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Article ; Online: In Reply: Transradial Carotid Artery Stenting Using Walrus Balloon Guide Catheter: Technical Aspects and Clinical Outcome.

Yaeger, Kurt / Majidi, Shahram

Operative neurosurgery (Hagerstown, Md.)

2023 Volume 25, Issue 5, Page(s) e298

MeSH term(s)	Animals ; Stents ; Carotid Stenosis/diagnostic imaging ; Carotid Stenosis/surgery ; Walruses ; Carotid Arteries ; Catheters
Language	English
Publishing date	2023-09-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2767575-0
ISSN	2332-4260 ; 2332-4252
ISSN (online)	2332-4260
ISSN	2332-4252
DOI	10.1227/ons.0000000000000894
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Article ; Online: Woven endo bridge device for recurrent intracranial aneurysms: A systematic review and meta-analysis.

Habibi, Mohammad Amin / Rashidi, Farhang / Fallahi, Mohammad Sadegh / Arshadi, Mohammad Reza / Mehrtabar, Saba / Ahmadi, Mohammad Reza / Shafizadeh, Milad / Majidi, Shahram

The neuroradiology journal

2024 , Page(s) 19714009241247457

Abstract: Background: Recurrent intracranial aneurysms present a significant clinical challenge, demanding innovative and effective treatment approaches. The Woven EndoBridge (WEB) device has emerged as a promising endovascular solution for managing these ... ...

Abstract	Background: Recurrent intracranial aneurysms present a significant clinical challenge, demanding innovative and effective treatment approaches. The Woven EndoBridge (WEB) device has emerged as a promising endovascular solution for managing these intricate cases. This study aims to assess the safety and efficacy of the WEB device in treating recurrent intracranial aneurysms. Methods: We conducted a comprehensive search across multiple databases, including PubMed, Scopus, Embase, and Web of Science, from inception to June 5, 2023. Eligible studies focused on evaluating WEB device performance and included a minimum of five patients with recurrent intracranial aneurysms. The complete and adequate occlusion rates, neck remnant rates, and periprocedural complication rates were pooled using SATA V.17. Results: Our analysis included five studies collectively enrolling 73 participants. Participant ages ranged from 52.9 to 65 years, with 64.4% being female. Aneurysms were wide-necked and predominantly located in the middle cerebral artery, basilar artery, and anterior cerebral artery. Previous treatments encompassed coiling, clipping, and the use of WEB devices. Our study found an overall adequate occlusion rate of 0.80 (95% CI 0.71-0.89), a complete occlusion rate of 0.39 (95% CI 0.28-0.50), and a neck remnant rate of 0.38 (95% CI 0.27-0.48). Periprocedural complications were reported at a rate of 0%, although heterogeneity was observed in this data. Notably, evidence of publication bias was identified in the reporting of periprocedural complication rates. Conclusion: Our findings suggest that the WEB device is associated with favorable outcomes for treating recurrent wide-neck intracranial aneurysms.
Language	English
Publishing date	2024-04-13
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2257770-1
ISSN	2385-1996 ; 1971-4009 ; 1120-9976
ISSN (online)	2385-1996
ISSN	1971-4009 ; 1120-9976
DOI	10.1177/19714009241247457
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Zs.A 2823: Show issues

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Article ; Online: Effects of Dimethyl Fumarate on the Karnofsky Performance Status and Serum S100β Level in Newly Glioblastoma Patients: A Randomized, Phase-II, Placebo, Triple Blinded, Controlled Trial: Effect of DMF On the Serum S100β Level and KPS Score of GBM Patients.

Milad, Shafizadeh / Ehsan, Jangholi / Seyed Farzad, Maroufi / Mohsen, Rostami / Ahmad, Bereimipour / Shahram, Majidi / Niayesh, Mohebi / Alireza, Khoshnevisan

Galen medical journal

2022 Volume 10, Page(s) 1–10

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2022-08-18
Publishing country	Iran
Document type	Journal Article
ZDB-ID	2717170-X
ISSN	2322-2379 ; 2322-2379
ISSN (online)	2322-2379
ISSN	2322-2379
DOI	10.31661/gmj.v11i.1897
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Article ; Online: Endovascular thrombectomy for distal vessel occlusion stroke: Single-center experience.

