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Article ; Online: Thrombectomy of the Profunda Femoral Vein in Iliofemoral Deep Venous Thrombosis Using an Antegrade Popliteal Approach.

Qamhawi, Zahi / Kearns, Daniel / Wilton, Emma / Wigham, Andrew

Cardiovascular and interventional radiology

2024 Volume 47, Issue 3, Page(s) 379–385

Abstract: Purpose: Residual or undertreated inflow disease is a major cause of stent occlusion following endovascular thrombectomy for iliofemoral deep venous thrombosis (DVT). The profunda femoral vein (PFV) is an important inflow vessel alongside the femoral ... ...

Abstract	Purpose: Residual or undertreated inflow disease is a major cause of stent occlusion following endovascular thrombectomy for iliofemoral deep venous thrombosis (DVT). The profunda femoral vein (PFV) is an important inflow vessel alongside the femoral vein but is traditionally challenging to treat via an antegrade popliteal approach. This technical note describes a novel approach for PFV clearance in iliofemoral thrombectomy via the popliteal vein. Materials and methods: Eight patients underwent PFV clearance as part of iliofemoral DVT thrombectomy via an antegrade popliteal approach. In seven patients, a popliteal-profunda communicating vessel was identified permitting PFV access and thrombectomy. In one patient, a popliteal-profunda communicator was not identified and an 'up and over' approach via the femoral bifurcation from the same popliteal access was utilised. Thrombectomy was performed using the Inari ClotTriever device or Penumbra's Indigo system. Results: Technical success in PFV thrombectomy was 100%. Six patients (75%) underwent stenting for an iliac stenotic lesion or May Thurner compression point. At the four-week ultrasound follow-up, the pelvic iliofemoral segment was patent in 7 patients (87.5%). The PFV was patent in 7 patients (87.5%) whereas the FV was only patent in 4 patients (50%). One patient underwent reintervention for iliofemoral stent occlusion. No PFV injury occurred and no post-procedure profunda reflux was identified. Conclusion: PFV clearance can be achieved via an antegrade popliteal approach in iliofemoral thrombectomy to optimise inflow, negating the need for alternative or additional venous access. PFV may maintain upstream iliofemoral vein patency even with an occluded femoral vein. Level of evidence: Level 4, Case Series.
MeSH term(s)	Humans ; Femoral Vein ; Thrombolytic Therapy/methods ; Treatment Outcome ; Thrombectomy/methods ; Venous Thrombosis/diagnostic imaging ; Venous Thrombosis/surgery ; Stents ; Iliac Vein/diagnostic imaging ; Iliac Vein/surgery ; Retrospective Studies ; Vascular Patency
Language	English
Publishing date	2024-02-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	603082-8
ISSN	1432-086X ; 0342-7196 ; 0174-1551
ISSN (online)	1432-086X
ISSN	0342-7196 ; 0174-1551
DOI	10.1007/s00270-024-03660-w
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Article: The State of Evidence in Prostate Artery Embolization.

Qamhawi, Zahi / Little, Mark W

Seminars in interventional radiology

2022 Volume 39, Issue 6, Page(s) 571–576

Abstract: Prostate artery embolization (PAE) has emerged over the past two decades as a minimally invasive, nonsurgical treatment for benign prostatic hypertrophy (BPH). While the majority of evidence for PAE stems from retrospective cohort studies, several ... ...

Abstract	Prostate artery embolization (PAE) has emerged over the past two decades as a minimally invasive, nonsurgical treatment for benign prostatic hypertrophy (BPH). While the majority of evidence for PAE stems from retrospective cohort studies, several seminal randomized controlled trials have been performed comparing short-term outcomes of PAE to transurethral resection of prostate (TURP) and against a sham procedure. Across clinical trials, PAE demonstrates consistent improvement in urological symptoms and quality of life in patients with BPH with low complication rates. When compared to TURP, the results are comparable, but there is a trend for better outcomes in certain clinical parameters with TURP. PAE is a suitable option for patients who are not surgical candidates, prefer nonsurgical treatment with an earlier return to routine activities, and wish to better preserve sexual function.
Language	English
Publishing date	2022-12-20
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	848341-3
ISSN	1098-8963 ; 0739-9529
ISSN (online)	1098-8963
ISSN	0739-9529
DOI	10.1055/s-0042-1759733
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Article: The State of Evidence in Prostate Artery Embolization

Qamhawi, Zahi / Little, Mark W.

