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Article ; Online: Response: successful endovascular treatment of three fusiform cerebral aneurysms with the pipeline embolization device in a patient with dilating HIV vasculopathy. Authors' reply.

Delgado Almandoz, Josser E / Kadkhodayan, Yasha / Scholz, Jill M / Fease, Jennifer L

2017 Volume 9, Issue e1, Page(s) e7–e8

Language	English
Publishing date	2017
Publishing country	England
Document type	Letter
ZDB-ID	2514982-9
ISSN	1759-8486 ; 1759-8478
ISSN (online)	1759-8486
ISSN	1759-8478
DOI	10.1136/neurintsurg-2015-011759
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Article ; Online: Direct puncture sclerotherapy of a thoracic duct cyst presenting as an enlarging left supraclavicular mass.

Kadkhodayan, Yasha / Yano, Motoyo / Cross, DeWitte T

Journal of neurointerventional surgery

2014 Volume 6, Issue 9, Page(s) e44

Abstract: A 58-year-old woman presented with a palpable mass at the base of the left neck which she had first noticed 12 years previously, shortly after abdominal surgery. The mass had progressively enlarged, resulting in dysphagia, dyspnea and occasional pain. ... ...

Abstract	A 58-year-old woman presented with a palpable mass at the base of the left neck which she had first noticed 12 years previously, shortly after abdominal surgery. The mass had progressively enlarged, resulting in dysphagia, dyspnea and occasional pain. Imaging showed a septated but otherwise simple cystic mass extending into the mediastinum and containing lymphocytic fluid on aspiration. A diagnosis of the rare entity of a thoracic duct cyst with supraclavicular extension was made. The patient opted for percutaneous sclerotherapy of the lesion, which was performed using glacial acetic acid. This resulted in complete resolution of the mass with one treatment. After exclusion of other causes of cystic left supraclavicular masses including cystic neoplasms and pseudoaneurysms of the carotid or subclavian arteries, direct puncture sclerotherapy can be safe and effective.
MeSH term(s)	Acetic Acid ; Diagnosis, Differential ; Female ; Humans ; Mediastinal Cyst/diagnosis ; Mediastinal Cyst/therapy ; Middle Aged ; Neck/pathology ; Sclerosing Solutions ; Sclerotherapy/methods ; Thoracic Duct ; Treatment Outcome
Chemical Substances	Sclerosing Solutions ; Acetic Acid (Q40Q9N063P)
Language	English
Publishing date	2014-11
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2514982-9
ISSN	1759-8486 ; 1759-8478
ISSN (online)	1759-8486
ISSN	1759-8478
DOI	10.1136/neurintsurg-2013-010844.rep
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Article ; Online: Direct puncture sclerotherapy of a thoracic duct cyst presenting as an enlarging left supraclavicular mass.

Kadkhodayan, Yasha / Yano, Motoyo / Cross, DeWitte T

BMJ case reports

2013 Volume 2013

Abstract	A 58-year-old woman presented with a palpable mass at the base of the left neck which she had first noticed 12 years previously, shortly after abdominal surgery. The mass had progressively enlarged, resulting in dysphagia, dyspnea and occasional pain. Imaging showed a septated but otherwise simple cystic mass extending into the mediastinum and containing lymphocytic fluid on aspiration. A diagnosis of the rare entity of a thoracic duct cyst with supraclavicular extension was made. The patient opted for percutaneous sclerotherapy of the lesion, which was performed using glacial acetic acid. This resulted in complete resolution of the mass with one treatment. After exclusion of other causes of cystic left supraclavicular masses including cystic neoplasms and pseudoaneurysms of the carotid or subclavian arteries, direct puncture sclerotherapy can be safe and effective.
MeSH term(s)	Biopsy, Needle ; Clavicle ; Contrast Media ; Female ; Fluoroscopy/methods ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Mediastinal Cyst/diagnostic imaging ; Mediastinal Cyst/pathology ; Mediastinal Cyst/therapy ; Middle Aged ; Neck ; Patient Safety ; Punctures ; Risk Assessment ; Sclerosing Solutions/therapeutic use ; Sclerotherapy/methods ; Severity of Illness Index ; Thoracic Duct/diagnostic imaging ; Thoracic Duct/surgery ; Tomography, X-Ray Computed/methods ; Treatment Outcome
Chemical Substances	Contrast Media ; Sclerosing Solutions
Language	English
Publishing date	2013-10-30
Publishing country	England
Document type	Case Reports ; Journal Article ; Review
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2013-010844
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Article ; Online: Postpartum reversible cerebral vasoconstriction syndrome: review and analysis of the current data.

