurysm., Results: Twenty-two patients with PTV were identified requiring 69 cerebral angiograms (mean: 3.2; range: 1-9 angiograms per patient) during this period. The average age upon presentation was 40 years old, 81% of the patients were male sex, and the average GCS was 6.8. 67% of the patients underwent craniotomy or craniectomy. All patients had SAH, although only 60% had cisternal SAH. Parenchymal contusion was noted on 90% as well as SDH in 90%. The PTV was noted between 3 and 19 days after trauma. There was more vasospasm involving proximal arteries and higher severity of vasospasm in patients with cisternal SAH. Otherwise, there was no strong association between the clinical or radiographic characteristics and cumulative severity noted on the angiograms for each patient., Conclusion: Posttraumatic vasospasm can be detected as early as posttrauma day 3-19 in patients with TBI and SAH. The absence of cisternal SAH does not rule out the occurrence of the vasospasm during the course of treatment., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Brain Circulation.) more...
- Published
- 2024
- Full Text
- View/download PDF
17. Robotic Diagnostic Cerebral Angiography: A Multicenter Experience of 113 Patients.
- Author
-
Beaman C, Gautam A, Peterson C, Kaneko N, Ponce L, Saber H, Khatibi K, Morales J, Kimball D, Lipovac JR, Narsinh KH, Baker A, Caton MT, Smith ER, Nour M, Szeder V, Jahan R, Colby GP, Cord BJ, Cooke DL, Tateshima S, Duckwiler G, and Waldau B more...
- Subjects
- Humans, Male, Retrospective Studies, Middle Aged, Female, Aged, Adult, Robotics methods, Cerebral Angiography methods, Cerebral Angiography adverse effects
- Abstract
Background: Neurointerventional robotic systems have potential to reduce occupational radiation, improve procedural precision, and allow for future remote teleoperation. A limited number of single institution case reports and series have been published outlining the safety and feasibility of robot-assisted diagnostic cerebral angiography., Methods: This is a multicenter, retrospective case series of patients undergoing diagnostic cerebral angiography at three separate institutions - University of California, Davis (UCD); University of California, Los Angeles (UCLA); and University of California, San Francisco (UCSF). The equipment used was the CorPath GRX Robotic System (Corindus, Waltham, MA)., Results: A total of 113 cases were analyzed who underwent robot-assisted diagnostic cerebral angiography from September 28, 2020 to October 27, 2022. There were no significant complications related to use of the robotic system including stroke, arterial dissection, bleeding, or pseudoaneurysm formation at the access site. Using the robotic system, 88 of 113 (77.9%) cases were completed successfully without unplanned manual conversion. The principal causes for unplanned manual conversion included challenging anatomy, technical difficulty with the bedside robotic cassette, and hubbing out of the robotic system due to limited working length. For robotic operation, average fluoroscopy time was 13.2 min (interquartile range (IQR), 9.3 to 16.8 min) and average cumulative air kerma was 975.8 mGY (IQR, 350.8 to 1073.5 mGy)., Conclusions: Robotic cerebral angiography with the CorPath GRX Robotic System is safe and easily learned by novice users without much prior manual experience. However, there are technical limitations such as a short working length and an inability to support 0.035" wires which may limit its widespread adoption in clinical practice., Competing Interests: Competing interests: ST previously consulted for Corindus Vascular Robotics in 2018 and 2019 but currently has no relationship or stock options with the company. BW was a consultant for Siemens/Corindus in 2020 but currently has no relationship or stock options with the company., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.) more...
- Published
- 2024
- Full Text
- View/download PDF
18. Distal mechanical thrombectomy using beveled tip aspiration zoom catheters: A preliminary study.
- Author
-
Dallas J, Nguyen VN, Sequeiros JM, Graham S, Burns-Martin J, Goyal N, and Khatibi K
- Abstract
Introduction: Distal medium vessel occlusion (DVO) thrombectomy has been shown to be efficacious with safety profiles comparable to large vessel occlusion (LVO) thrombectomy. A novel, highly-trackable, bevel-tipped Zoom 35 catheter can be used as an aspiration catheter for DVO thrombectomy., Methods: This is a retrospective, single-arm, multi-institutional observational study evaluating the efficacy and safety of aspiration thrombectomy for DVO using the Zoom 35 catheter. Patient demographics, presenting and discharge NIHSS, primary and rescue thrombectomy, site of occlusion, TICI score, and intracranial hemorrhage were chart abstracted. Descriptive statistics were used to evaluate the efficacy and safety of thrombectomy., Results: Fourteen patients (mean age 66.64 ± 13.75 years) were included. The mean NIHSS at presentation was 10.79 ± 5.48, and the mean ASPECTS was 9.00 ± 0.89. Nine patients (64.3%) received tPA. Primary occlusion location was M3 in nine cases (64.3%), M2/M3 junction in two cases (14.3%), A2 in one case (7.1%), A3 in one case (7.1%), and P1 in one case (7.1%). TICI scores were 3 in seven cases (50.0%), 2C in three cases (21.4%), and 2B in four cases (28.6%). There was one postoperative SAH (7.1%) and one asymptomatic ICH (7.1%). Mean discharge NIHSS was 3.38 ± 4.44, with a mean decrease of 7.31 from presentation (p < 0.0001, t-test)., Conclusion: Zoom 35 beveled-tip aspiration microcatheters are highly trackable and associated with improved radiographic and clinical outcomes for the treatment of DVO with a good safety profile., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. more...
- Published
- 2024
- Full Text
- View/download PDF
19. Prevalence of gender-based violence and factors associated with help-seeking among university students in sub-Saharan Africa.
- Author
-
Owusu-Antwi R, Fedina L, Robba MJB, Khatibi K, Bosomtwe D, Nsereko E, Shadare O, Compton S, Akinyemi A, Randa MB, Afolabi AA, and Munro-Kramer ML
- Subjects
- Humans, Female, Universities, Male, Cross-Sectional Studies, Africa South of the Sahara epidemiology, Prevalence, Young Adult, Adult, Adolescent, Surveys and Questionnaires, Sex Offenses statistics & numerical data, Students statistics & numerical data, Students psychology, Help-Seeking Behavior, Gender-Based Violence statistics & numerical data, Crime Victims statistics & numerical data, Crime Victims psychology
- Abstract
Background: Gender-based violence (GBV) is a global public health problem. While research exists on GBV and associated help-seeking behaviors among university students, few studies have assessed the prevalence of GBV, including experiences and barriers to help-seeking, within sub-Saharan African university settings., Objectives: The objective of this study was to examine the prevalence of GBV victimization among university students in six sub-Saharan African countries and describe experiences of formal and informal help-seeking among students who self-identified as victims of GBV since attending university., Design: An online, cross-sectional survey study was administered to university students from July to October 2023 at nine participating universities in sub-Saharan Africa., Methods: Descriptive statistics were used to describe types of violence experienced among students ( N = 2249). Bivariate analyses ( t -tests, chi-square) and multivariate logistic regressions were used to examine demographic factors associated with formal and informal help-seeking behavior among a sub-sample of GBV victims ( n = 298)., Results: Among the 2249 sample of students, the prevalence of physical violence was 30.9%, 18.7% for sexual violence, 64.9% for psychological violence, and 63.7% for stalking. Among a sub-sample of GBV victims ( n = 298), most (78.2%) sought informal help from friends, partners, or family members and less than one-third (29.5%) sought help from formal sources (e.g., university administrators, police). Logistic regression results indicated that university country was associated with formal help-seeking; that is, students in Ghana and Rwanda were over twice as likely to seek formal help than students in Nigeria (odds ratio (OR) = 2.58, 95% confidence interval (CI): 1.38-4.85, p < 0.01; OR = 2.62, 95% CI: 1.20-5.71, p < 0.05, respectively). While differences by gender were noted in formal help-seeking behavior at the bivariate level, gender was not associated with formal help-seeking after adjusting for GBV training and other demographics., Conclusion: GBV is a significant public health issue among university students in sub-Saharan Africa. University policies and prevention programs are needed to reduce GBV and increase the capacity of formal sources to effectively respond to GBV. more...
