2024
Radiomics-Based Prediction of Collateral Status from CT Angiography of Patients Following a Large Vessel Occlusion Stroke
Avery E, Abou-Karam A, Abi-Fadel S, Behland J, Mak A, Haider S, Zeevi T, Sanelli P, Filippi C, Malhotra A, Matouk C, Falcone G, Petersen N, Sansing L, Sheth K, Payabvash S. Radiomics-Based Prediction of Collateral Status from CT Angiography of Patients Following a Large Vessel Occlusion Stroke. Diagnostics 2024, 14: 485. PMID: 38472957, PMCID: PMC10930945, DOI: 10.3390/diagnostics14050485.Peer-Reviewed Original ResearchCollateral statusCollateral scoreLarge vessel occlusionAcute LVO strokeRadiomics modelTest cohortCT angiography of patientsAdmission computed tomography angiographyAnterior circulation territoryAngiography of patientsLong-term outcomesReceiver operating characteristic areaRadiomics-based predictionCollateral arterial circulationOperating characteristics areaAdmission CTACirculation territoryCT angiographyClinical outcomesRadiomic featuresTreatment triageOcclusion strokeVessel occlusionPatientsArterial circulationUncertainty-aware deep-learning model for prediction of supratentorial hematoma expansion from admission non-contrast head computed tomography scan
Tran A, Zeevi T, Haider S, Abou Karam G, Berson E, Tharmaseelan H, Qureshi A, Sanelli P, Werring D, Malhotra A, Petersen N, de Havenon A, Falcone G, Sheth K, Payabvash S. Uncertainty-aware deep-learning model for prediction of supratentorial hematoma expansion from admission non-contrast head computed tomography scan. Npj Digital Medicine 2024, 7: 26. PMID: 38321131, PMCID: PMC10847454, DOI: 10.1038/s41746-024-01007-w.Peer-Reviewed Original ResearchDeep learning modelsHematoma expansionIntracerebral hemorrhageICH expansionComputed tomographyNon-contrast head CTNon-contrast head computed tomographyHigh risk of HEHead computed tomographyHigh-confidence predictionsRisk of HENon-contrast headReceiver operating characteristic areaModifiable risk factorsMonte Carlo dropoutOperating characteristics areaPotential treatment targetHead CTVisual markersIdentified patientsAutomated deep learning modelDataset of patientsRisk factorsHigh riskPatientsLetter to the Editor Re “Rethinking Cervical Spine Clearance in Obtunded Trauma Patients: An Updated Systematic Review and Meta-Analysis”.
Malhotra A, Wu X, Khunte M. Letter to the Editor Re “Rethinking Cervical Spine Clearance in Obtunded Trauma Patients: An Updated Systematic Review and Meta-Analysis”. Injury 2024, 55: 111359. PMID: 38262333, DOI: 10.1016/j.injury.2024.111359.Peer-Reviewed Original ResearchTime-driven activity-based costing (TDABC) of direct-to-angiography pathway for acute ischemic stroke patients with suspected large vessel occlusion
Sangha K, White T, Boltyenkov A, Bastani M, Sanmartin M, Katz J, Malhotra A, Rula E, Naidich J, Sanelli P. Time-driven activity-based costing (TDABC) of direct-to-angiography pathway for acute ischemic stroke patients with suspected large vessel occlusion. Journal Of Stroke And Cerebrovascular Diseases 2024, 33: 107516. PMID: 38183964, DOI: 10.1016/j.jstrokecerebrovasdis.2023.107516.Peer-Reviewed Original ResearchAcute ischemic strokeEndovascular treatmentAcute ischemic stroke patientsAppropriate patient selection criteriaNovel care pathwayIschemic stroke patientsLarge vessel occlusionPatient selection criteriaInstitutional patient databaseTime-driven activity-based costingEligible patientsAnterior circulationIschemic strokeClinical outcomesPatient factorsStroke patientsAIS patientsVessel occlusionCare pathwayPatient costsMain cost driversPatientsPatient databaseAngiography suiteCT pathway
2023
CT With CTA Versus MRI in Patients Presenting to the Emergency Department With Dizziness: Analysis Using Propensity Score Matching.