Skeik, Nedaa / Porten, Brandon R / Kadkhodayan, Yasha / McDonald, William / Lahham, Firas

Vascular medicine (London, England)

2015 Volume 20, Issue 3, Page(s) 256–265

Abstract: Postpartum reversible cerebral vasoconstriction syndrome (PPRCVS) is a rare but serious cause of headache that occurs in the early postpartum period. The rarity of this disorder has limited the current literature to single case reports and small, ... ...

Abstract	Postpartum reversible cerebral vasoconstriction syndrome (PPRCVS) is a rare but serious cause of headache that occurs in the early postpartum period. The rarity of this disorder has limited the current literature to single case reports and small, observational case series. The lack of familiarity with PPRCVS may contribute to mismanagement of these unique patients and lead to poor outcomes. To address current gaps in the understanding of PPRCVS, this review and data analysis characterizes the demographics, presentation, clinical course, management and prognosis of PPRCVS and provides a general review of the epidemiology, pathophysiology and diagnosis to assist clinicians who may care for patients with this rare disorder.
MeSH term(s)	Cerebral Arteries ; Cerebrovascular Disorders/diagnosis ; Cerebrovascular Disorders/therapy ; Constriction, Pathologic ; Diagnosis, Differential ; Female ; Humans ; Puerperal Disorders/diagnosis ; Puerperal Disorders/therapy ; Syndrome
Language	English
Publishing date	2015-06
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1311628-9
ISSN	1477-0377 ; 1358-863X
ISSN (online)	1477-0377
ISSN	1358-863X
DOI	10.1177/1358863X14567976
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Zs.A 4409: Show issues

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Article ; Online: Incidence and mechanisms of stroke after permanent carotid artery occlusion following temporary occlusion testing.

Whisenant, Justin T / Kadkhodayan, Yasha / Cross, DeWitte T / Moran, Christopher J / Derdeyn, Colin P

Journal of neurointerventional surgery

2015 Volume 7, Issue 6, Page(s) 395–401

Abstract: Background and purpose: Patients who require sacrifice of the internal carotid artery (ICA) have a substantial risk of stroke, despite preoperative testing with temporary balloon occlusion (TBO). The purpose of this study is to examine the incidence and ...