- Published
- 2024
- Full Text
- View/download PDF
20. Rescue Intracranial Balloon Angioplasty with or without Stent Placement in Acute Strokes with Intracranial Atherosclerotic Disease.
- Author
-
Mowla A, Khatibi K, Razavi SM, Kaneko N, Ponce Mejia LL, Saber H, and Tateshima S
- Subjects
- Humans, Retrospective Studies, Treatment Outcome, Angioplasty methods, Thrombectomy methods, Stents, Ischemic Stroke etiology, Stroke complications, Stroke surgery, Angioplasty, Balloon, Intracranial Arteriosclerosis complications, Intracranial Arteriosclerosis surgery
- Abstract
Background: Optimal management of acute ischemic stroke (AIS) secondary to intracranial atherosclerotic disease (ICAD) refractory to conventional mechanical thrombectomy remains unclear. We aimed to investigate the clinical outcome of patients undergoing rescue intracranial balloon angioplasty with or without stent placement in the setting of AIS in our institution., Methods: This is a retrospective single-arm observational study to evaluate the efficacy and safety of rescue balloon angioplasty with or without stent placement in emergent large vessel occlusion (EVLO) strokes with underlying ICAD. We included all patients undergoing such rescue intervention within 24 hours of AIS presentation with EVLO between 2017 and 2021. We further evaluated stent or vessel reocclusion., Results: Of 20 patients undergoing rescue intervention, 3 cases achieved adequate recanalization of artery using balloon angioplasty alone. Seventeen patients required stent placement. Fourteen (70%) procedures resulted in National Institutes of Health Stroke Scale improvement in postprocedure and upon discharge. Among 6 (30%) procedures with worsening neurological measures, 3 had reoccluded stent 24-48 hours after procedure, 2 had symptomatic hemorrhagic conversion, and 1 had perforator occlusion. Nine patients (45%) had favorable functional outcome (modified Rankin Scale ≤2) at discharge, unchanged or improved at 3-month follow-up. The median modified Rankin Scale score was 4 (Interquartile range: 1.75-4) at discharge, improving to 3 (Interquartile range: 0-4) at 3-month follow-up. Two patients (10%) died during hospital stay., Conclusions: Rescue angioplasty with or without stenting can lead to significant clinical improvement in patients with ICAD presenting with ELVO and refractory to thrombectomy; however, this procedure is associated with a high rate of morbidity in acute setting., (Copyright © 2023 Elsevier Inc. All rights reserved.) more...
- Published
- 2023
- Full Text
- View/download PDF
21. Aneurysmal subarachnoid hemorrhage in pregnancy: National trends of treatment, predictors, and outcomes.
- Author
-
Khatibi K, Saber H, Patel S, Mejia LLP, Kaneko N, Szeder V, Nour M, Jahan R, Tateshima S, Colby G, Duckwiler G, and Afshar Y
- Subjects
- Infant, Newborn, Humans, Female, Pregnancy, Treatment Outcome, Cohort Studies, Hospitalization, Retrospective Studies, Subarachnoid Hemorrhage epidemiology, Subarachnoid Hemorrhage therapy, Subarachnoid Hemorrhage complications, Aneurysm, Ruptured complications, Intracranial Aneurysm epidemiology, Intracranial Aneurysm therapy, Intracranial Aneurysm complications
- Abstract
Introduction: Aneurysmal subarachnoid hemorrhage (aSAH) is a rare event associated with significant pregnancy-associated maternal and neonatal morbidity and mortality. The optimal treatment strategy and clinical outcome of aSAH in pregnancy remains unclear. We aimed to investigate the treatment utilizations and outcomes of aSAH in pregnant people., Methods: Using the 2010-2018 National Inpatient Sample, we identified all birth hospitalizations of women between ages of 18 to 45 associated with subarachnoid hemorrhage and aneurysm treatment were included. Multivariate analyses were used to evaluate the effect of pregnancy state, mode of treatment of aneurysms, severity of subarachnoid hemorrhage on mortality and discharge destination of this cohort. Trends in mode of treatment utilized for aneurysmal treatment in this time interval was evaluated., Results: 13,351 aSAH with treatment were identified, of which 440 were associated with pregnancy. There was no significant difference in mortality or rate of discharge to home in pregnancy related hospitalization. Worse aSAH severity, chronic hypertension, and smaller hospital size was associated with significantly higher rate of mortality from aSAH during pregnancy. Worse aSAH severity was associated with lower rate of discharge to home. Like the non-pregnant cohort, the treatment of ruptured aneurysms in pregnancy are increasingly through endovascular approaches. The mode of treatment does not change the mortality or discharge destination., Conclusions: Pregnancy does not alter mortality or the discharge destination for aSAH. Ruptured aneurysms during pregnancy are increasingly treated endovascularly. Mode of aneurysm treatment does not affect mortality or discharge destination in pregnancy., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Khatibi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) more...
- Published
- 2023
- Full Text
- View/download PDF
22. Endovascular Treatment of Large Vessel Occlusion Strokes Caused by Infective Endocarditis: A Systematic Review, Meta-Analysis, and Case Presentation.
- Author
-
Mowla A, Abdollahifard S, Sizdahkhani S, Taherifard E, Kheshti F, and Khatibi K
- Abstract
Thromboembolic events such as acute ischemic strokes are frequently seen in patients with infective endocarditis (IE). It is generally recommended that the administration of intravenous thrombolytics is avoided in these patients as they might encounter a higher risk of intracranial hemorrhages. In this setting, particularly with a large vessel occlusion (LVO), a mechanical thrombectomy may be an alternative option. In this systematic review and meta-analysis, we aimed to investigate the outcomes and safety of mechanical thrombectomies for LVO stroke patients secondary to IE. A search strategy was developed and we searched PubMed, Scopus, Web of Sciences, and Embase using the words "infective endocarditis", "stroke", and "mechanical thrombectomy". Including 6 studies and 120 patients overall, this study showed that a mechanical thrombectomy might reduce the National Institute of Health Stroke Scale (NIHSS), with a weighted mean difference of -3.06 and a 95% CI of -4.43 to -1.70. The pooled rate of symptomatic intracranial hemorrhages and all-cause mortality were also determined to be 15% (95% CI: 4-47%) and 34% (95% CI:14-61%), respectively. The results of this study showed that a mechanical thrombectomy might be an effective and reasonably safe option for the treatment of LVO strokes caused by IE. However, more large-scale studies are needed to consolidate these results. more...
