2023
Trends in Use of Intravenous Thrombolysis and Endovascular Thrombectomy in Patients With Acute Stroke With Large Vessel Occlusion 2016 to 2020 and Impact of COVID‐19 Pandemic
Khunte M, Chen H, Khunte A, Payabvash S, Gandhi D, Malhotra A. Trends in Use of Intravenous Thrombolysis and Endovascular Thrombectomy in Patients With Acute Stroke With Large Vessel Occlusion 2016 to 2020 and Impact of COVID‐19 Pandemic. Journal Of The American Heart Association 2023, 12: e029579. PMID: 37889182, PMCID: PMC10727381, DOI: 10.1161/jaha.122.029579.Peer-Reviewed Original Research
2022
CT angiographic radiomics signature for risk stratification in anterior large vessel occlusion stroke
Avery EW, Behland J, Mak A, Haider SP, Zeevi T, Sanelli PC, Filippi CG, Malhotra A, Matouk CC, Griessenauer CJ, Zand R, Hendrix P, Abedi V, Falcone GJ, Petersen N, Sansing LH, Sheth KN, Payabvash S. CT angiographic radiomics signature for risk stratification in anterior large vessel occlusion stroke. NeuroImage Clinical 2022, 34: 103034. PMID: 35550243, PMCID: PMC9108990, DOI: 10.1016/j.nicl.2022.103034.Peer-Reviewed Original ResearchConceptsLarge vessel occlusion strokeIndependent cohortPrognostication toolsMechanical thrombectomyRisk stratificationOcclusion strokeExternal cohortAnterior circulation large vessel occlusion strokeOutcome predictionAcute stroke triageAnterior circulation territoryRadiomic featuresTime of admissionGeisinger Medical CenterLVO stroke patientsReliable clinical informationSignificant differencesAdmission CTAStroke patientsPrognostic informationFavorable outcomeStroke triageTreatment decisionsMedical CenterRadiomics signatureImpact 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
Similar admission NIHSS may represent larger tissue-at-risk in patients with right-sided versus left-sided large vessel occlusion
Mak A, Matouk C, Avery EW, Behland J, Frey D, Madai VI, Vajkoczy P, Malhotra A, Karam A, Sanelli P, Falcone GJ, Petersen NH, Sansing L, Sheth KN, Payabvash S. Similar admission NIHSS may represent larger tissue-at-risk in patients with right-sided versus left-sided large vessel occlusion. Journal Of NeuroInterventional Surgery 2021, 14: 985-991. PMID: 34645705, DOI: 10.1136/neurintsurg-2021-017785.Peer-Reviewed Original ResearchMeSH KeywordsBrain IschemiaCerebral InfarctionHumansRetrospective StudiesStrokeThrombectomyTreatment OutcomeConceptsLarge vessel occlusionFinal infarct volumeLarger final infarct volumeWorse discharge outcomesInfarct volumeAdmission NIHSSDischarge outcomesVessel occlusionScale scoreMultivariate analysisAnterior large vessel occlusionLower admission NIHSS scoreHealth Stroke Scale scoreAdmission National InstitutesAdmission stroke severityPoor discharge outcomeStroke Scale scoreLarger infarct volumesAdmission NIHSS scoreRankin Scale scoreVoxel-wise analysisIncomplete reperfusionInfarct distributionOcclusion sideNIHSS scoreRapid Assessment of Blood Pressure Variability and Outcome After Successful Thrombectomy
Castro P, Ferreira F, Nguyen CK, Payabvash S, Tan C, Sorond F, Azevedo E, Petersen N. Rapid Assessment of Blood Pressure Variability and Outcome After Successful Thrombectomy. Stroke 2021, 52: e531-e535. PMID: 34311565, PMCID: PMC8384685, DOI: 10.1161/strokeaha.121.034291.Peer-Reviewed Original ResearchMeSH KeywordsBlood PressureBrain IschemiaHumansHypertensionOdds RatioProspective StudiesStrokeThrombectomyTreatment OutcomeConceptsBlood pressure variabilityEndovascular stroke therapyBP variabilityFunctional outcomeNeurological recoveryStroke therapyPressure variabilityAnterior circulation ischemic strokeHigh blood pressure variabilityLong-term functional outcomeBP variability measuresEarly clinical improvementEarly neurological recoveryPersonalized BP managementFavorable functional outcomeInitial clinical responsePoor functional outcomeRisk assessment toolSuccessful reperfusionClinical improvementClinical responseIschemic strokeRankin ScaleSuccessful thrombectomyPostreperfusion period
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 benefitsOcclusionEffects 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 imaging
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 ResearchConceptsQuality-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 age
2015
Middle Cerebral Artery Residual Contrast Stagnation on Noncontrast CT Scan Following Endovascular Treatment in Acute Ischemic Stroke Patients
Payabvash S, Qureshi MH, Taleb S, Pawar S, Qureshi AI. Middle Cerebral Artery Residual Contrast Stagnation on Noncontrast CT Scan Following Endovascular Treatment in Acute Ischemic Stroke Patients. Journal Of Neuroimaging 2015, 25: 946-951. PMID: 25684437, DOI: 10.1111/jon.12211.Peer-Reviewed Original ResearchConceptsAcute ischemic stroke patientsMCA M1 occlusionIschemic stroke patientsIntraparenchymal hemorrhageEndovascular treatmentContrast stagnationCT scanPostprocedural CT scanNoncontrast CT scanStroke patientsM1 occlusionContralateral arteryHounsfield unitsAverage HU valueM1 segmentRelative riskNoncontrast CTPatientsScansArteryTreatmentAttenuation differenceHU valuesOcclusionRisk