Matsoukas, Stavros / Paz, Santiago Gomez / Kellner, Christopher P / De Leacy, Reade / Fifi, Johanna T / Mocco, J / Majidi, Shahram

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences

2023 , Page(s) 15910199231162670

Abstract: Background: The safety and efficacy of endovascular thrombectomy (EVT) in distal vessel occlusion (DVO) are not well described. We aimed to evaluate the technical feasibility and safety of EVT in patients with DVO.: Methods: We performed a ... ...

Abstract	Background: The safety and efficacy of endovascular thrombectomy (EVT) in distal vessel occlusion (DVO) are not well described. We aimed to evaluate the technical feasibility and safety of EVT in patients with DVO. Methods: We performed a retrospective analysis of consecutive DVOs (defined as M3/M4, A1/A2, and P1/P2 occlusion) who underwent EVT within 24 h since last known well. The primary efficacy outcome was successful reperfusion (mTICI ≥ 2B). Secondary outcomes included successful recanalization with ≤3 passes. The safety outcome measures included the rate of subarachnoid hemorrhage (SAH), all intracerebral hemorrhage (ICH), and symptomatic ICH (sICH). Results: A total of 72 patients with DVO was identified: 39 (54%) with M3/M4, 13 (18%) with A1/A2, and 20 (28%) with P1/P2 occlusions. Admission NIHSS score median (IQR) was 12 (11), and 90% of the patients had baseline mRS ≤ 2. Thirty-six percent of the patients received intravenous thrombolytic therapy. Successful recanalization was achieved in 90% of the patients. The median number of passes was 2, with successful recanalization achieved with ≤3 passes in 83% of the patients. ICH was seen in 16% of the patients, including three SAHs. However, only one patient (1.4%) had sICH. Among 48 patients in whom 90-day outcome data were available, 33 (53.2%) had favorable clinical outcome (mRS ≤ 3). In a multivariable logistic regression, only baseline NIHSS was identified as an independent predictor of poor outcome. Conclusion: This single-center real-world experience demonstrates that EVT in patients with DVO stroke is safe and feasible and may lead to improved clinical outcome.
Language	English
Publishing date	2023-03-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	1354913-3
ISSN	2385-2011 ; 1591-0199 ; 1123-9344
ISSN (online)	2385-2011
ISSN	1591-0199 ; 1123-9344
DOI	10.1177/15910199231162670
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Zs.A 6325: Show issues

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Article ; Online: Cigarette Smoking as a Risk Factor for Hematoma Expansion in Primary Intracerebral Hemorrhage: Analysis From a Randomized Clinical Trial.

Schupper, Alexander J / Khorasanizadeh, Mirhojjat / Rossitto, Christina P / Foster, Lydia D / Kellner, Christopher P / Suarez, Jose I / Qureshi, Adnan I / Majidi, Shahram

Journal of the American Heart Association

2023 Volume 12, Issue 15, Page(s) e030431

Abstract: Background Cigarette smoking is a well-known risk factor for ischemic and hemorrhagic stroke. We evaluated the impact of smoking status on hematoma expansion and clinical outcome in patients with primary intracerebral hemorrhage. Methods and Results This ...

Abstract	Background Cigarette smoking is a well-known risk factor for ischemic and hemorrhagic stroke. We evaluated the impact of smoking status on hematoma expansion and clinical outcome in patients with primary intracerebral hemorrhage. Methods and Results This is a post hoc exploratory analysis of the ATACH (Antihypertensive Treatment at Acute Cerebral Hemorrhage)-2 trial. Patients with intracerebral hemorrhage were randomized into intensive blood pressure lowering (systolic blood pressure, <139 mm Hg) versus standard blood pressure lowering (systolic blood pressure, 140-179 mm Hg) in this study. We compared the demographic characteristics; hematoma size, location, and expansion rate; and clinical outcome based on subjects' smoking status. Of a total of 914 patients in the trial with known smoking status, 439 (48%) patients were ever smokers (264 current smokers and 175 former smokers). Current and former smokers were younger and more likely to be men. Baseline Glasgow Coma Scale score and initial hematoma size did not vary based on smoking status. Ever smokers had higher rates of thalamic hemorrhage (42% versus 34%) and intraventricular hemorrhage (29% versus 23%); this rate was highest among former smokers versus current smokers (49% versus 35%, respectively). Ever smokers had a higher rate of hematoma expansion in 24 hours (adjusted relative risk [RR] [95% CI], 1.46 [1.08-1.96]) compared with nonsmokers on multivariate analysis. There was no significant difference in the rate of death and disability at 90 days between the 2 groups (adjusted RR [95% CI], 1.18 [0.998-1.40]). Conclusions Our analysis demonstrates cigarette smoking as an independent predictor for hematoma expansion. There was no significant difference in death and disability based on smoking status.
MeSH term(s)	Male ; Humans ; Female ; Cigarette Smoking/adverse effects ; Cigarette Smoking/epidemiology ; Cerebral Hemorrhage/drug therapy ; Antihypertensive Agents/adverse effects ; Blood Pressure/physiology ; Risk Factors ; Hematoma/epidemiology ; Hematoma/drug therapy ; Treatment Outcome
Chemical Substances	Antihypertensive Agents
Language	English
Publishing date	2023-07-31
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.123.030431
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Article ; Online: Prediction of cerebral aneurysm rupture risk by machine learning algorithms: a systematic review and meta-analysis of 18,670 participants.