- Published
- 2022
- Full Text
- View/download PDF
23. Reconstruction of carotid stenosis hemodynamics based on guidewire pressure data and computational modeling.
- Author
-
Dinh H, Vinuela F, Szeder V, Khatibi K, Mejia LP, and Chien A
- Subjects
- Blood Flow Velocity, Computer Simulation, Constriction, Pathologic, Hemodynamics, Humans, Hydrodynamics, Models, Cardiovascular, Stress, Mechanical, Carotid Stenosis
- Abstract
A comparative analysis between intravascular guidewire-obtained and computational fluid dynamic (CFD) flow velocity and pressure data using simplified carotid stenosis models was performed. This information was used to evaluate the viability of using guidewire pressure data to provide inlet conditions for CFD flow, and to study the relationship between stenotic length and hemodynamic behavior. Carotid stenosis models differing in diameter and length were prepared and connected to a vascular pulsatile flow simulator. Time-dependent flow velocity and pressure measurements were taken by microcatheter guidewires and compared with CFD data. Guidewire and CFD-generated pressure profiles matched closely in all measurement locations. The guidewire was unable to reliably measure flow velocity at areas associated with higher CFD flow velocities (r = 0.92). CFD results showed that an increased length of stenosis generated expansive regions of elevated wall shear stress (WSS) within and distal to the stenosis. Low WSS was found immediately outside the stenosis outlet. An increase in stenotic length produced higher flow velocities with minimal lengthening of the distal high velocity flow jet due to faster dissipation of translational kinetic energy through turbulence. We found the accuracy of guidewire-obtained velocity measurements is limited to regions unaffected by disturbed flow. WSS and turbulence behavior distal to the stenosis may be important markers to evaluate the severity of atherosclerotic progression as a function of stenotic length., (© 2022. International Federation for Medical and Biological Engineering.) more...
- Published
- 2022
- Full Text
- View/download PDF
24. Endovascular biopsy of a sigmoid sinus lesion using a stent retriever and aspiration catheter.
- Author
-
Khatibi K, Saber H, Javahery R, Kaneko N, Ponce Mejia LL, and Tateshima S
- Subjects
- Adolescent, Biopsy, Catheters, Humans, Stents, Treatment Outcome, Cranial Sinuses diagnostic imaging, Cranial Sinuses surgery, Thrombectomy
- Abstract
A teenager with a history of acute myeloid leukemia presented with headache, nausea and blurry vision over a 2 week period. The MRI of the brain was concerning for the presence of a myeloid sarcoma within the right sigmoid sinus. For evaluation of venous obstruction and the underlying lesion the patient underwent a cerebral angiogram and transvenous biopsy of the sigmoid sinus lesion using a stent retriever and aspiration catheter. The tissue extracted was consistent with myeloid sarcoma. This pathologic finding was consistent with the recurrence of leukemia and guided the targeted oncologic treatment., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.) more...
- Published
- 2022
- Full Text
- View/download PDF
25. A new aspiration device equipped with a hydro-separator for acute ischemic stroke due to challenging soft and stiff clots.
- Author
-
Kaneko N, Ghovvati M, Komuro Y, Guo L, Khatibi K, Ponce Mejia LL, Saber H, Annabi N, and Tateshima S
- Subjects
- Humans, Stents, Thrombectomy methods, Treatment Outcome, Brain Ischemia surgery, Ischemic Stroke, Stroke surgery, Thrombosis surgery
- Abstract
Objective: Fragile soft clots and stiff clots remain challenging in the treatment of acute ischemic stroke. This study aims to investigate the impact of clot stiffness on the efficacy of thrombectomy devices and a new aspiration catheter with a hydro-separator., Methods: The Neurostar aspiration catheter has a novel hydro-separator technology that macerates clots by a stream of saline inside the catheter. The Neurostar catheter and two commercially available devices, the SOFIA aspiration catheter and Solitaire stent retriever, were tested in this study. We evaluated the efficacy of each device on clots with various stiffness in a simple in vitro model. We also assessed single-pass recanalization performance in challenging situations with large erythrocyte-rich clots and fibrin-rich clots in a realistic vascular model., Results: We observed an inverse association between the clot stiffness and recanalization rates. The aspiration catheter, SOFIA ingested soft clots but not moderately stiff clots. When removing soft clots with the stent retriever, fragmentation was observed, although relatively stiff clots were well-integrated and removed. The Neurostar ingested soft clots similar to the aspiration catheter, and also aspirated stiff clots by continuous suction with hydro-separator. In the experiments with challenging clots, the Neurostar led to significantly higher recanalization rates than the stent retriever and aspiration catheter., Conclusions: The stiffness of the clots affected the efficacy of endovascular thrombectomy based on the type of device. The Neurostar catheter with hydro-separator resulted in better success rates than a commercially available aspiration catheter and stent retriever in this experimental model. more...
- Published
- 2022
- Full Text
- View/download PDF
26. Prevalence, Predictors, and Outcomes of Prolonged Mechanical Ventilation After Endovascular Stroke Therapy.
- Author
-
Saber H, Palla M, Kazemlou S, Navi BB, Yoo AJ, Simonsen CZ, Sandio A, Rajah G, Khatibi K, Liebeskind DS, and Sheth SA
- Subjects
- Humans, Prevalence, Respiration, Artificial, Thrombectomy, Treatment Outcome, Brain Ischemia epidemiology, Brain Ischemia therapy, Endovascular Procedures, Stroke epidemiology, Stroke therapy
- Abstract
Background: To investigate the rates, predictors, and outcomes of prolonged mechanical ventilation (≥ 96 h) following endovascular treatment (EVT) of ischemic stroke., Methods: Hospitalizations with acute ischemic stroke and EVT were identified using validated codes in the National Inpatient Sample (2010-2015). The primary outcome was prolonged mechanical ventilation defined as ventilation ≥ 96 consecutive hours. We compared hospitalizations involving prolonged ventilation following EVT with those that did not involve prolonged ventilation. Propensity score matching was used to adjust for differences between groups. Clinical predictors of prolonged ventilation were assessed using multivariable conditional logistic regression analyses., Results: Among the 34,184 hospitalizations with EVT, 5087 (14.9%) required prolonged mechanical ventilation. There was a decline in overall intubation and prolonged ventilation during the study period. On multivariable analysis, history of heart failure [OR 1.28 (95% CI 1.05-1.57)] and diabetes [OR 1.22 (95% CI 1-1.50)] was independent predictors of prolonged ventilation following EVT. In a sensitivity analysis of anterior circulation stroke only, heart failure [OR 1.3 (95% CI 1.10-1.61)], diabetes [OR 1.25 (95% CI 1.01-1.57)], and chronic lung disease [OR 1.31 (95% CI 1.03-1.66)] were independent predictors of prolonged ventilation. The weighted proportions of in-hospital mortality, post-procedural shock, acute renal failure, and intracerebral hemorrhage were higher in the prolonged ventilation group., Conclusions: Among a nationally representative sample of hospitalizations, nearly one-in-six patients had prolonged mechanical ventilation after EVT. Heart failure and diabetes were significantly associated with prolonged mechanical ventilation following EVT. Prolonged ventilation was associated with significant increase in in-hospital mortality and morbidity. more...
