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1. CT Perfusion Derived rCBV < 42% Lesion Volume Is Independently Associated with Followup FLAIR Infarct Volume in Anterior Circulation Large Vessel Occlusion.

Author

Lakhani, Dhairya, Balar, Aneri, Salim, Hamza, Koneru, Manisha, Wen, Sijin, Ozkara, Burak, Lu, Hanzhang, Wang, Richard, Hoseinyazdi, Meisam, Xu, Risheng, Nabi, Mehreen, Mazumdar, Ishan, Cho, Andrew, Chen, Kevin, Sepehri, Sadra, Hyson, Nathan, Urrutia, Victor, Luna, Licia, Hillis, Argye, Heit, Jeremy, Albers, Greg, Rai, Ansaar, Dmytriw, Adam, Faizy, Tobias, Wintermark, Max, Nael, Kambiz, and Yedavalli, Vivek

Subjects
infarct volume, rCBV < 42%, relative cerebral blood volume
Abstract

Pretreatment CT Perfusion (CTP) parameter rCBV < 42% lesion volume has recently been shown to predict 90-day mRS. In this study, we aim to assess the relationship between rCBV < 42% and a radiographic follow-up infarct volume delineated on FLAIR images. In this retrospective evaluation of our prospectively collected database, we included acute stroke patients triaged by multimodal CT imaging, including CT angiography and perfusion imaging, with confirmed anterior circulation large vessel occlusion between 9 January 2017 and 10 January 2023. Follow-up FLAIR imaging was used to determine the final infarct volume. Student t, Mann-Whitney-U, and Chi-Square tests were used to assess differences. Spearmans rank correlation and linear regression analysis were used to assess associations between rCBV < 42% and follow-up infarct volume on FLAIR. In total, 158 patients (median age: 68 years, 52.5% female) met our inclusion criteria. rCBV < 42% (ρ = 0.56, p < 0.001) significantly correlated with follow-up-FLAIR infarct volume. On multivariable linear regression analysis, rCBV < 42% lesion volume (beta = 0.60, p < 0.001), ASPECTS (beta = -0.214, p < 0.01), mTICI (beta = -0.277, p < 0.001), and diabetes (beta = 0.16, p < 0.05) were independently associated with follow-up infarct volume. The rCBV < 42% lesion volume is independently associated with FLAIR follow-up infarct volume.

Published
2024

2. The Relative Cerebral Blood Volume (rCBV) < 42% Is Independently Associated with Collateral Status in Anterior Circulation Large Vessel Occlusion.

Author

Lakhani, Dhairya, Balar, Aneri, Koneru, Manisha, Wen, Sijin, Ozkara, Burak, Lu, Hanzhang, Wang, Richard, Hoseinyazdi, Meisam, Mei, Janet, Xu, Risheng, Nabi, Mehreen, Mazumdar, Ishan, Cho, Andrew, Chen, Kevin, Sepehri, Sadra, Hyson, Nathan, Urrutia, Victor, Luna, Licia, Hillis, Argye, Heit, Jeremy, Albers, Greg, Rai, Ansaar, Dmytriw, Adam, Faizy, Tobias, Wintermark, Max, Yedavalli, Vivek, and Nael, Kambiz

Subjects
ASITN collateral score, rCBV < 42%, relative cerebral blood volume
Abstract

Background: The pretreatment CT perfusion (CTP) marker the relative cerebral blood volume (rCBV) < 42% lesion volume has recently been shown to predict 90-day functional outcomes; however, studies assessing correlations of the rCBV < 42% lesion volume with other outcomes remain sparse. Here, we aim to assess the relationship between the rCBV < 42% lesion volume and the reference standard digital subtraction angiography (DSA)-derived American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN) collateral score, hereby referred as the DSA CS. Methods: In this retrospective evaluation of our prospectively collected database, we included acute stroke patients triaged by multimodal CT imaging, including CT angiography and perfusion imaging, with confirmed anterior circulation large vessel occlusion between 1 September 2017 and 1 October 2023. Group differences were assessed using the Students t test, Mann-Whitney U test and Chi-Square test. Spearmans rank correlation and logistic regression analyses were used to assess associations between rCBV < 42% and DSA CS. Results: In total, 222 patients (median age: 69 years, 56.3% female) met our inclusion criteria. In the multivariable logistic regression analysis, taking into account age, sex, race, hypertension, hyperlipidemia, diabetes, atrial fibrillation, prior stroke or transient ischemic attack, the admission National Institute of Health stroke scale, the premorbid modified Rankin score, the Alberta stroke program early CT score (ASPECTS), and segment occlusion, the rCBV < 42% lesion volume (adjusted OR: 0.98, p < 0.05) was independently associated with the DSA CS. Conclusion: The rCBV < 42% lesion volume is independently associated with the DSA CS.

Published
2024

3. The Compensation Index Is Better Associated with DSA ASITN Collateral Score Compared to the Cerebral Blood Volume Index and Hypoperfusion Intensity Ratio.

Author

Lakhani, Dhairya, Balar, Aneri, Koneru, Manisha, Wen, Sijin, Hoseinyazdi, Meisam, Greene, Cynthia, Xu, Risheng, Luna, Licia, Caplan, Justin, Dmytriw, Adam, Guenego, Adrien, Wintermark, Max, Gonzalez, Fernando, Urrutia, Victor, Huang, Judy, Rai, Ansaar, Albers, Gregory, Heit, Jeremy, Yedavalli, Vivek, and Nael, Kambiz

Subjects
CBV index, HIR, acute ischemic stroke, collateral status, compensation index, hypoperfusion intensity ratio
Abstract

BACKGROUND: Pretreatment CT Perfusion (CTP) parameters serve as reliable surrogates of collateral status (CS). In this study, we aim to assess the relationship between the novel compensation index (CI, Tmax > 4 s/Tmax > 6 s) and already established CTP collateral markers, namely cerebral blood volume (CBV) index and Hypoperfusion Intensity Ratio (HIR), with the reference standard American Society of Interventional and Therapeutic Neuroradiology (ASITN) collateral score (CS) on DSA. METHODS: In this retrospective study, inclusion criteria were the following: (a) CT angiography confirmed anterior circulation large vessel occlusion from 9 January 2017 to 10 January 2023; (b) diagnostic CT perfusion; and (c) underwent mechanical thrombectomy with documented DSA-CS. Student t-test, Mann-Whitney-U-test and Chi-square test were used to assess differences. Spearmans rank correlation and logistic regression analysis were used to assess associations. p ≤ 0.05 was considered significant. RESULTS: In total, 223 patients (mean age: 67.8 ± 15.8, 56% female) met our inclusion criteria. The CI (ρ = 0.37, p < 0.001) and HIR (ρ = -0.29, p < 0.001) significantly correlated with DSA-CS. Whereas the CBV Index (ρ = 0.1, p > 0.05) did not correlate with DSA-CS. On multivariate logistic regression analysis taking into account age, sex, ASPECTS, tPA, premorbid mRS, NIH stroke scale, prior history of TIA, stroke, atrial fibrillation, diabetes mellitus, hyperlipidemia, heart disease and hypertension, only CI was not found to be independently associated with DSA-CS (adjusted OR = 1.387, 95% CI: 1.09-1.77, p < 0.01). CONCLUSION: CI demonstrates a stronger correlation with DSA-CS compared to both the HIR and CBV Index where it may show promise as an additional quantitative pretreatment CS biomarker.

Published
2023

4. CT perfusion derived relative cerebral blood volume

Author

Lakhani, Dhairya A., Balar, Aneri B., Vagal, Vaibhav, Salim, Hamza, Mei, Janet, Koneru, Manisha, Wen, Sijin, Berksu Ozkara, Burak, Lu, Hanzhang, Wang, Richard, Xu, Risheng, Nabi, Mehreen, Mazumdar, Ishan, Cho, Andrew, Chen, Kevin, Sepehri, Sadra, Deng, Francis, Hyson, Nathan, Urrutia, Victor, Luna, Licia P., Sriwastwa, Aakanksha, Hillis, Argye E., Heit, Jeremy J., Albers, Greg W., Rai, Ansaar T., Dmytriw, Adam A., Faizy, Tobias D., Wintermark, Max, Nael, Kambiz, and Yedavalli, Vivek S.