Abstract	Background and purpose: Patients who require sacrifice of the internal carotid artery (ICA) have a substantial risk of stroke, despite preoperative testing with temporary balloon occlusion (TBO). The purpose of this study is to examine the incidence and mechanisms of stroke after permanent carotid artery occlusion in this population. Methods: Consecutive patients undergoing TBO testing from March 2002 to December 2011 were identified. The protocol included 30 min of balloon occlusion, continuous intraprocedural neurological assessment, angiographic imaging of collateral flow during the occlusion, and perfusion imaging. Clinical records were reviewed for procedure results, procedural complications, and the incidence and causes of stroke, transient ischemic attack (TIA) and death over 6 months. Strokes were categorized as thromboembolic or hypoperfusion based on available clinical and imaging data. Results: One hundred and fifty carotid occlusion tests were performed during the study period, including 84 women and 66 men. No procedural strokes were recorded. Thirty-seven patients (25%) had permanent occlusion of the tested ICA. Six of the 37 patients had ipsilateral stroke (16.2%) and three experienced TIA (8.1%). Two strokes occurred in the immediate postoperative period (thromboembolic), two strokes occurred within days of ICA occlusion (hypoperfusion), and two strokes occurred at least 30 days from the time of ICA occlusion (thromboembolic). Conclusions: The rate of ischemic stroke following carotid sacrifice remains high and most strokes are thromboembolic in nature. Our testing protocol did not eliminate the risk of hypoperfusion-related stroke. Delayed venous phase by angiography may be a better indicator of hemodynamic tolerance than perfusion imaging.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Balloon Occlusion/adverse effects ; Balloon Occlusion/statistics & numerical data ; Carotid Artery, Internal/diagnostic imaging ; Cerebrovascular Circulation/physiology ; Child ; Endovascular Procedures/adverse effects ; Endovascular Procedures/statistics & numerical data ; Female ; Hemostasis ; Humans ; Incidence ; Intraoperative Neurophysiological Monitoring ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Radiography ; Stroke/epidemiology ; Stroke/etiology ; Young Adult
Keywords	covid19
Language	English
Publishing date	2015-06
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-2014-011207
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Zs.A 6845: Show issues

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Article ; Online: Impact of vessel choice on outcomes of polyvinyl alcohol embolization for intractable idiopathic epistaxis.

Gottumukkala, Ravi / Kadkhodayan, Yasha / Moran, Christopher J / Cross, De Witte T / Derdeyn, Colin P

Journal of vascular and interventional radiology : JVIR

2013 Volume 24, Issue 2, Page(s) 234–239

Abstract: Purpose: To determine the safety and efficacy of internal maxillary artery (IMA) and facial artery polyvinyl alcohol (PVA) embolization for treatment of refractory idiopathic epistaxis.: Materials and methods: From 1998-2011, 84 patients were ... ...

Abstract	Purpose: To determine the safety and efficacy of internal maxillary artery (IMA) and facial artery polyvinyl alcohol (PVA) embolization for treatment of refractory idiopathic epistaxis. Materials and methods: From 1998-2011, 84 patients were referred for endovascular treatment of intractable idiopathic epistaxis. PVA (range, 180-300 μM) particles were used in all cases. One case required microcoils to prevent nontarget embolization. Medical records were reviewed for early recurrences and complications, which were correlated with the number of vessels receiving embolization using the Mantel-Haenszel χ(2)test for linear association; P<.05 was accepted for significance. Results: Vessels chosen for embolization were unilateral IMA in 8 patients, bilateral IMAs in 35 patients, bilateral IMAs with one facial artery in 32 patients, and bilateral IMAs and bilateral facial arteries in 9 patients. Early (<30 d) rebleeding requiring therapy occurred in nine patients (11%). Minor complications occurred in 22 patients (26%) and included mild facial or jaw pain, facial edema, headache, and transient ischemic attack. There was one major complication that consisted of facial skin sloughing and mild lip ulceration in a patient who had embolization of both IMAs and both facial arteries. A linear association was found when the number of vessels receiving embolization was correlated with both the rates of early recurrence (inversely, P = .04) and minor complications (P = .004). Conclusions: An initial treatment strategy involving embolization of bilateral IMAs with or without embolization of facial arteries for refractory idiopathic epistaxis is safe and effective. Additional facial artery embolization reduces the risk of early recurrence but increases the risk of minor complications.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Embolization, Therapeutic/methods ; Epistaxis/therapy ; Face/blood supply ; Female ; Hemostatics/therapeutic use ; Humans ; Male ; Maxillary Artery ; Middle Aged ; Polyvinyl Alcohol/therapeutic use ; Treatment Outcome
Chemical Substances	Hemostatics ; Polyvinyl Alcohol (9002-89-5)
Language	English
Publishing date	2013-02
Publishing country	United States
Document type	Controlled Clinical Trial ; Journal Article
ZDB-ID	1137756-2
ISSN	1535-7732 ; 1051-0443
ISSN (online)	1535-7732
ISSN	1051-0443
DOI	10.1016/j.jvir.2012.10.001
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Zs.A 3720: Show issues

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Article ; Online: Comparison of Enterprise with Neuroform stent-assisted coiling of intracranial aneurysms.