Habibi, Mohammad Amin / Fakhfouri, Amirata / Mirjani, Mohammad Sina / Razavi, Alireza / Mortezaei, Ali / Soleimani, Yasna / Lotfi, Sohrab / Arabi, Shayan / Heidaresfahani, Ladan / Sadeghi, Sara / Minaee, Poriya / Eazi, SeyedMohammad / Rashidi, Farhang / Shafizadeh, Milad / Majidi, Shahram

Neurosurgical review

2024 Volume 47, Issue 1, Page(s) 34

Abstract: It is possible to identify unruptured intracranial aneurysms (UIA) using machine learning (ML) algorithms, which can be a life-saving strategy, especially in high-risk populations. To better understand the importance and effectiveness of ML algorithms in ...

Abstract	It is possible to identify unruptured intracranial aneurysms (UIA) using machine learning (ML) algorithms, which can be a life-saving strategy, especially in high-risk populations. To better understand the importance and effectiveness of ML algorithms in practice, a systematic review and meta-analysis were conducted to predict cerebral aneurysm rupture risk. PubMed, Scopus, Web of Science, and Embase were searched without restrictions until March 20, 2023. Eligibility criteria included studies that used ML approaches in patients with cerebral aneurysms confirmed by DSA, CTA, or MRI. Out of 35 studies included, 33 were cohort, and 11 used digital subtraction angiography (DSA) as their reference imaging modality. Middle cerebral artery (MCA) and anterior cerebral artery (ACA) were the commonest locations of aneurysmal vascular involvement-51% and 40%, respectively. The aneurysm morphology was saccular in 48% of studies. Ten of 37 studies (27%) used deep learning techniques such as CNNs and ANNs. Meta-analysis was performed on 17 studies: sensitivity of 0.83 (95% confidence interval (CI), 0.77-0.88); specificity of 0.83 (95% CI, 0.75-0.88); positive DLR of 4.81 (95% CI, 3.29-7.02) and the negative DLR of 0.20 (95% CI, 0.14-0.29); a diagnostic score of 3.17 (95% CI, 2.55-3.78); odds ratio of 23.69 (95% CI, 12.75-44.01). ML algorithms can effectively predict the risk of rupture in cerebral aneurysms with good levels of accuracy, sensitivity, and specificity. However, further research is needed to enhance their diagnostic performance in predicting the rupture status of IA.
MeSH term(s)	Humans ; Intracranial Aneurysm/diagnostic imaging ; Stroke ; Algorithms ; Angiography, Digital Subtraction ; Machine Learning
Language	English
Publishing date	2024-01-06
Publishing country	Germany
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	6907-3
ISSN	1437-2320 ; 0344-5607
ISSN (online)	1437-2320
ISSN	0344-5607
DOI	10.1007/s10143-023-02271-2
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Zs.A 1445: Show issues

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Article ; Online: Early institutional experience using the TracStar Large Distal Platform in endovascular flow diversion.

Bageac, Devin V / Gershon, Blake S / Shigematsu, Tomoyoshi / Majidi, Shahram / De Leacy, Reade A

The neuroradiology journal

2021 Volume 35, Issue 3, Page(s) 313–318

Abstract: Introduction: The delivery of flow-diverting stents (FDS) necessitates a degree of catheter support beyond that required for endovascular coiling. The TracStar Large Distal Platform (LDP) is a novel 0.088″ platform intended for navigation into the ... ...