- Published
- 2021
- Full Text
- View/download PDF
27. Pathophysiologic mechanisms of cerebral endotheliopathy and stroke due to Sars-CoV-2.
- Author
-
Kakarla V, Kaneko N, Nour M, Khatibi K, Elahi F, Liebeskind DS, and Hinman JD
- Subjects
- Angiotensin-Converting Enzyme 2 metabolism, Blood-Brain Barrier metabolism, COVID-19 complications, COVID-19 virology, Cerebrovascular Disorders metabolism, Complement Activation, Humans, Proto-Oncogene Mas, Renin-Angiotensin System, Spike Glycoprotein, Coronavirus metabolism, Stroke metabolism, Virus Internalization, COVID-19 pathology, Cerebrovascular Disorders etiology, Stroke etiology
- Abstract
Cerebrovascular events have emerged as a central feature of the clinical syndrome associated with Sars-CoV-2 infection. This increase in infection-related strokes is marked by atypical presentations including stroke in younger patients and a high rate of hemorrhagic transformation after ischemia. A variety of pathogenic mechanisms may underlie this connection. Efforts to identify synergism in the pathophysiology underlying stroke and Sars-CoV-2 infection can inform the understanding of both conditions in novel ways. In this review, the molecular cascades connected to Sars-CoV-2 infection are placed in the context of the cerebral vasculature and in relationship to pathways known to be associated with stroke. Cytokine-mediated promotion of systemic hypercoagulability is suggested while direct Sars-CoV-2 infection of cerebral endothelial cells may also contribute. Endotheliopathy resulting from direct Sars-CoV-2 infection of the cerebral vasculature can modulate ACE2/AT
1 R/MasR signaling pathways, trigger direct viral activation of the complement cascade, and activate feed-forward cytokine cascades that impact the blood-brain barrier. All of these pathways are already implicated as independent mechanisms driving stroke and cerebrovascular injury irrespective of Sars-CoV-2. Recognizing the overlap of molecular pathways triggered by Sars-CoV-2 infection with those implicated in the pathogenesis of stroke provides an opportunity to identify future therapeutics targeting both Sars-CoV-2 and stroke thereby reducing the impact of the global pandemic. more...- Published
- 2021
- Full Text
- View/download PDF
28. Determinants of accuracy of freehand external ventricular drain placement by neurosurgical trainees.
- Author
-
Pishjoo M, Khatibi K, Etemadrezaie H, Zabihyan S, Ganjeifar B, Safdari M, and Baharvahdat H
- Subjects
- Adult, Catheters standards, Female, Humans, Male, Middle Aged, Neurosurgeons education, Postoperative Complications epidemiology, Trephining adverse effects, Ventriculostomy adverse effects, Trephining education, Ventriculostomy education
- Abstract
Background: The external ventricular drain (EVD) placement is one of the most common neurosurgical procedures. This operation is performed by freehand technique in the majority of cases; therefore, the operator's experience plays an important role in success and possible morbidity of this procedure., Objective: To evaluate the accuracy and safety of EVD placement by junior neurosurgery residents and factors predicting accuracy of EVD placement., Methods: This is a prospective cohort study conducted at our academic medical center, between September 2017 and August 2018. All patients 18 years or older who required EVD placement were included. The accuracy and complications of EVD placement were assessed in the first and second year resident cohorts as well as by their level of experience, using descriptive statistics. Univariate and multivariate models were used to assess predictive factors for optimal EVD., Results: A total of 100 EVDs were placed in 100 patients during the study period. According to Kakarla classification, the catheter was optimally placed in 80% of cases. The first year residents had a significantly higher rate of suboptimal burr hole placement compared to the second year residents (66.7% versus 27.1%, p = 0.004). The trainees with less than 10 EVD placement experience also had a significantly higher rate of suboptimal burr hole placement (55.2% vs. 23.9%, p = 0.003), significantly longer duration of operation (43.1 min ± 14.9SD vs 34.2 min ± 9.6 p = 0.005), and significantly lower rate of optimal EVD location (85.9% versus 65.5%, p = 0.023). Optimal location of the burr hole was the only significant predictor of optimal EVD placement in multivariate analysis (OR 11.9, 95% CI 3.2-44.6, p < 0.001)., Conclusions: Neurosurgery residents experience and optimal burr hole placement are the main predicators of accurate EVD placement. more...
- Published
- 2021
- Full Text
- View/download PDF
29. Os secours.
- Author
-
Bindschaedler C, Chammartin N, Gosetto M, Khatibi K, Nemeth A, Poncet C, Volery M, Carnesecchi S, and Perrin J
- Subjects
- Humans, Bone Neoplasms, Bone and Bones
- Published
- 2020
30. Reperfusion Therapy Frequency and Outcomes in Mild Ischemic Stroke in the United States.
- Author
-
Saber H, Khatibi K, Szeder V, Tateshima S, Colby GP, Nour M, Jahan R, Duckwiler G, Liebeskind DS, and Saver JL
- Subjects
- Age Factors, Aged, Aged, 80 and over, Comorbidity, Diabetes Mellitus epidemiology, Emergency Service, Hospital, Endovascular Procedures statistics & numerical data, Ethnicity statistics & numerical data, Female, Health Facility Size, Hospitalization, Hospitals, Rural, Hospitals, Teaching, Hospitals, Urban, Humans, Ischemic Stroke epidemiology, Ischemic Stroke physiopathology, Male, Middle Aged, Patient Discharge statistics & numerical data, Patient Transfer, Recovery of Function, Renal Insufficiency, Chronic epidemiology, Reperfusion statistics & numerical data, Retrospective Studies, Severity of Illness Index, Treatment Outcome, United States, Hospital Mortality, Hospitals statistics & numerical data, Ischemic Stroke therapy, Thrombectomy statistics & numerical data, Thrombolytic Therapy statistics & numerical data
- Abstract
Background and Purpose: More than half of patients with acute ischemic stroke have minor neurological deficits; however, the frequency and outcomes of reperfusion therapy in regular practice has not been well-delineated., Methods: Analysis of US National Inpatient Sample of hospitalizations with acute ischemic stroke and mild deficits (National Institutes of Health Stroke Scale [NIHSS] score 0-5) from October 1, 2016, to December 31, 2017. Patient- and hospital-level characteristics associated with use and outcome of reperfusion therapies were analyzed. Primary outcomes included excellent discharge disposition (discharge to home without assistance); poor discharge disposition (discharge to facility or death); in-hospital mortality; and radiological intracranial hemorrhage., Results: Among 179 710 acute ischemic stroke admissions with recorded NIHSS during the 15-month study period, 103 765 (57.7%) had mild strokes (47.3% women; median age, 69 [interquartile range, 59-79] years; median NIHSS score of 2 [interquartile range, 1-4]). Considering reperfusion therapies among strokes with documented NIHSS, mild deficit hospitalizations accounted for 40.0% of IVT and 10.7% of mechanical thrombectomy procedures. Characteristics associated with IVT and with mechanical thrombectomy utilization were younger age, absence of diabetes, higher NIHSS score, larger/teaching hospital status, and Western US region. Excellent discharge outcome occurred in 48.2% of all mild strokes, and in multivariable analysis, was associated with younger age, male sex, White race, lower NIHSS score, absence of diabetes, heart failure, and kidney disease, and IVT use. IVT was associated with increased likelihood of excellent outcome (odds ratio, 1.90 [95% CI, 1.71-2.13], P <0.001) despite an increased risk of intracranial hemorrhage (odds ratio, 1.41 [95% CI, 1.09-1.83], P <0.001)., Conclusions: In national US practice, more than one-half of acute ischemic stroke hospitalizations had mild deficits, accounting for 4 of every 10 IVT and 1 of every 10 mechanical thrombectomy treatments, and IVT use was associated with increased discharge to home despite increased intracranial hemorrhage. more...