Published
2024
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5. What is a Challenging Clot?: A DELPHI Consensus Statement from the CLOTS 7.0 Summit

Author

Ospel, Johanna M., Mirza, Mahmood, Clarençon, Frédéric, Siddiqui, Adnan, Doyle, Karen, Consoli, Arturo, Mokin, Maxim, Ullberg, Teresa, Zaidat, Osama, Bourcier, Romain, Kulcsar, Zsolt, Gounis, Matthew J., Liebeskind, David S., Fiehler, Jens, Narata, Ana Paula, Ribo, Marc, Jovin, Tudor, Sakai, Nobuyuki, Rai, Ansaar, McCarthy, Ray, Dorn, Franziska, Andersson, Tommy, Majoie, Charles B. L. M., Hanel, Ricardo, Jadhav, Ashutosh, Riedel, Christian, Chamorro, Angel, Brinjikji, Waleed, Costalat, Vincent, DeMeyer, Simon F., Nogueira, Raul G., Cognard, Christophe, Montaner, Joan, Leung, Thomas W., Molina, Carlos, van Beusekom, Heleen, Davalos, Antoni, Weisel, John, Chapot, Rene, Möhlenbruch, Markus, and Brouwer, Patrick

Published
2023
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6. Earlier Endovascular Thrombectomy and Mortality in Patients with Anterior Circulation Large Vessel Occlusion: A Propensity-Matched Analysis of the Stroke Thrombectomy and Aneurysm Registry

Author

Matsukawa, Hidetoshi, Crosa, Roberto, Cunningham, Conor, Maier, Ilko, Al Kasab, Sami, Jabbour, Pascal, Kim, Joon-Tae, Wolfe, Stacey Quintero, Rai, Ansaar, Starke, Robert M., Psychogios, Marios-Nikos, Shaban, Amir, Goyal, Nitin, Yoshimura, Shinichi, Cuellar, Hugo, Howard, Brian, Alawieh, Ali, Alaraj, Ali, Ezzeldin, Mohamad, Romano, Daniele G., Tanweer, Omar, Mascitelli, Justin, Fragata, Isabel, Polifka, Adam, Siddiqui, Fazeel, Osbun, Joshua, Matouk, Charles, Park, Min S., Levitt, Michael R., Brinjikji, Waleed, Moss, Mark, Williamson, Richard, Navia, Pedro, Kan, Peter, Leacy, Reade De, Chowdhry, Shakeel, and Spiotta, Alejandro M.

Published
2024
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7. Outcomes and differences by occluded vessel after endovascular thrombectomy for isolated medium vessel occlusions

Author

Matsukawa, Hidetoshi, Uchida, Kazutaka, Cunningham, Conor, Sowlat, Mohammad-Mahdi, Elawady, Sameh Samir, Maier, Ilko, Jabbour, Pascal, Kim, Joon-Tae, Wolfe, Stacey Quintero, Rai, Ansaar, Starke, Robert M., Psychogios, Marios-Nikos, Shaban, Amir, Arthur, Adam, Cuellar, Hugo, Howard, Brian M., Alawieh, Ali, Romano, Daniele G., Tanweer, Omar, Mascitelli, Justin, Fragata, Isabel, Polifka, Adam, Osbun, Joshua, Crosa, Roberto, Matouk, Charles, Park, Min S., Brinjikji, Waleed, Moss, Mark, Williamson, Richard, Navia, Pedro, Kan, Peter, De Leacy, Reade, Chowdhry, Shakeel, Ezzeldin, Mohamad, Spiotta, Alejandro M., Levitt, Michael R., and Yoshimura, Shinichi

Published
2024
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8. The Los Angeles motor scale (LAMS) is independently associated with CT perfusion collateral status markers

Author

Lakhani, Dhairya A., Mehta, Tejas R., Balar, Aneri B., Koneru, Manisha, Wen, Sijin, Ozkara, Burak Berksu, Caplan, Justin, Dmytriw, Adam A., Wang, Richard, Lu, Hanzhang, Hoseinyazdi, Meisam, Nabi, Mehreen, Mazumdar, Ishan, Cho, Andrew, Chen, Kevin, Sepehri, Sadra, Hyson, Nathan, Xu, Risheng, Urrutia, Victor, Luna, Licia, Hillis, Argye H, Heit, Jeremy J, Albers, Greg W., Rai, Ansaar T., Faizy, Tobias D, Wintermark, Max, Nael, Kambiz, and Yedavalli, Vivek S.

Published
2024
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9. Comparative Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke Patients with ASPECTS 2-3 vs. 4-5

Author

Orscelik, Atakan, Matsukawa, Hidetoshi, Elawady, Sameh Samir, Sowlat, Mohamed Mahdi, Cunningham, Conor, Zandpazandi, Sara, Kasem, Rahim Abo, Maier, Ilko, Jabbour, Pascal, Kim, Joon-Tae, Wolfe, Stacey Quintero, Rai, Ansaar, Starke, Robert M, Psychogios, Marios-Nikos, Shaban, Amir, Goyal, Nitin, Yoshimura, Shinichi, Cuellar, Hugo, Howard, Brian, Alawieh, Ali, Romano, Daniele G., Tanweer, Omar, Mascitelli, Justin, Fragata, Isabel, Polifka, Adam, Osbun, Joshua, Crosa, Roberto, Matouk, Charles, Park, Min S., Levitt, Michael R., Brinjikji, Waleed, Moss, Mark, Dumont, Travis, Williamson, Richard, Jr., Navia, Pedro, Kan, Peter, De Leacy, Reade, Chowdhry, Shakeel, Ezzeldin, Mohamad, Spiotta, Alejandro M., and Kasab, Sami Al

Published
2024
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12. Outcomes after endovascular mechanical thrombectomy for low compared to high National Institutes of Health Stroke Scale (NIHSS): A multicenter study

Author

Abecassis, Isaac Josh, Almallouhi, Eyad, Chalhoub, Reda, Kasab, Sami Al, Bass, Eric, Ding, Dale, Saini, Vasu, Burks, Joshua D., Maier, Ilko L., Psychogios, Marios-Nikos, Liman, Jan, Alawieh, Ali, Wolfe, Stacey, Arthur, Adam S., Shaban, Amir, Dumont, Travis, Kan, Peter, Kim, Joon-Tae, De Leacy, Reade, Osbun, Joshua, Rai, Ansaar, Jabbour, Pascal, Grossberg, Jonathan A., Park, Min S., Crosa, Roberto, Mascitelli, Justin, Levitt, Michael R., Polifka, Adam, Casagrande, Walter, Yoshimura, Shinichi, Matouk, Charles, Williamson, Richard W., Gory, Benjamin, Mokin, Maxim, Fragata, Isabel, Romano, Daniele G., Chowdhry, Shakeel A., Moss, Mark, Behme, Daniel, Limaye, Kaustubh, Spiotta, Alejandro M., and Starke, Robert M.

Published
2023
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13. Comprehensive analysis of the impact of procedure time and the 'golden hour' in subpopulations of stroke thrombectomy patients.

Author

Ash, Makenna, Dimisko, Laurie, Chalhoub, Reda M., Howard, Brian M., Cawley, C. Michael, Matouk, Charles, Pabaney, Aqueel, Spiotta, Alejandro M., Jabbour, Pascal, Maier, Ilko, Wolfe, Stacey Q., Rai, Ansaar T., Joon-tae Kim, Psychogios, Marios-Nikos, Mascitelli, Justin R., Starke, Robert M., Shaban, Amir, Shinichi Yoshimura, De Leacy, Reade, and Kan, Peter

Abstract

Objective To evaluate the effect of procedure time on thrombectomy outcomes in different subpopulations of patients undergoing endovascular thrombectomy (EVT), given the recently expanded indications for EVT. Methods This multicenter study included patients undergoing EVT for acute ischemic stroke at 35 centers globally. Procedure time was defined as time from groin puncture to successful recanalization (Thrombolysis in Cerebral Infarction score ≥2b) or abortion of procedure. Patients were stratified based on stroke location, use of IV tissue plasminogen activator (tPA), Alberta Stroke Program Early CT score, age group, and onset-to-groin time. Primary outcome was the 90-day modified Rankin Scale (mRS) score, with scores 0-2 designating good outcome. Secondary outcome was postprocedural symptomatic intracranial hemorrhage (sICH). Multivariate analyses were performed using generalized linear models to study the impact of procedure time on outcomes in each subpopulation. results Among 8961 patients included in the study, a longer procedure time was associated with higher odds of poor outcome (mRS score 3-6), with 10% increase in odds for each 10 min increment. When procedure time exceeded the 'golden hour', poor outcome was twice as likely. The golden hour effect was consistent in patients with anterior and posterior circulation strokes, proximal or distal occlusions, in patients with large core infarcts, with or without IV tPA treatment, and across age groups. Procedures exceeding 1 hour were associated with a 40% higher sICH rate. Posterior circulation strokes, delayed presentation, and old age were the variables most sensitive to procedure time. Conclusions In this work we demonstrate the universality of the golden hour effect, in which procedures lasting more than 1 hour are associated with worse clinical outcomes and higher rates of sICH across different subpopulations of patients undergoing EVT. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Thrombectomy for Stroke With Large Infarct on Noncontrast CT: The TESLA Randomized Clinical Trial.