Seminars in Interventional Radiology

(Men's Health)

2022 Volume 39, Issue 06, Page(s) 571–576

Series title	Men's Health
Abstract	Prostate artery embolization (PAE) has emerged over the past two decades as a minimally invasive, nonsurgical treatment for benign prostatic hypertrophy (BPH). While the majority of evidence for PAE stems from retrospective cohort studies, several seminal randomized controlled trials have been performed comparing short-term outcomes of PAE to transurethral resection of prostate (TURP) and against a sham procedure. Across clinical trials, PAE demonstrates consistent improvement in urological symptoms and quality of life in patients with BPH with low complication rates. When compared to TURP, the results are comparable, but there is a trend for better outcomes in certain clinical parameters with TURP. PAE is a suitable option for patients who are not surgical candidates, prefer nonsurgical treatment with an earlier return to routine activities, and wish to better preserve sexual function.
Keywords	prostate artery embolization ; benign prostatic hypertrophy ; lower urinary tract symptoms ; transurethral resection prostate ; prostate ; embolization ; interventional radiology
Language	English
Publishing date	2022-12-01
Publisher	Thieme Medical Publishers, Inc.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	848341-3
ISSN	1098-8963 ; 0739-9529
ISSN (online)	1098-8963
ISSN	0739-9529
DOI	10.1055/s-0042-1759733
Database	Thieme publisher's database

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Article ; Online: Transcatheter embolisation in chronic musculoskeletal disorders.

Braithwaite, Simon / Qamhawi, Zahi / Briggs, James / Little, Mark W

The British journal of radiology

2023 Volume 96, Issue 1149, Page(s) 20220728

Abstract: Chronic musculoskeletal conditions affect millions of patients worldwide resulting in disability, reduced quality of life, and have a profound economic impact on the individual and society. Current treatment strategies fail patients who have not ... ...

Abstract	Chronic musculoskeletal conditions affect millions of patients worldwide resulting in disability, reduced quality of life, and have a profound economic impact on the individual and society. Current treatment strategies fail patients who have not responded to conservative management but are not surgical candidates. Over the last decade, transcatheter embolisation has emerged as a potential treatment for these difficult to treat patients. By exploiting pathological neovascularisation within conditions such as knee osteoarthritis, adhesive capsulitis, and tendinopathy, embolisation has been used to improve patients' pain and function. This review explores the rationale for musculoskeletal transcatheter embolisation, illustrating the technique, and latest evidence for the most common procedures.
MeSH term(s)	Humans ; Quality of Life ; Treatment Outcome ; Pain ; Osteoarthritis, Knee ; Musculoskeletal Diseases/therapy ; Chronic Disease
Language	English
Publishing date	2023-06-29
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2982-8
ISSN	1748-880X ; 0007-1285
ISSN (online)	1748-880X
ISSN	0007-1285
DOI	10.1259/bjr.20220728
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Article ; Online: Diagnostic accuracy of ultrasound and magnetic resonance imaging in detecting Stener lesions of the thumb: systematic review and meta-analysis.

Qamhawi, Zahi / Shah, Karishma / Kiernan, Gareth / Furniss, Dominic / Teh, James / Azzopardi, Christine

The Journal of hand surgery, European volume

2021 Volume 46, Issue 9, Page(s) 946–953

Abstract: This study assesses the diagnostic accuracy of ultrasound and magnetic resonance imaging (MRI) in diagnosing Stener lesions of the thumb. MEDLINE, PubMed, Embase and Cochrane CENTRAL were searched for studies using ultrasound or MRI to detect Stener ... ...

Abstract	This study assesses the diagnostic accuracy of ultrasound and magnetic resonance imaging (MRI) in diagnosing Stener lesions of the thumb. MEDLINE, PubMed, Embase and Cochrane CENTRAL were searched for studies using ultrasound or MRI to detect Stener lesions following suspected thumb ulnar collateral ligament injuries. The reference standard was surgical exploration or clinical joint stability. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. A random-effects bivariate meta-analysis was used to estimate pooled sensitivity and specificity. Forest plots were generated. Nine ultrasound (315 thumbs) and six MRI (107 thumbs) studies were included in meta-analysis (all high risk of bias). Pooled sensitivity and specificity for ultrasound were 95% and 94%, and for MRI were 93% and 98%. Both ultrasound and MRI demonstrate high diagnostic accuracy in detecting Stener lesions. Ultrasound is an appropriate first-line imaging modality.
MeSH term(s)	Collateral Ligament, Ulnar/injuries ; Hand Injuries ; Humans ; Magnetic Resonance Imaging ; Thumb/diagnostic imaging ; Thumb/injuries ; Ultrasonography
Language	English
Publishing date	2021-02-17
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2272801-6
ISSN	2043-6289 ; 1753-1934
ISSN (online)	2043-6289
ISSN	1753-1934
DOI	10.1177/1753193421993015
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Article ; Online: Editor's Choice - Systematic Review of the Use of Endoanchors in Endovascular Aortic Aneurysm Repair.