- Published
- 2020
- Full Text
- View/download PDF
31. Targeted Radiation Therapy Can Treat Myxomatous Cerebral Aneurysms.
- Author
-
Khatibi K, Ponce Mejia LL, Kaneko N, Ooi Y, Kaprealian T, Gonzalez NR, Pouratian N, and Szeder V
- Subjects
- Aged, Angiography, Digital Subtraction, Cerebral Angiography, Female, Humans, Ischemic Attack, Transient etiology, Radiation Dosage, Treatment Outcome, Heart Neoplasms complications, Intracranial Aneurysm etiology, Intracranial Aneurysm radiotherapy, Myxoma complications, Radiotherapy methods
- Abstract
Background: Neoplastic cerebral aneurysms are rare presentations of cardiac myxomas. The natural history of such aneurysms is not well understood, and the optimal treatment strategy remains unclear. Clipping and coiling are effective, although can carry significant morbidity. Chemotherapy and radiation can theoretically be effective, although their clinical efficacy remains to be proven., Case Description: Here we describe a patient with cardiac myxoma presenting with multiple progressively fusiform aneurysms. These aneurysms were noted to be growing during conservative monitoring given the eloquent location. Subsequently, the patient underwent multiple sessions of targeted radiation therapy, which lead to obliteration, shrinkage, or halting in growth of these aneurysms., Conclusions: Low-dose targeted radiation therapy can be safe and effective in treatment of neoplastic myxomatous aneurysms., (Copyright © 2020 Elsevier Inc. All rights reserved.) more...
- Published
- 2020
- Full Text
- View/download PDF
32. COVID-19-Related Acute Ischemic Stroke in Young Adults: What Is the Optimal Antithrombotic Regimen for Secondary Prevention?
- Author
-
Vahabizad F, Sharifian Dorche M, Mohammadi P, Khatibi K, and Mowla A
- Abstract
Competing Interests: The authors declare that they have no relevant conflict of interest to report.
- Published
- 2020
- Full Text
- View/download PDF
33. In Vitro Modeling of Human Brain Arteriovenous Malformation for Endovascular Simulation and Flow Analysis.
- Author
-
Kaneko N, Ullman H, Ali F, Berg P, Ooi YC, Tateshima S, Colby GP, Komuro Y, Hu P, Khatibi K, Ponce Mejia LL, Szeder V, Nour M, Guo L, Chien A, Vinuela F, Nemoto S, Mashiko T, Sehara Y, Hinman JD, Duckwiler G, and Jahan R more...
- Subjects
- Cerebral Angiography, Hemodynamics, Humans, Hydrodynamics, Imaging, Three-Dimensional, Printing, Three-Dimensional, Embolization, Therapeutic methods, Endovascular Procedures methods, Intracranial Arteriovenous Malformations physiopathology, Intracranial Arteriovenous Malformations surgery, Models, Neurological
- Abstract
Background: Current in vitro models for human brain arteriovenous malformation (AVM) analyzing the efficacy of embolic materials or flow conditions are limited by a lack of realistic anatomic features of complex AVM nidus. The purpose of this study was to evaluate a newly developed in vitro AVM model for embolic material testing, preclinical training, and flow analysis., Methods: Three-dimensional (3D) images of the AVM nidus were extracted from 3D rotational angiography from a patient. Inner vascular mold was printed using a 3D printer, coated with polydimethylsiloxanes, and then was removed by acetone, leaving a hollow AVM model. Injections of liquid embolic material and 4-dimensional (4D) flow magnetic resonance imaging (MRI) were performed using the AVM models. Additionally, computational fluid dynamics analysis was performed to examine the flow volume rate as compared with 4D flow MRI., Results: The manufacture of 3D in vitro AVM models delivers a realistic representation of human nidus vasculature and complexity derived from patients. The injection of liquid embolic agents performed in the in vitro model successfully replicated real-life treatment conditions. The model simulated the plug and push technique before penetration of the liquid embolic material into the AVM nidus. The 4D flow MRI results were comparable to computational fluid dynamics analysis., Conclusions: An in vitro human brain AVM model with realistic geometric complexities of nidus was successfully created using 3D printing technology. This AVM model offers a useful tool for training of embolization techniques and analysis of hemodynamics analysis, and development of new devices and materials., (Copyright © 2020 Elsevier Inc. All rights reserved.) more...
- Published
- 2020
- Full Text
- View/download PDF
34. Increased Rate of Successful First Passage Recanalization During Mechanical Thrombectomy for M2 Occlusion.
- Author
-
Baharvahdat H, Ooi YC, Khatibi K, Ponce Mejia LL, Kaneko N, Nour M, Szeder V, Jahan R, Tateshima S, Vinuela F, Duckwiler G, and Colby G
- Subjects
- Humans, Infarction, Middle Cerebral Artery pathology, Postoperative Complications epidemiology, Retrospective Studies, Subarachnoid Hemorrhage epidemiology, Subarachnoid Hemorrhage etiology, Thrombectomy adverse effects, Treatment Outcome, Infarction, Middle Cerebral Artery surgery, Thrombectomy methods
- Abstract
Background: Mechanical thrombectomy (MT) is the standard of care for the treatment of acute ischemic stroke (AIS) caused by anterior circulation large-vessel occlusion. However, the true safety and efficacy of MT in medium-size vessel occlusions such as the M2 segment of the middle cerebral artery have yet to be completely defined. In this study, we analyze the safety and efficacy of MT in M2 occlusions compared with M1 occlusions., Methods: A retrospective analysis was performed of patients with AIS secondary to M1 and M2 occlusions between 2011 and 2018. The inclusion criteria were 1) AIS secondary to M1 or M2 occlusion, 2) MT performed by stentrieval technique alone, aspiration technique, or combined stentrieval-aspiration techniques. Basic patient characteristics, number of passages, first passage recanalization success (≥TICI [Thrombolysis in Cerebral Ischemia] grade 2b), total recanalization success, hemorrhagic complications (including intracerebral hemorrhage [ICH] and subarachnoid hemorrhage), and clinical outcomes were compared between both groups., Results: Two hundred and sixty patients met the inclusion criteria; 171 patients had M1 occlusion versus 89 with M2 occlusion. First passage recanalization success rate was significantly higher in the M2 group (55.1% vs. 39.2%; P = 0.015). Total recanalization success rate was higher in the M2 group but did not reach significance (83% vs. 75%; P = 0.128). Subarachnoid hemorrhage rate was significantly higher in the M2 group (25% vs. 12%; P = 0.010) but there was no difference for ICH complications (14.6% vs. 16.4%; P = 0.711)., Conclusions: MT for M2 occlusions has similar overall efficacy to that for M1 occlusions, but with higher first-pass successful recanalization rates. MT for M2 occlusions has a higher risk of associated subarachnoid hemorrhage., (Copyright © 2020 Elsevier Inc. All rights reserved.) more...