Author

Yoo, Albert J., Zaidat, Osama O., Sheth, Sunil A., Rai, Ansaar T., Ortega-Gutierrez, Santiago, Given II, Curtis A., Zaidi, Syed F., Grandhi, Ramesh, Cuellar, Hugo, Mokin, Maxim, Katz, Jeffrey M., Alshekhlee, Amer, Taqi, Muhammad A., Ansari, Sameer A., Siddiqui, Adnan H., Barazangi, Nobl, English, Joey D., Maud, Alberto, Kirmani, Jawad, and Gupta, Rishi

Subjects
INTRACRANIAL hemorrhage, MEDICAL care, ENDOVASCULAR surgery, SUBARACHNOID hemorrhage, STROKE
Abstract

Key Points: Question: Does endovascular thrombectomy improve functional outcome in patients with a large infarct on noncontrast computed tomographic (CT) scan within 24 hours of stroke onset? Findings: In this randomized trial of 300 patients, thrombectomy did not significantly improve 90-day functional outcome compared with medical management alone for the primary end point (adjusted difference in utility-weighted modified Rankin Scale score, 0.63). Meaning: Among patients with large infarct detected by noncontrast CT and presenting within 24 hours, thrombectomy did not significantly improve functional outcome at 90 days. Importance: Recent large infarct thrombectomy trials used heterogeneous imaging modalities and time windows for patient selection. Noncontrast computed tomographic (CT) scan is the most common stroke imaging approach. It remains uncertain whether thrombectomy is effective for patients with large infarcts identified using noncontrast CT alone within 24 hours of stroke onset. Objective: To evaluate the effect of thrombectomy in patients with a large infarct on a noncontrast CT scan within 24 hours of onset. Design, Setting, and Participants: Open-label, blinded–end point, bayesian-adaptive randomized trial with interim analyses for early stopping (futility or success) or population enrichment, which was conducted at 47 US academic and community-based stroke thrombectomy centers. Three hundred patients presenting within 24 hours with anterior-circulation, large-vessel occlusion and large infarct on noncontrast CT scan, with Alberta Stroke Program Early CT Scores of 2 to 5, were randomized to undergo thrombectomy or usual care. Enrollment occurred July 16, 2019 to October 17, 2022; final follow-up, January 25, 2023. Intervention: The intervention patients (n = 152) underwent endovascular treatment using standard thrombectomy devices and usual medical care. Control patients (n = 148) underwent usual medical care alone. Main Outcomes and Measures: The primary efficacy end point was improvement in 90-day functional outcome measured using mean utility-weighted modified Rankin Scale (UW-mRS) scores (range, 0 [death or severe disability] to 10 [no symptoms]; minimum clinically important difference, 0.3). A bayesian model determined the posterior probability that the intervention would be superior to usual care; statistical significance was a 1-sided posterior probability of.975 or more. The primary adverse event end point was 90-day mortality; secondary adverse event end points included symptomatic intracranial hemorrhage and radiographic intracranial hemorrhage. Results: The trial enrolled 300 patients (152 intervention, 148 control; 138 females [46%]; median age, 67 years), without early stopping or enrichment; 297 patients completed the 90-day follow-up. The mean (SD) 90-day UW-mRS score was 2.93 (3.39) for the intervention group vs 2.27 (2.98) for the control group with an adjusted difference of 0.63 (95% credible interval [CrI], −0.09 to 1.34; posterior probability for superiority of thrombectomy,.96). The 90-day mortality was similar between groups: 35.3% (53 of 150) for the intervention group vs 33.3% (49 of 147) for the control group. Six of 151 patients (4.0%) in the intervention group and 2 of 149 (1.3%) in the control group experienced 24-hour symptomatic intracranial hemorrhage. Fourteen patients of 148 (9.5%) in the intervention group vs 4 of 146 (2.7%) in the control group experienced parenchymal hematoma type 1 hemorrhages; 14 (9.5%) in the intervention group vs 5 (3.4%) in the control group experienced parenchymal hematoma type 2 hemorrhages; and 24 (16.2%) in the intervention group vs 9 (6.2%) in the control group experienced subarachnoid hemorrhages. Conclusions and Relevance: Among patients with a large infarct on noncontrast CT within 24 hours, thrombectomy did not demonstrate improvement in functional outcomes. But the width of the credible interval around the effect estimate includes the possibility of both no important effect and a clinically relevant benefit, so the potential role of thrombectomy with this imaging approach and time window will likely require additional study. Trial Registration: ClinicalTrials.gov Identifier: NCT03805308 This clinical trial evaluates whether endovascular thrombectomy and usual medical care vs medical care alone improves functional outcomes among patients who present within 24 hours after symptom onset with anterior-circulation, large-vessel occlusion, and large infarct detected by noncontrast CT scan. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Outcomes of Mechanical Thrombectomy for Patients With Stroke Presenting With Low Alberta Stroke Program Early Computed Tomography Score in Early and Late Time Windows.

Author

Elawady, Sameh Samir, Cunningham, Conor, Hidetoshi Matsukawa, Kazutaka Uchida, Lin, Steven, Maier, Ilko, Jabbour, Pascal, Joon-Tae Kim, Wolfe, Stacey Quintero, Rai, Ansaar, Starke, Robert M., Psychogios, Marios-Nikos, Samaniego, Edgar A., Arthur, Adam, Shinichi Yoshimura, Cuellar, Hugo, Grossberg, Jonathan A., Alawieh, Ali, Romano, Daniele G., and Tanweer, Omar

Published
2024
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17. Mid-term safety and efficacy in small intracranial aneurysm coiling: results from TARGET® nano prospective independent core lab adjudicated multicenter registry

Author

Ashouri, Yazan, primary, Paul, Alexandra R., additional, Puri, Ajit, additional, Liaw, Nicholas, additional, Majjhoo, Aniel, additional, Taqi, Asif, additional, Rai, Ansaar, additional, Badruddin, Aamir, additional, Alshekhlee, Amer, additional, Naravetla, Bharath, additional, Rayes, Mahmoud, additional, Lawson, Matthew, additional, Al Masaid, Batool, additional, Langerford, Claire, additional, Shah, Qaisar, additional, Beaty, Karen, additional, Lin, Eugene, additional, Gray-Duvall, Tanner, additional, Olvany, Jasmine, additional, Slight, Hannah, additional, Chaubal, Varun, additional, Bushnaq, Saif, additional, Tan, Benedict, additional, Al Majali, Mohammad, additional, Elijovich, Lucas, additional, Sunenshine, Peter, additional, and Zaidat, Osama O., additional

Published
2024
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19. 214 Technical and Clinical Outcomes in Patients With Short-term Repeated Mechanical Thrombectomy: An International Multicenter Study

Author

Saad, Hassan, primary, Zohdy, Youssef M., additional, Howard, Brian M., additional, Cawley, C. Michael, additional, Pabaney, Aqueel Hussain, additional, Dimisko, Laurie, additional, Alawieh, Ali M., additional, Maier, Ilko, additional, Spiotta, Alejandro M., additional, Jabbour, Pascal, additional, Wolfe, Stacey Q., additional, Rai, Ansaar, additional, Kim, Joon-Tae, additional, Masitelli, Justin Robert, additional, Starke, Robert M., additional, Shaban, Amir, additional, Yoshimura, Shinichi, additional, De Leacy, Reade, additional, Kan, Peter T., additional, Fragata, Isabel, additional, Polifka, Adam J., additional, Arthur, Adam S., additional, Park, Min S., additional, Matouk, Charles, additional, Levitt, Michael Robert, additional, Tjoumarkaris, Stavropoula I., additional, Liman, Jan, additional, Fargen, Kyle Michael, additional, and Grossberg, Jonathan Andrew, additional

