2024
Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion
Mak A, Matouk C, Avery E, Behland J, Haider S, Frey D, Madai V, Vajkoczy P, Griessenauer C, Zand R, Hendrix P, Abedi V, Sanelli P, Falcone G, Petersen N, Sansing L, Sheth K, Payabvash S, Malhotra A. Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion. PLOS ONE 2024, 19: e0304962. PMID: 38870240, PMCID: PMC11175522, DOI: 10.1371/journal.pone.0304962.Peer-Reviewed Original ResearchConceptsDiffusion-weighted imagingLarge vessel occlusionIrreversible ischemic changesPoor functional outcomeFunctional outcomesIschemic changesInfarct volumeAlberta Stroke Program Early CT ScorePredicting poor functional outcomeVessel occlusionFollow-up diffusion-weighted imagingAnterior circulation LVO strokeCTA source imagesReceiver operating characteristic curveExpert human readersPredicting final infarctionASPECTS regionsAdmission CTANon-inferior performanceBaseline CTACT scoreFinal infarctEndovascular therapyHU attenuationValidation cohort
2023
Clinical implications of Peri-hematomal edema microperfusion fraction in intracerebral hemorrhage intravoxel incoherent motion imaging – A pilot study
Abou Karam G, Tharmaseelan H, Aboian M, Malhotra A, Gilmore E, Falcone G, de Havenon A, Sheth K, Payabvash S. Clinical implications of Peri-hematomal edema microperfusion fraction in intracerebral hemorrhage intravoxel incoherent motion imaging – A pilot study. Journal Of Stroke And Cerebrovascular Diseases 2023, 32: 107375. PMID: 37738914, PMCID: PMC10591892, DOI: 10.1016/j.jstrokecerebrovasdis.2023.107375.Peer-Reviewed Original ResearchConceptsModified Rankin ScaleSecondary brain injuryIntracerebral hemorrhagePerihematomal edemaSubacute intracerebral hemorrhageIntravoxel incoherent motion imagingAdmission NIHSSBrain injuryMedian baseline National InstitutesPilot studyBaseline National InstitutesHealth Stroke ScalePerfusion fractionSupratentorial intracerebral hemorrhageIVIM metricsIncoherent motion imagingStroke ScaleNeuroprotective therapiesParenchymal injuryRankin ScaleRisk patientsConsecutive patientsUnivariable analysisPoor outcomeICH volume
2020
Effects of Collateral Status on Infarct Distribution Following Endovascular Therapy in Large Vessel Occlusion Stroke
Al-Dasuqi K, Payabvash S, Torres-Flores GA, Strander SM, Nguyen CK, Peshwe KU, Kodali S, Silverman A, Malhotra A, Johnson MH, Matouk CC, Schindler JL, Sansing LH, Falcone GJ, Sheth KN, Petersen NH. Effects of Collateral Status on Infarct Distribution Following Endovascular Therapy in Large Vessel Occlusion Stroke. Stroke 2020, 51: e193-e202. PMID: 32781941, PMCID: PMC7484023, DOI: 10.1161/strokeaha.120.029892.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overArterial Occlusive DiseasesCerebral InfarctionCohort StudiesCollateral CirculationComputed Tomography AngiographyEndovascular ProceduresFemaleHumansInfarction, Middle Cerebral ArteryLinear ModelsMagnetic Resonance AngiographyMaleMiddle AgedReperfusionRetrospective StudiesStrokeThrombectomyTreatment OutcomeWhite MatterConceptsLarge vessel occlusion strokeFinal infarct volumeCollateral statusPoor collateral statusFavorable outcomeInfarct distributionInfarct volumeReperfusion successIndependent predictorsOcclusion strokeInternal capsuleAnterior circulation large vessel occlusion ischemic strokeLarge vessel occlusion ischemic strokeDeep white matter tractsBaseline collateral statusBorder-zone infarctionEarly favorable outcomeEarly functional outcomesRankin Scale scoreCohort of patientsDegree of reperfusionLarge vessel occlusionComputed tomography angiographyDeep white matterMagnetic resonance imagingSeptic cavernous sinus thrombosis—Case series and review of the literature
Geng B, Wu X, Malhotra A. Septic cavernous sinus thrombosis—Case series and review of the literature. Clinical Neurology And Neurosurgery 2020, 197: 106092. PMID: 32693341, DOI: 10.1016/j.clineuro.2020.106092.Peer-Reviewed Original ResearchConceptsCavernous sinus thrombosisAcademic tertiary care centerSeptic cavernous sinus thrombosisExtension of thrombosisTertiary care centerInternal jugular veinTransverse-sigmoid sinusLife-threatening diseaseSource of infectionCST patientsInfectious thrombosisSinus thrombosisPatient demographicsPseudo aneurysmReported complicationsIntracranial complicationsSubdural empyemaBilateral narrowingHigh morbidityTreatment coursePersistent narrowingRadiology databaseCare centerUnilateral narrowingJugular veinThirty- and 90-Day Readmissions After Treatment of Traumatic Subdural Hematoma: National Trend Analysis