Tu L, Navaratnam D, Melnick E, Forman H, Venkatesh A, Malhotra A, Yaesoubi R, Sureshanand S, Sheth K, Mahajan A. CT With CTA Versus MRI in Patients Presenting to the Emergency Department With Dizziness: Analysis Using Propensity Score Matching. American Journal Of Roentgenology 2023, 221: 836-845. PMID: 37404082, DOI: 10.2214/ajr.23.29617.Peer-Reviewed Original ResearchConceptsSecondary stroke prevention medicationsStroke prevention medicationsEmergency departmentPrevention medicationsEchocardiography evaluationPosterior circulation strokeProportion of patientsGroup of patientsPhysical examination findingsNeuroimaging resultsUse of MRIReview of systemsGreater frequencyPropensity-score matchingExamination findingsRetrospective studyED readmissionMedical historyHead CTClinical impactMRI examinationsBrain MRINeck CTADizzinessPatientsFactors associated with door-in-door-out times in large vessel occlusion stroke patients undergoing endovascular therapy
Radmard M, Wu X, Khunte M, Malhotra A. Factors associated with door-in-door-out times in large vessel occlusion stroke patients undergoing endovascular therapy. The American Journal Of Emergency Medicine 2023, 70: 192-193. PMID: 37393131, DOI: 10.1016/j.ajem.2023.06.020.Peer-Reviewed Original ResearchNational Trends of Cerebral Venous Sinus Stenting for the Treatment of Idiopathic Intracranial Hypertension
Khunte M, Chen H, Colasurdo M, Chaturvedi S, Malhotra A, Gandhi D. National Trends of Cerebral Venous Sinus Stenting for the Treatment of Idiopathic Intracranial Hypertension. Neurology 2023, 101: 402-406. PMID: 36990721, PMCID: PMC10501094, DOI: 10.1212/wnl.0000000000207245.Peer-Reviewed Original ResearchConceptsVenous sinus stentingOptic nerve sheath fenestrationIdiopathic intracranial hypertensionIIH treatmentCSF shuntsIntracranial hypertensionSurgical proceduresCerebral venous sinus stentingNational Inpatient Sample databaseStandard medical treatmentCerebral venous sinusesNew surgical procedureRecent temporal trendsAdult patientsSheath fenestrationSinus stentingHospital characteristicsPractice patternsVenous sinusesMedical treatmentComparative effectivenessProcedure numbersPatientsSample databaseShunt
2022
Letter to the editor re “Minor stroke in large vessel occlusion: A matched analysis of patients from the German Stroke Registry—Endovascular Treatment and patients from the Safe Implementation of Treatments in Stroke—International Stroke Thrombolysis Register”
Malhotra A, Khunte M, Wu X, Radmard M. Letter to the editor re “Minor stroke in large vessel occlusion: A matched analysis of patients from the German Stroke Registry—Endovascular Treatment and patients from the Safe Implementation of Treatments in Stroke—International Stroke Thrombolysis Register”. European Journal Of Neurology 2022, 30: 290-291. PMID: 36260371, DOI: 10.1111/ene.15598.Commentaries, Editorials and LettersEE47 Short-Term Cost-Effectiveness of Using Mobile Stroke Unit VS. Standard Ambulance for Patients with Suspected Stroke
Sangha K, White T, Malhotra A, Boltyenkov A, Katz J, Sanelli P. EE47 Short-Term Cost-Effectiveness of Using Mobile Stroke Unit VS. Standard Ambulance for Patients with Suspected Stroke. Value In Health 2022, 25: s344. DOI: 10.1016/j.jval.2022.04.301.Peer-Reviewed Original ResearchOptimizing Small, Low-Risk, Unruptured Intracranial Aneurysm Treatment Using Game Theory
Boltyenkov A, Wang J, Malhotra A, Katz J, Dehdashti A, White T, Martinez G, Pandya A, Sanelli P. Optimizing Small, Low-Risk, Unruptured Intracranial Aneurysm Treatment Using Game Theory. American Journal Of Neuroradiology 2022, 43: 176-180. PMID: 35027349, PMCID: PMC8985687, DOI: 10.3174/ajnr.a7392.Peer-Reviewed Original Research
2020
Letter regarding: “Elderly Patients With Cervical Spine Fractures After Ground Level Falls Are at Risk for Blunt Cerebrovascular Injury”