Published
2024
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20. Mechanical Thrombectomy for Distal Occlusions: Efficacy, Functional and Safety Outcomes: Insight from the STAR Collaboration

Author

Anadani, Mohammad, Alawieh, Ali, Chalhoub, Reda, Jabbour, Pascal, Starke, Robert M., Arthur, Adam, Goyal, Nitin, Wolfe, Stacey, Fargen, Kyle M., Grossberg, Jonathan A., Howard, Brian M., De Leacy, Reade, Kellner, Christopher, Kan, Peter, Dumont, Travis, Rai, Ansaar, Osbun, Joshua, Crosa, Roberto, Maier, Ilko, Nascimento, Fábio A., Park, Min S., Levitt, Michael R., Fragata, Isabel, Matouk, Charles, Crowley, R. Webster, Chowdhry, Shakeel A., Ogilvy, Christopher, Mokin, Maxim, Mascitelli, Justin, Yoo, Albert J., Williamson, Richard W., Webb, Sharon, Psychogios, Marios-Nikos, Al kasab, Sami, and Spiotta, Alejandro M.

Published
2021
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21. CT perfusion based rCBF <38% volume is independently and negatively associated with digital subtraction angiography collateral score in anterior circulation large vessel occlusions.

Author

Lakhani, Dhairya A, Balar, Aneri B, Koneru, Manisha, Wen, Sijin, Ozkara, Burak Berksu, Wang, Richard, Hoseinyazdi, Meisam, Nabi, Mehreen, Mazumdar, Ishan, Cho, Andrew, Chen, Kevin, Sepehri, Sadra, Hyson, Nathan, Xu, Risheng, Urrutia, Victor, Luna, Licia, Hillis, Argye E, Heit, Jeremy J, Albers, Greg W, and Rai, Ansaar T

Abstract

Background: Collateral status (CS) is an important biomarker of functional outcomes in patients with acute ischemic stroke secondary to large vessel occlusion (AIS-LVO). Pretreatment CT perfusion (CTP) parameters serve as reliable surrogates of collateral status (CS). In this study, we aim to assess the relationship between the relative cerebral blood flow less than 38% (rCBF <38%), with the reference standard American Society of Interventional and Therapeutic Neuroradiology (ASITN) collateral score (CS) on DSA. Methods: In this prospectively collected, retrospectively reviewed analysis, inclusion criteria were as follows: (a) CT angiography (CTA) confirmed anterior circulation large vessel occlusion from 9/1/2017 to 10/01/2023; (b) diagnostic CT perfusion; and (c) underwent mechanical thrombectomy with documented ASITN CS. The ratios of the CTP-derived CBF values were calculated by dividing the values of the ischemic lesion by the corresponding values of the contralateral normal region (which were defined as rCBF). Spearman's rank correlation and logistic regression analysis were performed to determine the relationship of rCBF <38% lesion volume with DSA ASITN CS. p ≤.05 was considered significant. Results: In total, 223 patients [mean age: 67.77 ± 15.76 years, 56.1% (n = 125) female] met our inclusion criteria. Significant negative correlation was noted between rCBF <38% volume and DSA CS (ρ = −0.37, p <.001). On multivariate logistic regression analysis, rCBF <38% volume was found to be independently associated with worse ASITN CS (unadjusted OR: 3.03, 95% CI: 1.60–5.69, p <.001, and adjusted OR: 2.73, 95% CI: 1.34–5.50, p <.01). Conclusion: Greater volume of tissue with rCBF <38% is independently associated with better DSA CS. rCBF <38% is a useful adjunct tool in collateralization-based prognostication. Future studies are needed to expand our understanding of the role of rCBF <38% within the decision-making in patients with AIS-LVO. [ABSTRACT FROM AUTHOR]

Published
2024
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22. Multicenter investigation of technical and clinical outcomes after thrombectomy for Proximal Medium Vessel Occlusion (pMeVO) by frontline technique.

Author

Grossberg, Jonathan A, Chalhoub, Reda M, Al Kasab, Sami, Pullmann, Dominika, Jabbour, Pascal, Psychogios, Marios, Starke, Robert M, Arthur, Adam S, Fargen, Kyle M, De Leacy, Reade, Kan, Peter, Dumont, Travis, Rai, Ansaar, Crosa, Roberto J, Naamani, Kareem E, Maier, Ilko, Goyal, Nitin, Wolfe, Stacey Quintero, Michael Cawley, C, and Mocco, J

Subjects
PROPENSITY score matching, ENDOVASCULAR surgery, TREATMENT effectiveness, STROKE, THROMBECTOMY
Abstract

Background: Endovascular thrombectomy(EVT) is the standard of care for large vessel occlusion(LVO) stroke. Data on technical and clinical outcome in proximal medium vessel occlusions(pMeVOs) comparing frontline techniques remain limited. Methods: We report an international multicenter retrospective study of patients undergoing EVT for stroke at 32 centers between 2015–2021. Patients were divided into LVOs(ICA/M1/Vertebrobasilar) or pMeVOs(M2/A1/P1) and categorized by thrombectomy technique. Primary outcome was 90-day good functional outcome(mRS ≤ 2). Multivariate logistic regressions were used to evaluate the impact of technical variables on clinical outcomes. Propensity score matching was used to compare outcome in patients with pMeVO treated with aspiration versus stent-retriever. Results: In the cohort of 5977 LVO and 1287 pMeVO patients, pMeVO did not independently predict good-outcome(p = 0.55). In pMeVO patients, successful recanalization irrespective of frontline technique(aOR = 3.2,p < 0.05), procedure time ≤ 1-h(aOR = 2.2,p < 0.05), and thrombectomy attempts ≤ 4(aOR = 2.8,p < 0.05) were independent predictors of good-outcomes. In a propensity-matched cohort of aspiration versus stent-retriever pMeVO patients, there was no difference in good-outcomes. The rates of hemorrhage were higher(9%vs.4%,p < 0.01) and procedure time longer(51-min vs. 33-min,p < 0.01) with stent-retriever, while the number of attempts was higher with aspiration(2.5vs.2,p < 0.01). Rates of hemorrhage and good-outcome showed an exponential relationship to procedural metrics, and were more dependent on time in the aspiration group compared to attempts in the stent-retriever group. Conclusions: Clinical outcomes following EVT for pMeVO are comparable to those in LVOs. The golden hour or 3-pass rules in LVO thrombectomy still apply to pMeVO thrombectomy. Different techniques may exhibit different futility metrics; SR thrombectomy was more influenced by attempts whereas aspiration was more dependent on procedure time. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Abstract TP198: Factors Associated With Need for Decompressive Hemicraniectomy After Mechanical Thrombectomy in Stroke Patients

Author

Elawady, Sameh Samir, primary, Cunningham, Conor, additional, Matsukawa, Hidetoshi, additional, Uchida, Kazutaka, additional, Sowlat, Mohammad-Mahdi, additional, Lee Nawabi, Noah, additional, Zandpazandi, Sara, additional, Orscelik, Atakan, additional, Maier, Ilko, additional, Jabbour, Pascal M, additional, Kim, Joon-Tae, additional, Quintero, Stacey C, additional, rai, ansaar, additional, Starke, Robert, additional, Psychogios, Marios, additional, Shaban, Amir, additional, Arthur, Adam S, additional, Yoshimura, Shinichi, additional, Cuellar, Hugo, additional, Howard, Brian, additional, Alawieh, Ali M, additional, Romano, Daniele G., additional, Tanweer, Omar, additional, Mascitelli, Justin, additional, Fragata, Isabel, additional, Polifka, Adam, additional, Osbun, Joshua, additional, Crosa, Roberto, additional, Matouk, Charles C, additional, Park, Min S, additional, Levitt, Michael, additional, Brinjikji, Waleed, additional, Moss, Mark, additional, Dumont, Travis, additional, Williamson, Richard, additional, Navia, Pedro, additional, Kan, Peter, additional, De Leacy, Reade A, additional, Chowdhry, Shakeel A, additional, Ezzeldin, Mohamad, additional, and Spiotta, Alejandro M, additional

