2022
Impact of collateral flow on cost-effectiveness of endovascular thrombectomy.
Khunte M, Wu X, Avery EW, Gandhi D, Payabvash S, Matouk C, Heit JJ, Wintermark M, Albers GW, Sanelli P, Malhotra A. Impact of collateral flow on cost-effectiveness of endovascular thrombectomy. Journal Of Neurosurgery 2022, 137: 1801-1810. PMID: 35535841, DOI: 10.3171/2022.2.jns212887.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioEndovascular thrombectomyIschemic stroke patientsCollateral statusPoor collateral statusBetter outcomesPoor collateralsCollateral circulationStroke patientsAcute ischemic stroke patientsModified Rankin Scale scorePoor collateral circulationRankin Scale scoreLarge vessel occlusionCollateral blood flowGood collateral blood flowCost-effectiveness ratioBase-case analysisProbabilistic sensitivity analysesEVT strategyEVT treatmentIschemic strokeMedical therapyMore patientsCollateral flowCost-effectiveness of thrombectomy in patients with minor stroke and large vessel occlusion: effect of thrombus location on cost-effectiveness and outcomes
Khunte M, Wu X, Koo A, Payabvash S, Matouk C, Heit JJ, Wintermark M, Albers GW, Sanelli PC, Gandhi D, Malhotra A. Cost-effectiveness of thrombectomy in patients with minor stroke and large vessel occlusion: effect of thrombus location on cost-effectiveness and outcomes. Journal Of NeuroInterventional Surgery 2022, 15: 39-45. PMID: 35022300, DOI: 10.1136/neurintsurg-2021-018375.Peer-Reviewed Original ResearchConceptsLarge vessel occlusionProximal M1 occlusionEndovascular thrombectomyMinor strokeM2 occlusionsIntravenous thrombolysisM1 occlusionMedical managementVessel occlusionRankin score 0Markov decision-analytic modelBase-case analysisDecision analytic modelProbabilistic sensitivity analysesProximal M1More patientsPoor outcomeThrombus locationDistal M1Occlusion siteObservational studyScore 0Significant disabilityBetter outcomesPatients
2021
Cost-effectiveness of endovascular thrombectomy in patients with low Alberta Stroke Program Early CT Scores (< 6) at presentation.
Wu X, Payabvash S, Matouk CC, Lev MH, Wintermark M, Sanelli P, Gandhi D, Malhotra A. Cost-effectiveness of endovascular thrombectomy in patients with low Alberta Stroke Program Early CT Scores (< 6) at presentation. Journal Of Neurosurgery 2021, 135: 1645-1655. PMID: 33962378, DOI: 10.3171/2020.9.jns202965.Peer-Reviewed Original ResearchAlberta Stroke Program Early CT ScoreLow Alberta Stroke Program Early CT ScoreEndovascular thrombectomyLarge vessel occlusionMedical managementCT scoreBetter outcomesCost-effective strategyEVT-treated patientsIncremental cost-effectiveness ratioAcute ischemic strokeCost-effectiveness ratioDecision-analytical studyIschemic strokePoor outcomeVessel occlusionLifetime horizonSignificant disabilityPatientsHealth outcomesAge groupsPerfect healthSocietal perspectiveQALYHealth benefits
2020
Outcomes after Thrombectomy for Minor Stroke: A Meta-Analysis
Wu X, Khunte M, Payabvash S, Zhu C, Brackett A, Matouk CC, Gandhi D, Sanelli P, Malhotra A. Outcomes after Thrombectomy for Minor Stroke: A Meta-Analysis. World Neurosurgery 2020, 149: e1140-e1154. PMID: 33359881, DOI: 10.1016/j.wneu.2020.12.047.Peer-Reviewed Original ResearchConceptsSymptomatic intracranial hemorrhageBest medical managementMedical managementMechanical thrombectomyExcellent outcomesBetter outcomesImmediate thrombectomyMinor strokeIncidence of sICHLarge vessel occlusionSignificant selection biasStroke symptomatologyIntravenous thrombolysisBaseline characteristicsPooled proportionIntracranial hemorrhageOdds ratioThrombectomyMT outcomesMeta-AnalysisPatientsMortalityOutcomesStrokeSelection biasCost-effectiveness of endovascular thrombectomy in patients with acute stroke and M2 occlusion
Khunte M, Wu X, Payabvash S, Zhu C, Matouk C, Schindler J, Sanelli P, Gandhi D, Malhotra A. Cost-effectiveness of endovascular thrombectomy in patients with acute stroke and M2 occlusion. Journal Of NeuroInterventional Surgery 2020, 13: 784-789. PMID: 33077578, DOI: 10.1136/neurintsurg-2020-016765.Peer-Reviewed Original ResearchConceptsEndovascular thrombectomyMedical managementProbabilistic sensitivity analysesM2 occlusionsAcute strokeBranch occlusionEVT-treated patientsAcute ischemic strokeQuality-adjusted life yearsLifetime quality-adjusted life yearsDecision analytic modelDecision analytic studyIschemic strokeReperfusion techniquesLifetime horizonBetter outcomesPatientsLife yearsAge groupsPerfect healthSocietal perspectiveCost-effective strategyStrokeHealth benefitsOcclusion
2013
Good Outcome Rate of 35% in IV-tPA–Treated Patients With Computed Tomography Angiography Confirmed Severe Anterior Circulation Occlusive Stroke
González RG, Furie KL, Goldmacher GV, Smith WS, Kamalian S, Payabvash S, Harris GJ, Halpern EF, Koroshetz WJ, Camargo EC, Dillon WP, Lev MH. Good Outcome Rate of 35% in IV-tPA–Treated Patients With Computed Tomography Angiography Confirmed Severe Anterior Circulation Occlusive Stroke. Stroke 2013, 44: 3109-3113. PMID: 24003051, PMCID: PMC4374554, DOI: 10.1161/strokeaha.113.001938.Peer-Reviewed Original ResearchConceptsAnterior circulation occlusionGood outcome rateIV-tPACT angiographyBetter outcomesRankin ScaleOutcome ratesAnterior circulation ischemic strokeHealth Stroke Scale scoreIntravenous tissue plasminogen activatorAdmission National InstitutesEndovascular therapy trialsNoncontrast CT scanningStroke Scale scoreLarge artery occlusionIV-tPA treatmentLogistic regression analysisTissue plasminogen activatorRoutine clinical protocolsSymptomatic strokeOcclusive strokeAcute strokeAdmission NIHSSArtery occlusionIschemic stroke