Abstract	Introduction: The delivery of flow-diverting stents (FDS) necessitates a degree of catheter support beyond that required for endovascular coiling. The TracStar Large Distal Platform (LDP) is a novel 0.088″ platform intended for navigation into the intracranial internal carotid artery (ICA). We present an early institutional experience using the TracStar LDP in 44 cases of endovascular aneurysm embolization using FDS. Methods: Inclusion criteria for this single-center retrospective review encompassed all patients >18 years of age who were treated for intracranial aneurysms. Procedural success was defined as successful stent deployment using the TracStar LDP. Other outcomes included periprocedural complications, use of an intermediate catheter, length of stay, and discharge disposition. Results: The TracStar LDP was utilized in 44 consecutive FDS cases in 42 patients. Cavernous segment aneurysms constituted the majority of cases (12/42; 28.6%), followed by posterior communicating artery (8/42; 19.0%) and supraclinoid aneurysms (8/42; 19.0%). Successful FDS deployment was achieved in 43/44 cases. The LDP achieved stable positioning within the ascending cavernous ICA in 63.6% of cases. A biaxial system was utilized in 54.5% of cases. There was one complication potentially related to use of the TracStar LDP, which was an asymptomatic ICA vessel dissection managed conservatively. Conclusions: The TracStar LDP is safe and effective during use in the endovascular treatment of intracranial aneurysms with a FDS. Access to the ascending portion of the cavernous ICA was regularly achieved, and the platform allowed for both biaxial and triaxial configurations.
MeSH term(s)	Aortic Aneurysm, Abdominal/etiology ; Aortic Aneurysm, Abdominal/therapy ; Blood Vessel Prosthesis Implantation ; Embolization, Therapeutic/adverse effects ; Endovascular Procedures ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Retrospective Studies ; Stents ; Treatment Outcome
Language	English
Publishing date	2021-09-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2257770-1
ISSN	2385-1996 ; 1971-4009 ; 1120-9976
ISSN (online)	2385-1996
ISSN	1971-4009 ; 1120-9976
DOI	10.1177/19714009211041520
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Zs.A 2823: Show issues

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Article ; Online: Modeling the Impact of Prehospital Triage on a True-Life Drip and Ship Mechanical Thrombectomy Urban Patient Cohort.

Matsoukas, Stavros / Giovanni, Brian / Rubinstein, Liorah / Majidi, Shahram / Stein, Laura K / Fifi, Johanna T

Cerebrovascular diseases extra

2021 Volume 11, Issue 3, Page(s) 137–144

Abstract: Objective: The aim of the study was to model the effect of prehospital triage of emergent large vessel occlusion (ELVO) to endovascular capable center (ECC) on the timing of thrombectomy and intravenous (IV) thrombolysis using real-world data from a ... ...

Abstract	Objective: The aim of the study was to model the effect of prehospital triage of emergent large vessel occlusion (ELVO) to endovascular capable center (ECC) on the timing of thrombectomy and intravenous (IV) thrombolysis using real-world data from a multihospital system. Methods: We selected a cohort of 77 consecutive stroke patients who were brought by emergency medical services (EMS) to a nonendovascular capable center and then transferred to an ECC for mechanical thrombectomy (MT) ("actual" drip and ship [DS] cohort). We created a hypothetical scenario (bypass model [BM]), modeling transfer of the patients directly to an ECC, based on patients' initial EMS pickup address and closest ECC. Using another cohort of 73 consecutive patients, who were brought directly to an ECC by EMS and underwent endovascular intervention, we calculated mean door-to-needle and door-to-arterial puncture (AP) times ("actual" mothership [MS] cohort). Timings in the actual MS cohort and the actual DS cohort were compared to timings from the BM cohort. Results: Median first medical contact (FMC) to IV thrombolysis time was 87.5 min (interquartile range [IQR] = 38) for the DS versus 78.5 min (IQR = 8.96) for the BM cohort, with p = 0.1672. Median FMC to AP was 244 min (IQR = 97) versus 147 min (IQR = 8.96) (p < 0.001), and median FMC to TICI 2B+ time was 299 min (IQR = 108.5) versus 197 min (IQR = 8.96) (p < 0.001) for the DS versus BM cohort, respectively. Conclusions: Modeled EMS prehospital triage of ELVO patients' results in shorter MT times without a change in thrombolysis times. As triage tools increase in sensitivity and specificity, EMS triage protocols stand to improve patient outcomes.
MeSH term(s)	Brain Ischemia ; Emergency Medical Services ; Humans ; Stroke/diagnosis ; Stroke/drug therapy ; Thrombectomy ; Triage
Language	English
Publishing date	2021-11-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2651613-5
ISSN	1664-5456 ; 1664-5456
ISSN (online)	1664-5456
ISSN	1664-5456
DOI	10.1159/000520078
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Article ; Online: Prognostic Utility of Serum Biomarkers in Intracerebral Hemorrhage: A Systematic Review.