Koo AB, Elsamadicy AA, David WB, Zogg CK, Santarosa C, Sujijantarat N, Robert SM, Kundishora AJ, Cord BJ, Hebert R, Bahrassa F, Malhotra A, Matouk CC. Thirty- and 90-Day Readmissions After Treatment of Traumatic Subdural Hematoma: National Trend Analysis. World Neurosurgery 2020, 139: e212-e219. PMID: 32272271, PMCID: PMC7380544, DOI: 10.1016/j.wneu.2020.03.168.Peer-Reviewed Original ResearchConceptsTraumatic subdural hematomaSubdural hematomaRheumatoid arthritis/collagen vascular diseasesMultivariate logistic regression analysisCollagen vascular diseaseNationwide Readmissions DatabaseCongestive heart failureLikelihood of readmissionPrimary procedure codeTraumatic brain injuryLogistic regression analysisReadmission ratesRenal failureHeart failurePostoperative infectionNinth RevisionSurgical interventionPatient populationVascular diseaseCerebral meningesBrain injuryClinical ModificationPatient managementReadmissionInternational ClassificationCT 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 ResearchMeSH KeywordsAgedAged, 80 and overComputed Tomography AngiographyCost-Benefit AnalysisHumansMiddle AgedStrokeTriageConceptsLarge 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
Comparative Effectiveness of Endovascular Thrombectomy in Elderly Stroke Patients
Malhotra A, Wu X, Payabvash S, Matouk CC, Forman HP, Gandhi D, Sanelli P, Schindler J. Comparative Effectiveness of Endovascular Thrombectomy in Elderly Stroke Patients. Stroke 2019, 50: 963-969. PMID: 30908156, DOI: 10.1161/strokeaha.119.025031.Peer-Reviewed Original ResearchMeSH KeywordsAged, 80 and overBrain IschemiaFemaleFibrinolytic AgentsHumansMaleStrokeThrombectomyTissue Plasminogen ActivatorTreatment OutcomeConceptsQuality-adjusted life yearsIntravenous thrombolysisEndovascular thrombectomyLarge vessel occlusionAge 80 yearsEVT strategyVessel occlusionModified Rankin Scale scorePoststroke functional outcomeAcute ischemic strokeRankin Scale scoreElderly stroke patientsMarkov decision-analytic modelYears of ageDecision analytic modelMultiple sensitivity analysesPurpose- StrokeAcute strokeBaseline disabilityElderly patientsIschemic strokeStroke patientsFunctional outcomeHealthy patientsAdvanced ageManagement of Unruptured Intracranial Aneurysms in Older Adults: A Cost-effectiveness Analysis.
Malhotra A, Wu X, Forman HP, Matouk CC, Hughes DR, Gandhi D, Sanelli P. Management of Unruptured Intracranial Aneurysms in Older Adults: A Cost-effectiveness Analysis. Radiology 2019, 291: 411-417. PMID: 30888931, DOI: 10.1148/radiol.2019182353.Peer-Reviewed Original Research
2018
Utility of MRI for cervical spine clearance in blunt trauma patients after a negative CT
Malhotra A, Durand D, Wu X, Geng B, Abbed K, Nunez DB, Sanelli P. Utility of MRI for cervical spine clearance in blunt trauma patients after a negative CT. European Radiology 2018, 28: 2823-2829. PMID: 29450715, DOI: 10.1007/s00330-017-5285-y.Peer-Reviewed Original ResearchConceptsBlunt trauma evaluationCervical spine CTCervical spine MRIUnstable injuriesBlunt traumaTrauma evaluationSpine CTSpine MRIBlunt cervical spine traumaCervical spine clearanceCT cervical spineAbnormal neurological examinationBlunt trauma patientsPercent of patientsCervical spine traumaCervical spine studiesSoft tissue injuriesUtility of MRICervical CTSpine clearanceAdult patientsSubsequent MRINeurological examinationSpine traumaTrauma patients
2015
Predictors of Vertebral Artery Injury in Isolated C2 Fractures Based on Fracture Morphology Using CT Angiography
Durand D, Wu X, Kalra VB, Abbed KM, Malhotra A. Predictors of Vertebral Artery Injury in Isolated C2 Fractures Based on Fracture Morphology Using CT Angiography. Spine 2015, 40: e713-e718. PMID: 25803220, DOI: 10.1097/brs.0000000000000893.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCervical VertebraeDatabases, FactualFemaleHumansMaleMiddle AgedPredictive Value of TestsPrognosisRetrospective StudiesRisk AssessmentRisk FactorsSpinal FracturesTomography, X-Ray ComputedTrauma CentersVascular System InjuriesVertebral ArteryYoung AdultConceptsVertebral artery injuryC2 fracturesComputed tomography angiographyTransverse foramenTomography angiographyArtery injuryLevel I trauma centerInstitutional board review approvalTransverse foramen fracturesType III densI trauma centerVertebral body fracturesRetrospective database analysisC2 transverse foramenFracture patternsFisher's exact testMultiplanar CT scansFracture classification schemeStudent's t-testAntithrombotic treatmentNeurological sequelaeFracture hospitalizationsOccipital fractureDens fracturesTrauma centerBilateral osteomas and exostoses of the internal auditory canal
Schutt CA, Guo JN, Bagwell KA, Bulsara KR, Malhotra A, Michaelides E. Bilateral osteomas and exostoses of the internal auditory canal. American Journal Of Otolaryngology 2015, 36: 583-586. PMID: 25896777, DOI: 10.1016/j.amjoto.2015.03.006.Peer-Reviewed Original Research