Malhotra A, Wu X, Khunte M. Letter regarding: “Elderly Patients With Cervical Spine Fractures After Ground Level Falls Are at Risk for Blunt Cerebrovascular Injury”. Journal Of Surgical Research 2020, 256: 696-697. PMID: 32861424, DOI: 10.1016/j.jss.2020.06.064.Peer-Reviewed Original ResearchReduced 2-year aneurysm retreatment and costs among patients treated with flow diversion versus non-flow diversion embolization: A Premier Healthcare Database retrospective cohort study
Grandhi R, Karsy M, Taussky P, Ricker CN, Malhotra A. Reduced 2-year aneurysm retreatment and costs among patients treated with flow diversion versus non-flow diversion embolization: A Premier Healthcare Database retrospective cohort study. PLOS ONE 2020, 15: e0234478. PMID: 32555657, PMCID: PMC7302520, DOI: 10.1371/journal.pone.0234478.Peer-Reviewed Original ResearchConceptsPipeline Embolization DeviceEndovascular treatmentRetreatment ratePS matchingIntracranial aneurysmsRetrospective cohort studyRate of readmissionEmergency department visitsLength of stayLower retreatment rateInitial treatment costsUnruptured intracranial aneurysmsPropensity-score matchingTime of treatmentCumulative followCohort studyReadmission costsDepartment visitsPatient subgroupsPED placementCase selection biasSame hospitalAneurysm retreatmentEmbolization DevicePatientsUtility of routine follow-up imaging in patients with small paraflacine and/or paratentorial hemorrhages
Seifert KD, Wu X, Malhotra A. Utility of routine follow-up imaging in patients with small paraflacine and/or paratentorial hemorrhages. Clinical Neurology And Neurosurgery 2020, 196: 105956. PMID: 32526488, DOI: 10.1016/j.clineuro.2020.105956.Peer-Reviewed Original ResearchConceptsSubdural hemorrhageRoutine follow-up imagingSubsequent imagingImaging studiesSecond imaging studyAbsence of anticoagulationSubsequent imaging studiesFollow-up imagingAcute intracranial hemorrhageAnticoagulation useStable patientsRetrospective reviewClinical progressionIntracranial hemorrhageEmergency departmentClinical dataHemorrhage sizeHemorrhageRoutine imagingPatient statusPatientsParafalcineMultiple followSame protocolAverage numberImplications of achieving TICI 2b vs TICI 3 reperfusion in patients with ischemic stroke: a cost-effectiveness analysis
Wu X, Khunte M, Gandhi D, Matouk C, Hughes DR, Sanelli P, Malhotra A. Implications of achieving TICI 2b vs TICI 3 reperfusion in patients with ischemic stroke: a cost-effectiveness analysis. Journal Of NeuroInterventional Surgery 2020, 12: 1161-1165. PMID: 32457225, DOI: 10.1136/neurintsurg-2020-015873.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsLarge vessel occlusionTICI 3 reperfusionEndovascular thrombectomyTICI 2bTICI 3Stroke patientsHealth benefitsAge groupsAcute stroke patientsDegree of recanalizationDegree of reperfusionLifetime quality-adjusted life yearsCost-effectiveness analysisDecision analytic studyUnited States settingsIncomplete reperfusionIschemic strokeComplete reperfusionPatient selectionReperfusionPatientsHealth outcomesLife yearsCost savingsDiagnostic Value of CT of Chest, Abdomen, and Pelvis in Patients With Solitary and Multiple Brain Lesions.
Rothman RK, Weinreb J, Zucconi W, Malhotra A. Diagnostic Value of CT of Chest, Abdomen, and Pelvis in Patients With Solitary and Multiple Brain Lesions. American Journal Of Roentgenology 2020, 214: 636-640. PMID: 31939701, DOI: 10.2214/ajr.19.22051.Peer-Reviewed Original ResearchConceptsPrimary neoplasmsBrain lesionsChest CTIntracranial lesionsCT CAPAncillary signsBrain neoplasmsNew intracranial lesionsPrimary brain neoplasmsMultiple brain lesionsMalignant brain neoplasmsLarge academic hospitalPresence of enhancementBrain metastasesLung primaryMetastatic workupSuch patientsPrimary cancerLesion characteristicsAcademic hospitalBenign entityCT scanPatientsMalignant casesNeoplasmsCT Angiography for Triage of Patients with Acute Minor Stroke: A Cost-effectiveness Analysis.