Troiani, Zachary / Ascanio, Luis / Rossitto, Christina P / Ali, Muhammad / Mohammadi, Nicki / Majidi, Shahram / Mocco, J / Kellner, Christopher P

Neurorehabilitation and neural repair

2021 Volume 35, Issue 11, Page(s) 946–959

Abstract: Background. ...

Abstract	Background.
MeSH term(s)	Biomarkers/blood ; Cerebral Hemorrhage/blood ; Cerebral Hemorrhage/diagnosis ; Cerebral Hemorrhage/immunology ; Cerebral Hemorrhage/metabolism ; Humans ; Predictive Value of Tests ; Prognosis
Chemical Substances	Biomarkers
Language	English
Publishing date	2021-09-18
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	1491637-x
ISSN	1552-6844 ; 1545-9683 ; 0888-4390
ISSN (online)	1552-6844
ISSN	1545-9683 ; 0888-4390
DOI	10.1177/15459683211041314
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Zs.B 3096: Show issues

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Article ; Online: Laterality of previous stoke affects endovascular thrombectomy outcomes.

Bageac, Devin V / Gershon, Blake S / Chada, Deeksha / Siddiqui, Neha / Majidi, Shahram / Fifi, Johanna T / De Leacy, Reade

Journal of neurointerventional surgery

2022 Volume 15, Issue 3, Page(s) 238–241

Abstract: Background: Investigations into the effect of previous stroke on thrombectomy outcomes have yielded conflicting results, and are limited by small sample sizes. We present the results of a large single center retrospective study aimed at investigating ... ...

Abstract	Background: Investigations into the effect of previous stroke on thrombectomy outcomes have yielded conflicting results, and are limited by small sample sizes. We present the results of a large single center retrospective study aimed at investigating the effect of chronic stroke laterality on thrombectomy outcomes. Methods: A prospectively maintained database was queried for all thrombectomy cases conducted between December 2014 and January 2020, and patient imaging was prospectively reviewed for evidence of prior supratentorial infarction. Procedural, clinical, and demographic characteristics were recorded, and good clinical outcome was defined as a 90 day modified Rankin Scale (mRS) score of <2 or mRS score unchanged if baseline was >2. Results: The final analysis cohort included 555 patients, 79 of whom were found to have radiographic evidence of prior chronic infarcts. On univariate analysis, patients with any chronic supratentorial infarct achieved a lower rate of good clinical outcome than patients with no chronic infarct (22.8% vs 41.0%, p=0.0021). With regard to subgroups, this difference remained only in patients with ipsilateral (14.3%, p=0.0018) and bilateral (11.8%, p=0.015) lesions. Patients with chronic contralateral supratentorial infarcts were no less likely to achieve good outcomes (40.7%, p=0.98). After multivariate regression controlling for age, sex, and baseline mRS, chronic ipsilateral infarcts (OR 0.22, CI 0.07 to 0.67) and chronic bilateral infarcts (OR 0.19, CI 0.04 to 0.85) were the only independent predictors of poor outcome in endovascular thrombectomy patients. Conclusions: In this single center retrospective study of thrombectomy patients with chronic supratentorial infarcts, the laterality of the previous stroke significantly affected the likelihood of good clinical outcomes.
MeSH term(s)	Humans ; Retrospective Studies ; Treatment Outcome ; Stroke/diagnostic imaging ; Stroke/surgery ; Stroke/pathology ; Thrombectomy/methods ; Infarction ; Endovascular Procedures/methods ; Brain Ischemia
Language	English
Publishing date	2022-01-31
Publishing country	England
Document type	Journal Article
ZDB-ID	2514982-9
ISSN	1759-8486 ; 1759-8478
ISSN (online)	1759-8486
ISSN	1759-8478
DOI	10.1136/neurintsurg-2021-018011
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