Kadkhodayan, Yasha / Rhodes, Nicholas / Blackburn, Spiros / Derdeyn, Colin P / Cross, DeWitte T / Moran, Christopher J

AJR. American journal of roentgenology

2013 Volume 200, Issue 4, Page(s) 872–878

Abstract: Objective: The Enterprise stent is the first closed-cell stent designed to treat wide-necked intracranial aneurysms. Advantages of the design can include improvement in keeping coils within an aneurysm and the ability of the stent to be recaptured. We ... ...

Abstract	Objective: The Enterprise stent is the first closed-cell stent designed to treat wide-necked intracranial aneurysms. Advantages of the design can include improvement in keeping coils within an aneurysm and the ability of the stent to be recaptured. We compared the technical and clinical complications of the Enterprise stent with the open-cell Neuroform stent, its primary alternative. Subjects and methods: Patients undergoing Enterprise and Neuroform stent-assisted aneurysm coiling were enrolled in prospective registries starting in March 2007 and February 2003, respectively. All consecutive patients through December 2011 were included. Deployment success and difficulty, stent movement and misplacement, and procedural complications were compared. Results: Enterprise deployment success was high (108 of 115 attempts, 93.9%) with 102 aneurysms receiving a stent compared with Neuroform (173 of 214 attempts, 80.8%, p = 0.001) with 163 aneurysms. Enterprise was easier to deploy (1.7% vs 15.9% difficult deployment, p < 0.0001). There were no significant differences in the rates of stent movement, misplacement, or symptomatic hemorrhage. Symptomatic thromboembolic events, however, were more frequent with the Enterprise stent (8.7% vs 1.4%, p = 0.0021). The Enterprise stent enabled treatment of 10 additional aneurysms that could not be treated with Neuroform and had a higher rate of immediate aneurysm occlusion (87.3% vs 73.0%, p = 0.0058). Conclusion: Enterprise was easier to deploy and enabled treatment of additional aneurysms; however, there were more thromboembolic complications. On the basis of these findings, we prefer to use the Neuroform stent first and rely on the Enterprise stent as an easy-to-deliver backup for stent-assisted coiling.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Cerebral Angiography ; Embolization, Therapeutic/adverse effects ; Embolization, Therapeutic/instrumentation ; Female ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/therapy ; Male ; Middle Aged ; Prospective Studies ; Registries ; Stents/adverse effects ; Treatment Outcome
Keywords	covid19
Language	English
Publishing date	2013-04
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	82076-3
ISSN	1546-3141 ; 0361-803X ; 0092-5381
ISSN (online)	1546-3141
ISSN	0361-803X ; 0092-5381
DOI	10.2214/AJR.12.8954
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Article ; Online: Endovascular treatment of 346 middle cerebral artery aneurysms: results of a 16-year single-center experience.

Kadkhodayan, Yasha / Delgado Almandoz, Josser E / Fease, Jennifer L / Scholz, Jill M / Blem, Anna M / Tran, Kira / Crandall, Benjamin M / Tubman, David E

Neurosurgery

2015 Volume 76, Issue 1, Page(s) 54–60; discussion 60–1

Abstract: Background: The endovascular treatment of middle cerebral artery (MCA) aneurysms has been controversial because of the frequency of complex anatomy and the relative ease of surgical clipping in this location.: Objective: To present a large single- ... ...