Published
2024
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26. Abstract WP215: Number of Passes Matter in Acute Ischemic Stroke Patients Who Underwent Failed Mechanical Thrombectomy

Author

Elawady, Sameh Samir, primary, Cunningham, Conor, additional, Matsukawa, Hidetoshi, additional, Sowlat, Mohammad-Mahdi, additional, Uchida, Kazutaka, additional, Zandpazandi, Sara, additional, Orscelik, Atakan, additional, Maier, Ilko, additional, Al Kasab, Sami, additional, Jabbour, Pascal M, additional, Kim, Joon-Tae, additional, Quintero, Stacey C, additional, rai, ansaar, additional, Starke, Robert, additional, Psychogios, Marios, additional, Shaban, Amir, additional, Arthur, Adam S, additional, Yoshimura, Shinichi, additional, Cuellar, Hugo, additional, Howard, Brian, additional, Alawieh, Ali M, additional, Romano, Daniele G., additional, Tanweer, Omar, additional, Mascitelli, Justin, additional, Fragata, Isabel, additional, Polifka, Adam, additional, Osbun, Joshua, additional, Crosa, Roberto, additional, Matouk, Charles C, additional, Park, Min S, additional, Levitt, Michael, additional, Brinjikji, Waleed, additional, Moss, Mark, additional, Dumont, Travis, additional, Williamson, Richard, additional, Navia, Pedro, additional, Kan, Peter, additional, De Leacy, Reade A, additional, Chowdhry, Shakeel A, additional, Ezzeldin, Mohamad, additional, and Spiotta, Alejandro M, additional

Published
2024
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27. Abstract TP187: Comparison of Balloon Guide Catheter versus Non-Balloon Guide Catheter for Mechanical Thrombectomy in Distal Medium Vessel Occlusion

Author

Orscelik, Atakan, primary, Kallmes, David F, additional, Bilgin, Cem, additional, Senol, Yigit Can, additional, Kobeissi, Hassan, additional, Elawady, Sameh Samir, additional, Cunningham, Conor, additional, Matsukawa, Hidetoshi, additional, Zandpazandi, Sara, additional, Sowlat, Mohammad-Mahdi, additional, Maier, Ilko, additional, Al Kasab, Sami, additional, Jabbour, Pascal M, additional, Kim, Joon-Tae, additional, Quintero, Stacey C, additional, rai, ansaar, additional, Starke, Robert, additional, Psychogios, Marios, additional, Samaniego, Edgar A, additional, Arthur, Adam S, additional, Yoshimura, Shinichi, additional, Cuellar, Hugo, additional, Howard, Brian, additional, Alawieh, Ali, additional, Romano, Daniele G., additional, Tanweer, Omar, additional, Mascitelli, Justin, additional, Fragata, Isabel, additional, Polifka, Adam, additional, Osbun, Joshua, additional, Crosa, Roberto, additional, Matouk, Charles C, additional, Park, Min S, additional, Levitt, Michael, additional, Moss, Mark, additional, Dumont, Travis, additional, Williamson, Richard, additional, Navia, Pedro, additional, Kan, Peter, additional, De Leacy, Reade A, additional, Chowdhry, Shakeel A, additional, Ezzeldin, Mohamad, additional, Brinjikji, Waleed, additional, and Spiotta, Alejandro M, additional

Published
2024
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28. Abstract WP184: Intravenous Thrombolysis Improves Outcomes in Stroke Patients With Unsuccessful Mechanical Thrombectomy

Author

Elawady, Sameh S, primary, Nawabi, Noah, additional, Matsukawa, Hidetoshi, additional, Cunningham, Conor, additional, Sowlat, Mohammad Mahdi, additional, Orscelik, Atakan, additional, Zandpazandi, Sara, additional, Maier, Ilko, additional, Al Kasab, Sami, additional, Jabbour, Pascal M, additional, Kim, Joon-Tae, additional, Quintero, Stacey C, additional, rai, ansaar, additional, Starke, Robert, additional, Psychogios, Marios, additional, Samaniego, Edgar A, additional, Arthur, Adam S, additional, Yoshimura, Shinichi, additional, Cuellar, Hugo, additional, Howard, Brian, additional, Alawieh, Ali, additional, Romano, Daniele G., additional, Tanweer, Omar, additional, Mascitelli, Justin, additional, Fragata, Isabel, additional, Polifka, Adam, additional, Osbun, Joshua, additional, Crosa, Roberto, additional, Matouk, Charles C, additional, Park, Min S, additional, Levitt, Michael, additional, Brinjikji, Waleed, additional, Moss, Mark, additional, Dumont, Travis, additional, Williamson, Richard, additional, Navia, Pedro, additional, Kan, Peter, additional, De Leacy, Reade A, additional, Chowdhry, Shakeel A, additional, Ezzeldin, Mohamad, additional, and Spiotta, Alejandro M, additional

Published
2024
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29. Abstract TP197: Impact of First-Pass Effect on Clinical Outcomes in Stroke Patients With Low Aspects

Author

Elawady, Sameh S, primary, Sowlat, Mohammad Mahdi, additional, Matsukawa, Hidetoshi, additional, Cunningham, Conor, additional, Orscelik, Atakan, additional, Zandpazandi, Sara, additional, Al Kasab, Sami, additional, Maier, Ilko, additional, Jabbour, Pascal M, additional, Kim, Joon-Tae, additional, Wolfe, Stacey Q, additional, Rai, Ansaar, additional, Starke, Robert, additional, Samaniego, Edgar A, additional, Arthur, Adam S, additional, Yoshimura, Shinichi, additional, Cuellar, Hugo, additional, Grossberg, Jonathan A, additional, Alawieh, Ali, additional, Romano, Daniele G., additional, Tanweer, Omar, additional, mascitelli, Justin, additional, Fragata, Isabel, additional, Polifka, Adam, additional, Osbun, Joshua, additional, Crosa, Roberto, additional, Matouk, Charles C, additional, Park, Min S, additional, Levitt, Michael, additional, Brinjikji, Waleed, additional, Moss, Mark, additional, Dumont, Travis, additional, Williamson, Richard, additional, Navia, Pedro, additional, Kan, Peter, additional, De Leacy, Reade A, additional, Chowdhry, Shakeel A, additional, Ezzeldin, Mohamad, additional, and Spiotta, Alejandro M, additional

Published
2024
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30. Abstract WP180: Novel Machine Learning Model for Prediction of Futile Recanalization in Acute Ischemic Stroke Patients With Anterior Circulation Large Vessel Occlusion

Author

Cunningham, Conor, primary, Zohdy, Youssef, additional, Elawady, Sameh Samir, additional, Matsukawa, Hidetoshi, additional, Sowlat, Mohammad-Mahdi, additional, Uchida, Kazutaka, additional, Zandpazandi, Sara, additional, Orscelik, Atakan, additional, Maier, Ilko, additional, Al Kasab, Sami, additional, Jabbour, Pascal M, additional, Kim, Joon-Tae, additional, Quintero, Stacey C, additional, rai, ansaar, additional, Starke, Robert, additional, Psychogios, Marios, additional, Samaniego, Edgar A, additional, Arthur, Adam S, additional, Yoshimura, Shinichi, additional, Cuellar, Hugo, additional, Howard, Brian, additional, Alawieh, Ali M, additional, Romano, Daniele G., additional, Tanweer, Omar, additional, Mascitelli, Justin, additional, Fragata, Isabel, additional, Polifka, Adam, additional, Osbun, Joshua, additional, Crosa, Roberto, additional, Matouk, Charles C, additional, Park, Min S, additional, Levitt, Michael, additional, Brinjikji, Waleed, additional, Moss, Mark, additional, Dumont, Travis, additional, Williamson, Richard, additional, Navia, Pedro, additional, Kan, Peter, additional, De Leacy, Reade A, additional, Chowdhry, Shakeel A, additional, Ezzeldin, Mohamad, additional, and Spiotta, Alejandro M, additional

Published
2024
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31. Abstract WP205: Development and Validation of a Prediction Model for Outcome in Mechanical Thrombectomy for Large-Vessel Occlusion Anterior Circulation Stroke With Low ASPECTS