Wu X, Hughes DR, Gandhi D, Matouk CC, Sheth K, Schindler J, Wira C, Wintermark M, Sanelli P, Malhotra A. CT Angiography for Triage of Patients with Acute Minor Stroke: A Cost-effectiveness Analysis. Radiology 2020, 294: 580-588. PMID: 31934828, DOI: 10.1148/radiol.2019191238.Peer-Reviewed Original ResearchConceptsLarge vessel occlusionAcute minor strokeBest medical managementMinor strokeCT angiographyMedical managementProbabilistic sensitivity analysesLower health benefitsImmediate thrombectomyHealth benefitsHealth outcomesVascular imagingAcute ischemic strokeMarkov decision-analytic modelWorse health outcomesImproved health outcomesDecision analytic modelNet monetary benefitIntravenous thrombolysisIschemic strokeYounger patientsThrombectomy strategyPatientsAngiographyStroke
2019
PND77 IMPACT OF THE INTERHOSPITAL TRANSFER TIME ON THE CLINICAL OUTCOMES OF ACUTE STROKE PATIENTS TREATED WITH MECHANICAL THROMBECTOMY
Boltyenkov A, Wang J, Martinez M, Adinarayan K, Hoang A, Malhotra A, Sanelli P. PND77 IMPACT OF THE INTERHOSPITAL TRANSFER TIME ON THE CLINICAL OUTCOMES OF ACUTE STROKE PATIENTS TREATED WITH MECHANICAL THROMBECTOMY. Value In Health 2019, 22: s751. DOI: 10.1016/j.jval.2019.09.1847.Peer-Reviewed Original ResearchScreening for Intracranial Aneurysms in Patients with Thoracic Aortic Aneurysms
Malhotra A, Seifert K, Wu X, Matouk C, Elefteriades JA. Screening for Intracranial Aneurysms in Patients with Thoracic Aortic Aneurysms. Cerebrovascular Diseases 2019, 47: 253-259. PMID: 31412341, DOI: 10.1159/000501194.Peer-Reviewed Original ResearchConceptsPrevalence of IAsThoracic aortic aneurysmIntracranial aneurysmsRetrospective studyAortic aneurysmRisk factorsPrevious retrospective studySignificant risk factorsPotential risk factorsMagnetic resonance angiogramStudent's t-testPatient demographicsUnivariate analysisHigh prevalenceLarge cohortGeneral populationPatientsAneurysmsPrevalenceCategorical variablesΧ2 testHypertensionT-testContinuous variablesIA locationA comparison of benign positional vertigo and stroke patients presenting to the emergency department with vertigo or dizziness
Hanna J, Malhotra A, Brauer PR, Luryi A, Michaelides E. A comparison of benign positional vertigo and stroke patients presenting to the emergency department with vertigo or dizziness. American Journal Of Otolaryngology 2019, 40: 102263. PMID: 31358317, DOI: 10.1016/j.amjoto.2019.07.007.Peer-Reviewed Original ResearchConceptsBenign paroxysmal positional vertigoStroke risk factorsCT/CTAEmergency departmentBPPV patientsNeurologic symptomsStroke patientsRisk factorsPositional vertigoCT headExam findingsNeurologic exam findingsPosterior circulation strokeProfile of patientsBenign positional vertigoParoxysmal positional vertigoCommon imaging modalityAcute strokeNeurologic examInitial imagingMRI brainDischarge diagnosisComputed tomographyPatientsVertigoMeta-analysis of recent literature on utility of follow-up imaging in isolated perimesencephalic hemorrhage
Geng B, Wu X, Brackett A, Malhotra A. Meta-analysis of recent literature on utility of follow-up imaging in isolated perimesencephalic hemorrhage. Clinical Neurology And Neurosurgery 2019, 180: 111-116. PMID: 30974309, DOI: 10.1016/j.clineuro.2019.03.006.Peer-Reviewed Original ResearchConceptsPerimesencephalic subarachnoid hemorrhageSubarachnoid hemorrhageTomographic angiogramInitial angiographic studyRetrospective institutional analysisUtility of repeatSubarachnoid hemorrhage patientsVascular causesBenign prognosisVascular etiologyAngiographic studiesClinical pictureHemorrhage patientsHemorrhage patternAneurysmal ruptureAdditional imagingHemorrhageUse of repeatPatientsInstitutional reviewAngiogramsDistinct subtypesPerimesencephalic hemorrhageLimited benefitEtiology