Abstract	Background: The endovascular treatment of middle cerebral artery (MCA) aneurysms has been controversial because of the frequency of complex anatomy and the relative ease of surgical clipping in this location. Objective: To present a large single-center experience with the endovascular treatment of MCA aneurysms. Methods: The neurointerventional database at our institution was reviewed for all endovascular treatments of MCA aneurysms. Demographics, aneurysm characteristics, treatment modality, intraprocedural hemorrhagic and thromboembolic events, 30-day neurological events, and follow-up angiographic studies were recorded. Results: From December 1996 to April 2013, 292 patients underwent endovascular treatment of 346 MCA aneurysms. Of these, 341 (98.6%) were successfully completed. Balloon neck remodeling was used in 230 procedures (66.5%). Ninety-five procedures (27.4%) were for ruptured aneurysms. The rate of intraprocedural hemorrhage was 2.6% (9 of 346). The overall rate of intraprocedural thromboembolic events was 13.6% (47 of 346), significantly more common in patients with acute subarachnoid hemorrhage (27.4%; P < .001). The 30-day major (modified Rankin Scale score > 2) neurological event rate was 2.9% (10 of 346), significantly more common in patients with subarachnoid hemorrhage (8.4%) compared with those without (0.8%; P < .001). The rate of complete or near-complete aneurysm occlusion at was 90.6% ≥ 6 months and 91.8% at ≥ 2 years, with an average of 24 months of follow-up available for 247 procedures. Conclusion: Endovascular treatment of MCA aneurysms can be safe and effective. However, it is associated with a high asymptomatic thromboembolic event rate that is more frequent in the setting of acute subarachnoid hemorrhage.
MeSH term(s)	Aneurysm, Ruptured/complications ; Aneurysm, Ruptured/therapy ; Embolization, Therapeutic/adverse effects ; Endovascular Procedures/adverse effects ; Female ; Follow-Up Studies ; Humans ; Intracranial Aneurysm/complications ; Intracranial Aneurysm/therapy ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Subarachnoid Hemorrhage/epidemiology ; Subarachnoid Hemorrhage/therapy ; Thromboembolism/epidemiology ; Thromboembolism/therapy ; Treatment Outcome
Keywords	covid19
Language	English
Publishing date	2015-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/NEU.0000000000000562
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Zs.A 1424: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Hemorrhagic complications after prasugrel (Effient) therapy for vascular neurointerventional procedures.

Akbari, S Hassan / Reynolds, Matthew R / Kadkhodayan, Yasha / Cross, Dewitte T / Moran, Christopher J

Journal of neurointerventional surgery

2012 Volume 5, Issue 4, Page(s) 337–343

Abstract: Introduction: Dual antiplatelet therapy (DAPT) with aspirin and a thienopyridine (eg, clopidogrel) prevents stent related thromboembolic events in cardiac patients and is frequently utilized during neurointerventional surgery. However, recent data ... ...