Author

Matsukawa, Hidetoshi, primary, Elawady, Sameh S, additional, Cunningham, Conor, additional, Sowlat, Mohammad-Mahdi, additional, Uchida, Kazutaka, additional, Maier, Ilko, additional, Al Kasab, Sami, additional, Jabbour, Pascal, additional, Kim, Joon-Tae, additional, Quintero, Stacey C, additional, Rai, Ansaar, additional, Starke, Robert, additional, Psychogios, Marios, additional, Shaban, Amir, additional, Arthur, Adam, additional, Cuellar, Hugo, additional, Grossberg, Jonathan A, additional, Alawieh, Ali, additional, Romano, Daniele G., additional, Tanweer, Omar, additional, Mascitelli, Justin, additional, Fragata, Isabel, additional, Polifka, Adam, additional, Osbun, Joshua, additional, Crosa, Roberto, additional, Matouk, Charles, additional, Park, Min S, additional, Levitt, Michael, additional, Brinjikji, Waleed, additional, Moss, Mark, additional, Dumont, Travis, additional, Williamson, Richard, additional, Navia, Pedro, additional, Kan, Peter, additional, De Leacy, Reade, additional, Chowdhry, Shakeel A, additional, Ezzeldin, Mohamad, additional, Yoshimura, Shinichi, additional, and Spiotta, Alejandro M, additional

Published
2024
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32. Abstract TP193: Impact of Number of Passes on Outcomes of Mechanical Thrombectomy in Stroke Patients With Low ASPECTS

Author

Sowlat, Mohammad-Mahdi, primary, Elawady, Sameh S, additional, Matsukawa, Hidetoshi, additional, Cunningham, Conor, additional, Orscelik, Atakan, additional, Zandpazandi, Sara, additional, Lee Nawabi, Noah, additional, Maier, Ilko, additional, Al Kasab, Sami, additional, Jabbour, Pascal M, additional, Kim, Joon-Tae, additional, Quintero, Stacey C, additional, rai, ansaar, additional, Starke, Robert, additional, Psychogios, Marios, additional, Samaniego, Edgar A, additional, Arthur, Adam S, additional, Yoshimura, Shinichi, additional, Cuellar, Hugo, additional, Grossberg, Jonathan A, additional, Alawieh, Ali, additional, Romano, Daniele G., additional, Tanweer, Omar, additional, Mascitelli, Justin, additional, Fragata, Isabel, additional, Polifka, Adam, additional, Osbun, Joshua, additional, Crosa, Roberto, additional, Matouk, Charles C, additional, Park, Min S, additional, Levitt, Michael, additional, Brinjikji, Waleed, additional, Moss, Mark, additional, Dumont, Travis, additional, Williamson, Richard, additional, Navia, Pedro, additional, Kan, Peter, additional, De Leacy, Reade A, additional, Chowdhry, Shakeel A, additional, Ezzeldin, Mohamad, additional, and Spiotta, Alejandro M, additional

Published
2024
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33. Abstract 153: First Pass Effect in Mechanical Thrombectomy for Anterior Circulation Acute Ischemic Stroke is Modified by Procedure Time: Proposal of a New Measure for Thrombectomy Procedures

Author

Koo, Andrew, primary, Reeves, Benjamin, additional, Renedo, Daniela, additional, Maier, Ilko, additional, Al Kasab, Sami, additional, Jabbour, Pascal M, additional, Kim, Joon-Tae, additional, Quintero, Stacey C, additional, rai, ansaar, additional, Starke, Robert, additional, Psychogios, Marios, additional, Shaban, Amir, additional, Arthur, Adam S, additional, Yoshimura, Shinichi, additional, Cuellar, Hugo, additional, Grossberg, Jonathan A, additional, Alawieh, Ali M, additional, Romano, Daniele, additional, Tanweer, Omar, additional, Mascitelli, Justin, additional, Fragata, Isabel, additional, Polifka, Adam, additional, Osbun, Joshua, additional, Crosa, Roberto, additional, Park, Min, additional, Levitt, Michael, additional, Brinjikji, Waleed, additional, Moss, Mark, additional, Dumont, Travis, additional, Williamson, Richard, additional, Navia, Pedro, additional, Kan, Peter, additional, Spiotta, Alejandro M, additional, Sheth, Kevin N, additional, de Havenon, Adam H, additional, and Matouk, Charles C, additional

Published
2024
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34. Abstract TP192: Combined Intra-Venous and Intra-Arterial Thrombolysis versus Intra-Venous Thrombolysis Alone in Stroke Patients Undergoing Mechanical Thrombectomy for Large Vessel Occlusion: A Propensity-Matched Analysis

Author

Elawady, Sameh Samir, primary, Matsukawa, Hidetoshi, additional, Goyal, Nitin, additional, Cunningham, Conor, additional, Sowlat, Mohammad Mahdi, additional, Zandpazandi, Sara, additional, Orscelik, Atakan, additional, Maier, Ilko, additional, Al Kasab, Sami, additional, Mulpur, Bhageeradh, additional, Jabbour, Pascal M, additional, Kim, Joon-Tae, additional, Quintero, Stacey C, additional, rai, ansaar, additional, Starke, Robert, additional, Psychogios, Marios, additional, Samaniego, Edgar A, additional, Yoshimura, Shinichi, additional, Cuellar, Hugo, additional, Grossberg, Jonathan A, additional, Alawieh, Ali M, additional, Romano, Daniele G., additional, Tanweer, Omar, additional, Mascitelli, Justin, additional, Fragata, Isabel, additional, Polifka, Adam, additional, Osbun, Joshua, additional, Crosa, Roberto, additional, Matouk, Charles C, additional, Park, Min S, additional, Levitt, Michael, additional, Brinjikji, Waleed, additional, Moss, Mark, additional, Dumont, Travis, additional, Williamson, Richard, additional, Navia, Pedro, additional, Kan, Peter, additional, De Leacy, Reade A, additional, Chowdhry, Shakeel A, additional, Ezzeldin, Mohamad, additional, and Spiotta, Alejandro M, additional

Published
2024
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35. Abstract WP192: Impact of Second Line Thrombectomy Technique Following Failed First Pass Thrombectomy for Anterior Circulation Stroke: To Switch or Not to Switch?

Author

Matsukawa, Hidetoshi, primary, Uchida, Kazutaka, additional, Alawieh, Ali, additional, Matouk, Charles, additional, Al Kasab, Sami, additional, Sowlat, Mohammad-Mahdi, additional, Elawady, Sameh S, additional, Maier, Ilko, additional, Jabbour, Pascal, additional, Kim, Joon-Tae, additional, Wolfe, Stacey Q, additional, Rai, Ansaar, additional, Starke, Robert M, additional, Psychogios, Marios-Nikos, additional, Samaniego, Edgar, additional, Arthur, Adam, additional, Cuellar, Hugo, additional, Howard, Brian, additional, Romano, Daniele G., additional, Tanweer, Omar, additional, Mascitelli, Justin, additional, Fragata, Isabel, additional, Polifka, Adam, additional, Osbun, Joshua, additional, Crosa, Roberto, additional, Park, Min S, additional, Levitt, Michael, additional, Brinjikji, Waleed, additional, Moss, Mark, additional, Dumont, Travis, additional, Williamson, Richard, additional, Navia, Pedro, additional, Kan, Peter, additional, De Leacy, Reade, additional, Chowdhry, Shakeel, additional, Ezzeldin, Mohamad, additional, Yoshimura, Shinichi, additional, and Spiotta, Alejandro M, additional

Published
2024
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36. Abstract TMP88: Impact of Tandem Vertebrobasilar Occlusion on Outcome of Mechanical Thrombectomy for Basilar Artery Occlusion

Author

Cunningham, Conor, primary, Elawady, Sameh Samir, additional, Matsukawa, Hidetoshi, additional, Lee Nawabi, Noah, additional, Sowlat, Mohammad-Mahdi, additional, Zandpazandi, Sara, additional, Uchida, Kazutaka, additional, Orscelik, Atakan, additional, Maier, Ilko, additional, Al Kasab, Sami, additional, Jabbour, Pascal M, additional, Kim, Joon-Tae, additional, Quintero, Stacey C, additional, rai, ansaar, additional, Starke, Robert, additional, Psychogios, Marios, additional, Shaban, Amir, additional, Arthur, Adam S, additional, Yoshimura, Shinichi, additional, Cuellar, Hugo, additional, Grossberg, Jonathan A, additional, Alawieh, Ali M, additional, Romano, Daniele G., additional, Tanweer, Omar, additional, Mascitelli, Justin, additional, Fragata, Isabel, additional, Polifka, Adam, additional, Osbun, Joshua, additional, Crosa, Roberto, additional, Matouk, Charles C, additional, Park, Min S, additional, Levitt, Michael, additional, Brinjikji, Waleed, additional, Moss, Mark, additional, Dumont, Travis, additional, Williamson, Richard, additional, Navia, Pedro, additional, Kan, Peter, additional, De Leacy, Reade A, additional, Chowdhry, Shakeel A, additional, Ezzeldin, Mohamad, additional, and Spiotta, Alejandro M, additional