- Published
- 2020
- Full Text
- View/download PDF
35. Love My Body: Pilot Study to Understand Reproductive Health Vulnerabilities in Adolescent Girls.
- Author
-
Tzilos Wernette G, Countryman K, Khatibi K, Riley E, and Stephenson R
- Subjects
- Adolescent, Adult, Female, Humans, Male, Pilot Projects, Young Adult, Reproductive Health standards, Sexual Behavior statistics & numerical data, Sexually Transmitted Diseases prevention & control
- Abstract
Background: Sexually transmitted infections (STIs) are on the rise in the United States, and adolescent girls (15-19 years old) are more susceptible to acquiring STIs than their male peers. The co-occurrence of alcohol use and sexual risk taking contribute significantly to STI acquisition. Mobile health (mHealth) interventions are ideally suited for our target population and have demonstrated increases in STI testing in young people, as well as reductions in alcohol use., Objective: This pilot study used both qualitative and quantitative methods to explore the views of adolescent girls (age range 15-19 years old; 74.6%, 279/374 white) on the desired qualities and content of an mHealth app for sexual health., Methods: We conducted nine 60-min in-depth interviews (IDIs) to gather information and identify themes of sexual health and alcohol use, and we tested the feasibility of using a two-week social media campaign to collect survey information regarding sexual health risk in adolescent girls., Results: We iteratively coded IDIs and identified major themes around pressure of alcohol use, lack of STI knowledge, male pressure to not use condoms, and pregnancy as a worse outcome than STIs. Results from the web-based survey on risky health behaviors, which was completed by 367 participants, support the use of a sexual health app designed for girls., Conclusions: Future work will integrate these themes to inform the development of a culturally sensitive mHealth app to prevent STIs among adolescent girls., (©Golfo Tzilos Wernette, Kristina Countryman, Kristie Khatibi, Erin Riley, Rob Stephenson. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 30.03.2020.) more...
- Published
- 2020
- Full Text
- View/download PDF
36. Role of Bedside Multimodality Monitoring in the Detection of Cerebral Vasospasm Following Subarachnoid Hemorrhage.
- Author
-
Khatibi K, Szeder V, Blanco MB, Tateshima S, Jahan R, Duckwiler G, and Vespa P
- Subjects
- Humans, Retrospective Studies, Brain Ischemia, Point-of-Care Testing, Subarachnoid Hemorrhage complications, Vasospasm, Intracranial diagnosis, Vasospasm, Intracranial etiology
- Abstract
Background: Detection of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) in patients with a poor clinical exam is challenging. Brain tissue oxygen tension monitoring (PbtO
2 ) and cerebral microdialysis (CMD) can detect ischemia and metabolic derangements. Our aim was to evaluate efficacy of these modalities in real-time detection of DCI., Methods: All patients with aSAH who underwent with multimodality monitoring (MMM) with PbtO2 and/or CMD between the years of 2013 and 2015 at our institution were retrospectively studied. Mean PbTO2 , lactate to pyruvate ratio (LPR), and glucose over the 24-h period prior to each angiogram for evaluation and treatment of vasospasm were correlated to the extent of vasospasm observed in the hemisphere with the monitors. The average measurements were also compared in the setting of presence and absence of angiographically significant vasospasm., Results: A total of ten patients with aSAH who underwent MMM were identified. PbtO2 decline correlates with severity of proximal vasospasm (r = -0.66). PbtO2 was significantly lower in the setting of vasospasm (17.6 vs. 25.8, p = 0.003), but LPR (34.5 vs. 26.8, p = 0.1) and glucose (0.8 vs. 1.1, p = 0.6) were not significantly different., Conclusion: Proximal vasospasm after aSAH is associated with MMM indicator of tissue ischemia and/or metabolic derangement. PbtO2 and CMD help in real-time detection and management of DCI. more...- Published
- 2020
- Full Text
- View/download PDF
37. Seizures, Confusion, and Strokes in a Patient With AIDS.
- Author
-
Khatibi K, Levy V, Vogel H, and Muppidi S
- Abstract
Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- Published
- 2019
- Full Text
- View/download PDF
38. Posterior Circulation Thrombectomy-pc-ASPECT Score Applied to Preintervention Magnetic Resonance Imaging Can Accurately Predict Functional Outcome.
- Author
-
Khatibi K, Nour M, Tateshima S, Jahan R, Duckwiler G, Saver J, and Szeder V
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Prognosis, Retrospective Studies, Stroke diagnostic imaging, Treatment Outcome, Cerebral Revascularization methods, Stroke surgery, Thrombectomy methods
- Abstract
Background: There are currently no imaging criteria to identify patients who would benefit from endovascular recanalization of posterior circulation strokes. Applying the Posterior Circulation Alberta Stroke Program Early Computed Tomography Score (pc-ASPECTS) to magnetic resonance imaging (MRI) has been demonstrated to be an accurate predictor of functional outcome. Here, we aimed to evaluate the accuracy of the pc-ASPECTS with preintervention MRI as a predictor of functional outcome in a cohort undergoing endovascular recanalization., Methods: This is a 15-year retrospective study of patients undergoing endovascular recanalization of posterior circulation with baseline MRI or computed tomography. We analyzed baseline imaging, clinical data, and type and timing of intervention to the functional outcome at 90 days. Using MRI pc-ASPECTS, we evaluated interrater reliability and accuracy in predicting functional outcome and compared them to the use of single-anatomic location for this function., Results: Door-to-recanalization time in the MRI cohort was significantly longer (median: 8.7 vs. 2.7 hours, P = 0.03); however, functional outcome was not different. Within the MRI cohort, pc-ASPECTS and National Institutes of Health Stroke Scale were the only factors that were significantly different between the groups with good and bad functional outcome (P < 0.001). The area under the receiver operating characteristic curve for the pc-ASPECTS and good functional outcome was 0.96, with the optimal threshold of ≥8 resulting in positive predictive value of 90% and negative predictive value of 100%., Conclusions: Despite longer time to intervention with MRI as the initial imaging modality in posterior circulation strokes, it does not negatively affect the functional outcome. Pc-ASPECTS is an easy to use and accurate prognostic tool for the real-time evaluation of preintervention MRI in this population., (Copyright © 2019 Elsevier Inc. All rights reserved.) more...
- Published
- 2019
- Full Text
- View/download PDF
39. pH-weighted molecular MRI in human traumatic brain injury (TBI) using amine proton chemical exchange saturation transfer echoplanar imaging (CEST EPI).
- Author
-
Ellingson BM, Yao J, Raymond C, Chakhoyan A, Khatibi K, Salamon N, Villablanca JP, Wanner I, Real CR, Laiwalla A, McArthur DL, Monti MM, Hovda DA, and Vespa PM
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Protons, Young Adult, Brain Injuries, Traumatic diagnostic imaging, Brain Injuries, Traumatic metabolism, Echo-Planar Imaging methods, Magnetic Resonance Imaging methods, Molecular Imaging methods
- Abstract
Cerebral acidosis is a consequence of secondary injury mechanisms following traumatic brain injury (TBI), including excitotoxicity and ischemia, with potentially significant clinical implications. However, there remains an unmet clinical need for technology for non-invasive, high resolution pH imaging of human TBI for studying metabolic changes following injury. The current study examined 17 patients with TBI and 20 healthy controls using amine chemical exchange saturation transfer echoplanar imaging (CEST EPI), a novel pH-weighted molecular MR imaging technique, on a clinical 3T MR scanner. Results showed significantly elevated pH-weighted image contrast (MTR
asym at 3 ppm) in areas of T2 hyperintensity or edema (P < 0.0001), and a strong negative correlation with Glasgow Coma Scale (GCS) at the time of the MRI exam (R2 = 0.4777, P = 0.0021), Glasgow Outcome Scale - Extended (GOSE) at 6 months from injury (R2 = 0.5334, P = 0.0107), and a non-linear correlation with the time from injury to MRI exam (R2 = 0.6317, P = 0.0004). This evidence suggests clinical feasibility and potential value of pH-weighted amine CEST EPI as a high-resolution imaging tool for identifying tissue most at risk for long-term damage due to cerebral acidosis., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.) more...- Published
- 2019
- Full Text
- View/download PDF
40. Reducing HIV Vulnerability Through a Multilevel Life Skills Intervention for Adolescent Men (The iREACH Project): Protocol for a Randomized Controlled Trial.