Abstract	Introduction: Dual antiplatelet therapy (DAPT) with aspirin and a thienopyridine (eg, clopidogrel) prevents stent related thromboembolic events in cardiac patients and is frequently utilized during neurointerventional surgery. However, recent data suggest that many patients exhibit clopidogrel resistance. Prasugrel-a newer thienopyridine-lowers the rate of cardiac stent thromboses in clopidogrel non-responders but a paucity of data exist regarding its safety and efficacy in neurointerventional surgery. Methods: All patients undergoing neurointerventional surgery by a single interventionalist (CJM) over a 20 month period were retrospectively identified. Charts were reviewed for pre- and post-procedural DAPT regimens, pre-procedural coagulation parameters and procedural complications. Results: 76 patients received pre- and post-procedural DAPT for endovascular treatment of an intracerebral aneurysm, dural arteriovenous fistula or intra/extracranial arterial stenosis. 51 patients underwent 55 total procedures and were treated with aspirin/clopidogrel; 25 patients underwent 31 total procedures and were treated with aspirin/prasugrel. Those patients who received aspirin/prasugrel DAPT were identified pre-procedurally to be clopidogrel non-responders. Both treatment groups had a similar percentage of patients undergoing aneurysm coiling, stent assisted aneurysm coiling, aneurysm Onyx embolization, aneurysm pipeline embolization device treatment, extra/intracranial carotid artery angioplasty and stenting, and dural arteriovenous fistula coil embolization. A total of eight (9.3%) hemorrhagic complications were observed, two (3.6%) in the aspirin/clopidogrel group and six (19.4%) in the aspirin/prasugrel group (p=0.02). No differences were noted in hemorrhage rates for each procedure between treatment groups, nor were there any differences in thrombotic complications between groups. Conclusion: Our results suggest that DAPT with aspirin/prasugrel may predispose to a higher risk of hemorrhage during neurointerventional surgery compared with DAPT with aspirin/clopidogrel.
MeSH term(s)	Adult ; Aged ; Cerebral Hemorrhage/diagnostic imaging ; Cerebral Hemorrhage/etiology ; Embolization, Therapeutic/adverse effects ; Female ; Humans ; Male ; Middle Aged ; Neuroprotective Agents/adverse effects ; Piperazines/adverse effects ; Prasugrel Hydrochloride ; Purinergic P2X Receptor Antagonists/adverse effects ; Radiography ; Retrospective Studies ; Thiophenes/adverse effects
Chemical Substances	Neuroprotective Agents ; Piperazines ; Purinergic P2X Receptor Antagonists ; Thiophenes ; Prasugrel Hydrochloride (G89JQ59I13)
Language	English
Publishing date	2012-05-03
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2514982-9
ISSN	1759-8486 ; 1759-8478
ISSN (online)	1759-8486
ISSN	1759-8478
DOI	10.1136/neurintsurg-2012-010334
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Article ; Online: Successful endovascular treatment of three fusiform cerebral aneurysms with the Pipeline Embolization Device in a patient with dilating HIV vasculopathy.

Delgado Almandoz, Josser E / Crandall, Benjamin M / Fease, Jennifer L / Scholz, Jill M / Anderson, Ruth E / Kadkhodayan, Yasha / Tubman, David E

Journal of neurointerventional surgery

2014 Volume 6, Issue 2, Page(s) e12

Abstract: Dilating HIV vasculopathy can be a cause of ischemic and hemorrhagic stroke in patients with HIV. Although first identified in children, this condition is increasingly being recognized in adults and has a dismal natural history under medical or expectant ...

Abstract	Dilating HIV vasculopathy can be a cause of ischemic and hemorrhagic stroke in patients with HIV. Although first identified in children, this condition is increasingly being recognized in adults and has a dismal natural history under medical or expectant management. Vessel wall invasion by varicella zoster virus, HIV or Mycobacterium avium intracellulare complex (MAI) has been postulated as a possible etiology. We present a case of an adult patient with HIV and chronic disseminated MAI infection who presented with ischemic stroke and three fusiform cerebral aneurysms that were successfully treated with the pipeline embolization device (PED). Flow diversion may be a viable treatment option for patients presenting with this serious neurovascular condition when aneurysm location precludes parent vessel sacrifice or surgical bypass. In addition, platelet function testing with VerifyNow may be valuable in selecting the appropriate P2Y12 receptor antagonist to be used in order to prevent PED thrombosis, since some of the antiretroviral drugs may inhibit clopidogrel or prasugrel metabolism.
MeSH term(s)	Adult ; Dilatation, Pathologic/complications ; Dilatation, Pathologic/diagnosis ; Dilatation, Pathologic/therapy ; Embolization, Therapeutic/instrumentation ; Embolization, Therapeutic/methods ; Follow-Up Studies ; HIV Infections/complications ; HIV Infections/diagnosis ; HIV Infections/therapy ; Humans ; Intracranial Aneurysm/complications ; Intracranial Aneurysm/diagnosis ; Intracranial Aneurysm/therapy ; Male ; Treatment Outcome
Language	English
Publishing date	2014-03
Publishing country	England
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2514982-9
ISSN	1759-8486 ; 1759-8478
ISSN (online)	1759-8486
ISSN	1759-8478
DOI	10.1136/neurintsurg-2012-010634.rep
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