Published
2024
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37. Repeat thrombectomy after large vessel re-occlusion: a propensity score matched analysis of technical and clinical outcomes

Author

Zohdy, Youssef M, primary, Saad, Hassan, additional, Howard, Brian M, additional, Cawley, C Michael, additional, Pabaney, Aqueel, additional, Akbik, Feras, additional, Dimisko, Laurie, additional, Maier, Ilko, additional, Spiotta, Alejandro M, additional, Jabbour, Pascal, additional, Wolfe, Stacey Q, additional, Rai, Ansaar, additional, Kim, Joon-tae, additional, Mascitelli, Justin, additional, Starke, Robert M, additional, Shaban, Amir, additional, Yoshimura, Shinichi, additional, De Leacy, Reade, additional, Kan, Peter, additional, Fragata, Isabel, additional, Polifka, Adam J, additional, Arthur, Adam S, additional, Park, Min S, additional, Matouk, Charles, additional, Levitt, Michael R, additional, Tjoumakaris, Stavropoula I, additional, Liman, Jan, additional, Waiters, Vanesha, additional, Pradilla, Gustavo, additional, Fargen, Kyle M, additional, Alawieh, Ali, additional, and Grossberg, Jonathan A, additional

Published
2024
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38. Predictors and clinical relevance of hemorrhagic transformation after endovascular therapy for anterior circulation large vessel occlusion strokes: a multicenter retrospective analysis of 1122 patients

Author

Nogueira, Raul G, Gupta, Rishi, Jovin, Tudor G, Levy, Elad I, Liebeskind, David S, Zaidat, Osama O, Rai, Ansaar, Hirsch, Joshua A, Hsu, Daniel P, Rymer, Marilyn M, Tayal, Ashis H, Lin, Ridwan, Natarajan, Sabareesh K, Nanda, Ashish, Tian, Melissa, Hao, Qing, Kalia, Junaid S, Chen, Michael, Abou-Chebl, Alex, Nguyen, Thanh N, and Yoo, Albert J

Subjects
Brain Disorders, Stroke, Clinical Research, Neurosciences, Good Health and Well Being, Aged, Aged, 80 and over, Arterial Occlusive Diseases, Brain Ischemia, Female, Humans, Intracranial Hemorrhages, Male, Middle Aged, Outcome Assessment, Health Care, Retrospective Studies, Thrombolytic Therapy, Tissue Plasminogen Activator, Emergency care, Hemorrhage, Thrombectomy
Abstract

Background and purposeEndovascular techniques are frequently employed to treat large artery occlusion in acute ischemic stroke (AIS). We sought to determine the predictors and clinical impact of intracranial hemorrhage (ICH) after endovascular therapy.MethodsRetrospective analysis of consecutive patients presenting to 13 high volume stroke centers with AIS due to proximal occlusion in the anterior circulation who underwent endovascular treatment within 8 h from symptom onset. Logistic regression was performed to determine the variables associated with ICH, hemorrhagic infarction (HI), and parenchymal hematomas (PHs), as well as 90 day poor outcome (modified Rankin Scale score ≥3) and mortality.ResultsThere were a total of 363 ICHs (overall rate 32.3%; HI=267, 24%; PH=96, 8.5%) among the 1122 study patients (mean age 67±15 years; median National Institutes of Health Stroke Scale score 17 (IQR 13-20)). Independent predictors for HI included diabetes mellitus (OR 2.27, 95% CI (1.58 to 3.26), p

Published
2015

41. Impact of Procedure Time on First Pass Effect in Mechanical Thrombectomy for Anterior Circulation Acute Ischemic Stroke

Author

Koo, Andrew B., Reeves, Benjamin C., Renedo, Daniela, Maier, Ilko L., Al Kasab, Sami, Jabbour, Pascal, Kim, Joon-Tae, Wolfe, Stacey Q., Rai, Ansaar, Starke, Robert M., Psychogios, Marios-Nikos, Shaban, Amir, Arthur, Adam, Yoshimura, Shinichi, Cuellar, Hugo, Grossberg, Jonathan A., Alawieh, Ali, Romano, Daniele G., Tanweer, Omar, Mascitelli, Justin, Fragata, Isabel, Polifka, Adam, Osbun, Joshua, Crosa, Roberto, Park, Min S., Levitt, Michael R., Brinjikji, Waleed, Moss, Mark, Dumont, Travis, Williamson, Richard, Navia, Pedro, Kan, Peter, Spiotta, Alejandro M., Sheth, Kevin N., de Havenon, Adam, and Matouk, Charles C.

Published
2024
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42. Comparison of balloon guide catheter versus nonballoon guide catheter for mechanical thrombectomy in patients with distal medium vessel occlusion.

Author

Orscelik, Atakan, Kallmes, David F., Bilgin, Cem, Musmar, Basel, Senol, Yigit Can, Kobeissi, Hassan, Elawady, Sameh Samir, Cunningham, Conor, Hidetoshi Matsukawa, Zandpazandi, Sara, Sowlat, Mohammad-Mahdi, Maier, Ilko, Kasab, Sami Al, Jabbour, Pascal, Joon-tae Kim, Wolfe, Stacey Q., Rai, Ansaar, Starke, Robert M., Psychogios, Marios-Nikos, and Samaniego, Edgar A.

Subjects
VASCULAR catheters, PATIENT safety, SURGERY, PATIENTS, CEREBRAL arterial diseases, ANTERIOR cerebral artery, CATHETERIZATION, TREATMENT effectiveness, RETROSPECTIVE studies, DESCRIPTIVE statistics, CEREBRAL arteries, INTRAOPERATIVE care, ISCHEMIC stroke, POSTERIOR cerebral artery, THROMBECTOMY, ARTERIAL occlusions, STROKE patients, COMPARATIVE studies
Abstract

Background Several studies have established the safety and efficacy of balloon guide catheters (BGCs) for large vessel occlusions. However, the utility of BGCs remains largely unexplored for distal medium vessel occlusions (DMVOs). In this study, we aim to compare the outcomes of BGC vs. Non-BGC in patients undergoing mechanical thrombectomy (MT) for DMVO. Method This retrospective study from the Stroke Thrombectomy and Aneurysm Registry (STAR) encompassed adult patients with acute anterior cerebral artery, posterior cerebral artery, and middle cerebral artery-M2--3--4 occlusions. Procedure times, safety, recanalization, and neurological outcomes were compared between the two groups, with subgroup analysis based on first-line thrombectomy techniques. Results A total of 1508 patients were included, with 231 patients (15.3%) in the BGC group and 1277 patients (84.7%) in the non-BGC group. The BGC group had a lower modified Thrombolysis in Cerebral Infarction (mTICI) score ≥2C (43.2% vs 52.7%, P=0.01), longer time from puncture to intracranial access (15 vs 8 min, P<0.01), and from puncture to final recanalization (97 vs 34 min, P<0.01). In the Solumbra subgroup, the first pass effect (FPE) rate was lower in the BGC group (17.4% vs 30.7%, P=0.03). Regarding clinical outcomes, the BGC group had a lower rate of distal embolization (8.8% vs 14.9%, P=0.03). Conclusion Our study found that use of BGC in patients with DMVO was associated with lower mTICI scores, decreased FPE rates, reduced distal embolization, and longer procedure times. [ABSTRACT FROM AUTHOR]

Published
2024
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43. High variability in physician estimations of flowdiverting stent deployment versus PreSize Neurovascular software simulation: a comparison study.