- Author
-
Bauermeister J, Sullivan PS, Gravens L, Wolfe J, Countryman K, Smith-Bankhead N, Drab RA, Sallabank G, Helms JD, Khatibi K, Filipowicz R, Horvath KJ, Bonar E, Castel A, Hightow-Weidman L, Guest J, and Stephenson R more...
- Abstract
Background: Few HIV interventions have demonstrated efficacy in reducing HIV risk among adolescent men who have sex with men (AMSM), and fewer still have recognized the unique needs of AMSM based on race/ethnicity or geographical setting. Recognizing that youths' HIV vulnerability is intricately tied to their development and social context, delivering life skills training during adolescence might delay the onset or reduce the consequences of risk factors for HIV acquisition and equip AMSM with the skills to navigate HIV prevention. This protocol describes the development and testing of iREACH, an online multilevel life skills intervention for AMSM., Objective: This randomized controlled trial (RCT) aims to test the efficacy of an online-delivered life skills intervention, iREACH, on cognitive and behavioral HIV-related outcomes for AMSM., Methods: iREACH is a prospective RCT of approximately 600 cisgender adolescent males aged 13 to 18 years who report same-sex attractions. The intervention will be tested with a racial/ethnically diverse sample (≥50% racial/ethnic minority) of AMSM living in four regions in the United States: (1) Chicago to Detroit, (2) Washington, DC to Atlanta, (3) San Francisco to San Diego, and (4) Memphis to New Orleans., Results: This project is currently recruiting participants. Recruitment began in March 2018., Conclusions: iREACH represents a significant innovation in the development and testing of a tailored life skills-focused intervention for AMSM, and has the potential to fill a significant gap in HIV prevention intervention programming and research for AMSM., Registered Report Identifier: RR1-10.2196/10174., (©Jose Bauermeister, Patrick S Sullivan, Laura Gravens, James Wolfe, Kristina Countryman, Neena Smith-Bankhead, Ryan A Drab, Gregory Sallabank, Jordan D Helms, Kristie Khatibi, Rebecca Filipowicz, Keith Joseph Horvath, Erin Bonar, Amanda Castel, Lisa Hightow-Weidman, Jodie Guest, Rob Stephenson. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 10.07.2018.) more...
- Published
- 2018
- Full Text
- View/download PDF
41. Asystole During Onyx Embolization of a Pediatric Arteriovenous Malformation: A Severe Case of the Trigeminocardiac Reflex.
- Author
-
Khatibi K, Choudhri O, Connolly ID, McTaggart RA, and Do HM
- Subjects
- Adolescent, Humans, Male, Treatment Outcome, Arteriovenous Malformations physiopathology, Arteriovenous Malformations surgery, Dimethyl Sulfoxide adverse effects, Embolization, Therapeutic adverse effects, Heart Arrest etiology, Reflex, Trigeminocardiac physiology
- Abstract
Background: Trigeminal-cardiac reflex (TCR) from the stimulation of sensory branches of trigeminal nerve can lead to hemodynamic instability. This phenomenon has been described during ophthalmologic, craniofacial, and skull base surgeries. TCR has been reported rarely with endovascular onyx embolization of dural arteriovenous fistulas., Case Description: We report a case of TCR during endovascular Onyx embolization of an arteriovenous malformation (AVM). A 16-year-old boy presented with a large cerebellar AVM with arterial feeders from the external carotid artery and posterior cerebral artery branches. The middle meningeal artery was catheterized, through which dimethyl sulfoxide was injected, followed by Onyx, into the nidus and the feeders. Near the completion of embolization, patient became bradycardic and proceeded to asystole; he was resuscitated with chest compression, atropine, and vasopressors. We used PubMed to identify the reported cases of Onyx and other endovascular embolizations complicated by hemodynamic instability. We found 16 cases of endovascular onyx embolization complicated by clinically significant hemodynamic changes in the treatment of dural arteriovenous fistula, cavernous carotid fistula, and juvenile nasopharygeal angiofibroma but not with AVMs. In these cases, arterial supply to the nidus involved the sensory receptive field of trigeminal nerve. Hemodynamic changes have been reported during the injection of dimethyl sulfoxide before the introduction of Onyx, as well as Onyx injection and cast formation., Conclusions: TCR can lead to significant hemodynamic changes during endovascular Onyx embolization of vascular malformations (both pial AVM and dural arteriovenous fistulas) involving receptive field of trigeminal nerve. Therefore, the anesthesiologist should be made aware of treatment approach before intervention and appropriate precautions taken., (Copyright © 2016 Elsevier Inc. All rights reserved.) more...
- Published
- 2017
- Full Text
- View/download PDF
42. Cerebral vascular findings in PAPA syndrome: cerebral arterial vasculopathy or vasculitis and a posterior cerebral artery dissecting aneurysm.
- Author
-
Khatibi K, Heit JJ, Telischak NA, Elbers JM, and Do HM
- Subjects
- Acne Vulgaris surgery, Aortic Dissection surgery, Arthritis, Infectious surgery, Cerebral Angiography, Diagnosis, Differential, Endovascular Procedures methods, Humans, Intracranial Aneurysm surgery, Magnetic Resonance Angiography, Methicillin-Resistant Staphylococcus aureus, Posterior Cerebral Artery surgery, Pyoderma Gangrenosum surgery, Staphylococcal Infections complications, Subarachnoid Hemorrhage diagnostic imaging, Subarachnoid Hemorrhage surgery, Treatment Outcome, Vasculitis, Central Nervous System surgery, Acne Vulgaris diagnostic imaging, Aortic Dissection diagnostic imaging, Arthritis, Infectious diagnostic imaging, Intracranial Aneurysm diagnostic imaging, Posterior Cerebral Artery diagnostic imaging, Pyoderma Gangrenosum diagnostic imaging, Vasculitis, Central Nervous System diagnostic imaging
- Abstract
A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior cerebral artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affected segment of the PCA. The patient made an excellent recovery with no significant residual neurologic deficit., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/) more...
- Published
- 2016
- Full Text
- View/download PDF
43. Cerebral vascular findings in PAPA syndrome: cerebral arterial vasculopathy or vasculitis and a posterior cerebral artery dissecting aneurysm.
- Author
-
Khatibi K, Heit JJ, Telischak NA, Elbers JM, and Do HM
- Subjects
- Acne Vulgaris complications, Aortic Dissection diagnostic imaging, Aneurysm, Ruptured surgery, Anti-Bacterial Agents therapeutic use, Arthritis, Infectious complications, Cefazolin therapeutic use, Cerebral Angiography, Humans, Intracranial Aneurysm diagnostic imaging, Methylprednisolone therapeutic use, Pyoderma Gangrenosum complications, Staphylococcal Infections complications, Staphylococcal Infections diagnostic imaging, Treatment Outcome, Vasculitis microbiology, Acne Vulgaris pathology, Aortic Dissection pathology, Aneurysm, Ruptured pathology, Arthritis, Infectious pathology, Intracranial Aneurysm pathology, Methicillin-Resistant Staphylococcus aureus isolation & purification, Pyoderma Gangrenosum pathology, Staphylococcal Infections pathology, Vasculitis etiology
- Abstract
A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior cerebral artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affected segment of the PCA. The patient made an excellent recovery with no significant residual neurologic deficit., (2015 BMJ Publishing Group Ltd.) more...