Author

Rai, Ansaar T., Boo, SoHyun, Downer, Jonathan, DuPlessis, Johannes, Rautio, Riitta, Sinisalo, Matias, Pekkola, Johanna, Nascimento, Vinicius Carraro do, Given, Curtis, and Patankar, Tufail

Subjects
COMPUTER simulation, REPEATED measures design, PEARSON correlation (Statistics), COMPUTER software, T-test (Statistics), SURGICAL stents, BLOOD vessel prosthesis, ENDOVASCULAR surgery, QUANTITATIVE research, DESCRIPTIVE statistics, BLOOD circulation, ANALYSIS of variance, COMPARATIVE studies, DATA analysis software, CONFIDENCE intervals
Abstract

Background Physician variablity in preoperative planning of endovascular implant deployment and associated inaccuracies have not been documented. This study aimed to quantify the variability in accuracy of physician flow diverter (FD) planning and directly compares it with PreSize Neurovascular (Oxford Heartbeat Ltd) software simulations. Methods Eight experienced neurointerventionalists (NIs), blinded to procedural details, were provided with preoperative 3D rotational angiography (3D-RA) volumetric data along with images annotated with the distal landing location of a deployed Surpass Evolve (Stryker Neurovascular) FD from 51 patient cases. NIs were asked to perform a planning routine reflecting their normal practice and estimate the stent's proximal landing using volumetric data and the labeled dimensions of the FD used. Equivalent deployed length estimation was performed using PreSize software. NI-and softwareestimated lengths were compared with postprocedural observed deployed stent length (control) using Bland-- Altman plots. NI assessment agreement was assessed with the intraclass correlation coefficient (ICC). Results The mean accuracy of NI-estimated deployed FD length was 81% (±15%) versus PreSize's accuracy of 95% (±4%), demonstrating significantly higher accuracy for the software (p<0.001). The mean absolute error between estimated and control lengths was 4 mm (±3.5 mm, range 0.03--30.2 mm) for NIs and 1 mm (±0.9 mm, range 0.01--3.9 mm) for PreSize. No discernable trends in accuracy among NIs or across vasculature and aneurysm morphology (size, vessel diameter, tortuousity) were found. Conclusions The study quantified experienced physicians' significant variablity in predicting an FD deployment with current planning approaches. In comparison, PreSize-simulated FD deployment was consistently more accurate and reliable, demonstrating its potential to improve standard of practice. [ABSTRACT FROM AUTHOR]

Published
2024
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44. Pretreatment CT perfusion collateral parameters correlate with penumbra salvage in middle cerebral artery occlusion

Author

Lakhani, Dhairya A., primary, Balar, Aneri B., additional, Koneru, Manisha, additional, Hoseinyazdi, Meisam, additional, Hyson, Nathan, additional, Cho, Andrew, additional, Greene, Cynthia, additional, Xu, Risheng, additional, Luna, Licia, additional, Caplan, Justin, additional, Dmytriw, Adam, additional, Guenego, Adrien, additional, Wintermark, Max, additional, Gonzalez, Fernando, additional, Urrutia, Victor, additional, Huang, Judy, additional, Nael, Kambiz, additional, Rai, Ansaar T., additional, Albers, Gregory W., additional, Heit, Jeremy J., additional, and Yedavalli, Vivek, additional

Published
2023
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45. Outcomes of mechanical thrombectomy in stroke patients with extreme large infarction core

Author

Almallouhi, Eyad, primary, Zandpazandi, Sara, additional, Anadani, Mohammad, additional, Cunningham, Conor, additional, Sowlat, Mohammad-Mahdi, additional, Matsukawa, Hidetoshi, additional, Orscelik, Atakan, additional, Elawady, Sameh Samir, additional, Maier, Ilko, additional, Al Kasab, Sami, additional, Jabbour, Pascal, additional, Kim, Joon-tae, additional, Wolfe, Stacey Q, additional, Rai, Ansaar, additional, Starke, Robert M, additional, Psychogios, Marios-Nikos, additional, Samaniego, Edgar A, additional, Arthur, Adam S, additional, Yoshimura, Shinichi, additional, Cuellar, Hugo, additional, Grossberg, Jonathan A, additional, Alawieh, Ali, additional, Romano, Daniele G, additional, Tanweer, Omar, additional, Mascitelli, Justin, additional, Fragata, Isabel, additional, Polifka, Adam J, additional, Osbun, Joshua W, additional, Crosa, Roberto Javier, additional, Matouk, Charles, additional, Park, Min S, additional, Levitt, Michael R, additional, Brinjikji, Waleed, additional, Moss, Mark, additional, Dumont, Travis M, additional, Williamson, Richard, additional, Navia, Pedro, additional, Kan, Peter, additional, De Leacy, Reade, additional, Chowdhry, Shakeel A, additional, Ezzeldin, Mohamad, additional, and Spiotta, Alejandro M, additional

Published
2023
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46. Mechanical thrombectomy for the treatment of primary and secondary anterior cerebral artery occlusions: insights from STAR

Author

Dabhi, Nisha, primary, Kumar, Jeyan Sathia, additional, Ironside, Natasha, additional, Kellogg, Ryan T, additional, Sowlat, Mohammad-Mahdi, additional, Uchida, Kazutaka, additional, Maier, Ilko, additional, Al Kasab, Sami, additional, Jabbour, Pascal, additional, Kim, Joon-tae, additional, Wolfe, Stacey Q, additional, Rai, Ansaar, additional, Starke, Robert M, additional, Psychogios, Marios-Nikos, additional, Samaniego, Edgar A, additional, Arthur, Adam S, additional, Yoshimura, Shinichi, additional, Cuellar, Hugo, additional, Howard, Brian M, additional, Alawieh, Ali, additional, Romano, Daniele G, additional, Tanweer, Omar, additional, Mascitelli, Justin, additional, Fragata, Isabel, additional, Polifka, Adam J, additional, Osbun, Joshua W, additional, Crosa, Roberto Javier, additional, Matouk, Charles, additional, Levitt, Michael R, additional, Brinjikji, Waleed, additional, Moss, Mark, additional, Dumont, Travis M, additional, Williamson, Richard, additional, Navia, Pedro, additional, Kan, Peter, additional, De Leacy, Reade, additional, Chowdhry, Shakeel A, additional, Ezzeldin, Mohamad, additional, Spiotta, Alejandro M, additional, and Park, Min S, additional

Published
2023
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47. Comprehensive analysis of the impact of procedure time and the ‘golden hour’ in subpopulations of stroke thrombectomy patients

Author

Ash, Makenna, primary, Dimisko, Laurie, additional, Chalhoub, Reda M, additional, Howard, Brian M, additional, Cawley, C Michael, additional, Matouk, Charles, additional, Pabaney, Aqueel, additional, Spiotta, Alejandro M, additional, Jabbour, Pascal, additional, Maier, Ilko, additional, Wolfe, Stacey Q, additional, Rai, Ansaar T, additional, Kim, Joon-tae, additional, Psychogios, Marios-Nikos, additional, Mascitelli, Justin R, additional, Starke, Robert M, additional, Shaban, Amir, additional, Yoshimura, Shinichi, additional, De Leacy, Reade, additional, Kan, Peter, additional, Fragata, Isabel, additional, Polifka, Adam J, additional, Arthur, Adam S, additional, Park, Min S, additional, Crosa, Roberto Javier, additional, Williamson, Richard, additional, Dumont, Travis M, additional, Levitt, Michael R, additional, Al Kasab, Sami, additional, Tjoumakaris, Stavropoula I, additional, Liman, Jan, additional, Saad, Hassan, additional, Samaniego, Edgar A, additional, Fargen, Kyle M, additional, Grossberg, Jonathan A, additional, and Alawieh, Ali, additional

Published
2023
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49. Proceedings of the Seventh Annual CLOTS Meeting: CLOTS 7.0, Madrid, Spain

Author

McCarthy, Ray, primary, Clarençon, Frédéric, additional, Bourcier, Romain, additional, Brouwer, Patrick, additional, Consoli, Arturo, additional, Doyle, Karen, additional, Gounis, Matthew, additional, Hacke, Werner, additional, Kulcsar, Zsolt, additional, Jovin, Tudor, additional, Mirza, Mahmood, additional, Mokin, Maxim, additional, Narata, Ana Paula, additional, Ospel, Johanna, additional, Rai, Ansaar, additional, Ribo, Marc, additional, Sakai, Nobuyuki, additional, Siddiqui, Adnan, additional, Ullberg, Teresa, additional, Zaidat, Osama, additional, Fiehler, Jens, additional, and Liebeskind, David, additional

Published
2023
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