- Published
- 2015
- Full Text
- View/download PDF
44. Children with autism show reduced somatosensory response: an MEG study.
- Author
-
Marco EJ, Khatibi K, Hill SS, Siegel B, Arroyo MS, Dowling AF, Neuhaus JM, Sherr EH, Hinkley LN, and Nagarajan SS
- Subjects
- Case-Control Studies, Child, Evoked Potentials, Somatosensory, Humans, Linear Models, Magnetoencephalography, Male, Prospective Studies, Autistic Disorder physiopathology, Somatosensory Cortex physiopathology, Touch Perception
- Abstract
The neural underpinnings of sensory processing differences in autism remain poorly understood. This prospective magnetoencephalography (MEG) study investigates whether children with autism show atypical cortical activity in the primary somatosensory cortex (S1) in comparison with matched controls. Tactile stimuli were clearly detectable, and painless taps were applied to the distal phalanx of the second (D2) and third (D3) fingers of the right and left hands. Three tactile paradigms were administered: an oddball paradigm (standard taps to D3 at an interstimulus interval (ISI) of 0.33 and deviant taps to D2 with ISI ranging from 1.32 s to 1.64 s); a slow-rate paradigm (D2) with an ISI matching the deviant taps in the oddball paradigm; and a fast-rate paradigm (D2) with an ISI matching the standard taps in the oddball. Study subjects were boys (age 7-11 years) with and without autism disorder. Sensory behavior was quantified using the Sensory Profile questionnaire. Boys with autism exhibited smaller amplitude left hemisphere S1 response to slow and deviant stimuli during the right-hand paradigms. In post-hoc analysis, tactile behavior directly correlated with the amplitude of cortical response. Consequently, the children were re-categorized by degree of parent-report tactile sensitivity. This regrouping created a more robust distinction between the groups with amplitude diminution in the left and right hemispheres and latency prolongation in the right hemisphere in the deviant and slow-rate paradigms for the affected children. This study suggests that children with autism have early differences in somatosensory processing, which likely influence later stages of cortical activity from integration to motor response., (© 2012 International Society for Autism Research, Wiley Periodicals, Inc.) more...
- Published
- 2012
- Full Text
- View/download PDF
45. A time-based account of the perception of odor objects and valences.
- Author
-
Olofsson JK, Bowman NE, Khatibi K, and Gottfried JA
- Subjects
- Adult, Female, Humans, Male, Recognition, Psychology physiology, Smell physiology, Young Adult, Emotions physiology, Memory physiology, Odorants, Olfactory Perception physiology, Reaction Time physiology
- Abstract
Is human odor perception guided by memory or emotion? Object-centered accounts predict that recognition of unique odor qualities precedes valence decoding. Valence-centered accounts predict the opposite: that stimulus-driven valence responses precede and guide identification. In a speeded response time study, participants smelled paired odors, presented sequentially, and indicated whether the second odor in each pair belonged to the same category as the first (object evaluation task) or whether the second odor was more pleasant than the first (valence evaluation task). Object evaluation was faster and more accurate than valence evaluation. In a complementary experiment, participants performed an identification task, in which they indicated whether an odor matched the previously presented word label. Responses were quicker for odors preceded by semantically matching, rather than nonmatching, word labels, but results showed no evidence of interference from valence on nonmatching trials. These results are in accordance with object-centered accounts of odor perception. more...
- Published
- 2012
- Full Text
- View/download PDF
46. Parental consanguinity among parents of neonates with congenital hypothyroidism in Isfahan.
- Author
-
Hashemipour M, Amini M, Talaie M, Kelishadi R, Hovespian S, Iranpour R, Salek M, Haghigh S, and Khatibi KH
- Subjects
- Case-Control Studies, Chi-Square Distribution, Congenital Hypothyroidism blood, Congenital Hypothyroidism diagnosis, Female, Hospitals, Maternity, Hospitals, Private, Hospitals, Public, Humans, Infant, Newborn, Iran epidemiology, Male, Neonatal Screening, Pedigree, Prevalence, Radiopharmaceuticals, Risk Factors, Sodium Pertechnetate Tc 99m, Surveys and Questionnaires, Thyrotropin blood, Thyroxine blood, Congenital Hypothyroidism epidemiology, Congenital Hypothyroidism genetics, Consanguinity
- Abstract
We determined the prevalence of congenital hypothyroidism and the rate of consanguin-ity among parents of hypothyroid neonates among 93 381 neonates born in 17 hospitals in Isfahan from May 2002 to April 2005. Serum thyroxine (T4) and thyroid stimulating hormone (TSH) levels were measured on the 3rd-7th day of birth and neonates with abnormal levels were recalled and the levels reassessed. Those with TSH > or = 10 mlU/L and T4 < 6.5 microg/dL on the second assay were considered hypothyroid. In all, 1038 neonates were recalled and 274 were diagnosed as hypothyroid. There was a significant association between parental consanguinity and congenital hypothyroidism (P = 0.006); congenital hypothyroidism was commoner in neonates with 1st cousin parental consanguinity than 2nd cousin parental consanguinity (P = 0.008). more...
- Published
- 2007
47. Rate of recalls in congenital hypothyroidism based upon a regional survey in Isfahan, Iran, using serum T4 and TSH analyses: comparison of two different recall methods.
- Author
-
Amini M, Hashemipour M, Iranpour R, Hovsepian S, Haghighi S, and Khatibi K
- Subjects
- Congenital Hypothyroidism diagnosis, Follow-Up Studies, Humans, Infant, Newborn, Iran epidemiology, Neonatal Screening standards, Patient Acceptance of Health Care, Congenital Hypothyroidism epidemiology, Neonatal Screening methods, Thyrotropin blood, Thyroxine blood
- Abstract
Aims: To evaluate and compare the recall rate in congenital hypothyroidism screening project in Isfahan, first using an approach involving measures of both TSH and T4 and then using TSH alone., Methods: From June 2002 to January 2005, serum TSH and T4 level of referred neonates were measured at 3rd to 7th day of birth through venous sampling. If neonates' serum TSH was >20 mIU/l or T4 was <6.5 microg/dl by the first protocol, or TSH was >20 mIU/l by the second protocol, they were recalled. TSH and T4 were measured using an immunoradiometric assay and radioimmunoassay, respectively. Neonates with TSH > 10 and T4 < 6.5 on their second measurement were considered as congenitally hypothyroid., Results: Serum T4 and TSH of 29,425 neonates by first and 57,235 neonates by second recall approach were measured. Recall rate was higher in the first protocol (2.2% vs. 0.6%, p < 0.05). Most of the recalled neonates in the first protocol were recalled for low T4 level (p < 0.05). The prevalence of CH was 1 in 350 livebirths., Conclusion: Although the recall rate was in the acceptable range by either approach, the TSH alone protocol seems to be a more sensitive and practical approach with the least recall burden and considering the high prevalence of CH in our region merit adaptation of widespread screening for CH using TSH measurements from heel stab blood spotted on filter paper., (Copyright 2005 S. Karger AG, Basel) more...
- Published
- 2005
- Full Text
- View/download PDF
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.