Qamhawi, Zahi / Barge, Thomas F / Makris, Gregory C / Patel, Rafiuddin / Wigham, Andrew / Anthony, Suzie / Uberoi, Raman

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

2020 Volume 59, Issue 5, Page(s) 748–756

Abstract: Objective: Endoanchor fixation might be a potential adjunct for the prevention and treatment of type Ia endoleak (TIaE) and graft migration in thoracic or abdominal endovascular aortic aneurysm repairs (TEVAR or EVAR). This review aimed to explore the ... ...

Abstract	Objective: Endoanchor fixation might be a potential adjunct for the prevention and treatment of type Ia endoleak (TIaE) and graft migration in thoracic or abdominal endovascular aortic aneurysm repairs (TEVAR or EVAR). This review aimed to explore the safety and effectiveness of endoanchor fixation in TEVAR and EVAR. Methods: A systematic review and random effects meta-analysis was conducted. Data sources were PubMed/MEDLINE, Embase, and the Cochrane Library. Results: Seven EVAR and three TEVAR studies using the Heli-FX™ EndoAnchor™ system were included in the meta-analysis. A total of 455 EVAR patients underwent primary endoanchor fixation. Technical success was 98.4% (95% CI 95.7-99.8%). The rate of TIaE and graft migration was 3.5% (95% CI 1.7-5.9%) and 2.0% (95% CI 0.12-6.0%), respectively, after 15.4 months (95% CI 1.76-29.0) follow up. A total of 107 EVAR patients underwent secondary fixation with a technical success of 91.8% (95% CI 86.1-96.2%). Rates of TIaE and graft migration were 22.6% (95% CI 9.1-40.0%) and 0% after a mean 10.7 month (95% CI 7.8-13.6) follow up. Adverse events included three endoanchor fractures, three dislocated endoanchors, one entrapped endoanchor, and one common iliac artery dissection. All cause 30 day EVAR mortality was 0.82% (95% CI 0.20-1.85%). Sixty-six TEVAR patients underwent endoanchor fixation with a mean 9.8 month (95% CI 8.1-11.5) follow up. Technical success was 90.3% (95% CI 72.1-99.4%). The rates of TIaE and migration were 8.7% (95% CI 1.0-18.9%) and 0%, respectively. Adverse events included two misdeployed endoanchors with one fatal aortic dissection. All cause 30 day TEVAR mortality was 11.9% (95% CI 5.4-20.6%). Conclusion: Endoanchor fixation in EVAR is technically feasible and safe, with at least comparable early outcomes to the latest generation of stent grafts. Endostapling in TEVAR is associated with lower technical success, higher peri-operative mortality, and potential serious adverse events. Current evidence lacks long term follow up and case controlled trials to recommend endoanchor use in routine practice.
MeSH term(s)	Aortic Aneurysm/surgery ; Endovascular Procedures/instrumentation ; Humans ; Treatment Outcome
Language	English
Publishing date	2020-03-17
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	1225869-6
ISSN	1532-2165 ; 1078-5884
ISSN (online)	1532-2165
ISSN	1078-5884
DOI	10.1016/j.ejvs.2020.02.008
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Zs.A 2283: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Sex differences in Parkinson's disease.

Gillies, Glenda E / Pienaar, Ilse S / Vohra, Shiv / Qamhawi, Zahi

Frontiers in neuroendocrinology

2014 Volume 35, Issue 3, Page(s) 370–384

Abstract: Parkinson's disease (PD) displays a greater prevalence and earlier age at onset in men. This review addresses the concept that sex differences in PD are determined, largely, by biological sex differences in the NSDA system which, in turn, arise from ... ...

Abstract	Parkinson's disease (PD) displays a greater prevalence and earlier age at onset in men. This review addresses the concept that sex differences in PD are determined, largely, by biological sex differences in the NSDA system which, in turn, arise from hormonal, genetic and environmental influences. Current therapies for PD rely on dopamine replacement strategies to treat symptoms, and there is an urgent, unmet need for disease modifying agents. As a significant degree of neuroprotection against the early stages of clinical or experimental PD is seen, respectively, in human and rodent females compared with males, a better understanding of brain sex dimorphisms in the intact and injured NSDA system will shed light on mechanisms which have the potential to delay, or even halt, the progression of PD. Available evidence suggests that sex-specific, hormone-based therapeutic agents hold particular promise for developing treatments with optimal efficacy in men and women.
MeSH term(s)	Animals ; Dopamine/therapeutic use ; Gonadal Steroid Hormones/metabolism ; Humans ; Neuroprotective Agents/therapeutic use ; Parkinson Disease/drug therapy ; Sex Characteristics ; Substantia Nigra/drug effects
Chemical Substances	Gonadal Steroid Hormones ; Neuroprotective Agents ; Dopamine (VTD58H1Z2X)
Language	English
Publishing date	2014-03-04
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	390985-2
ISSN	1095-6808 ; 0532-7466 ; 0091-3022
ISSN (online)	1095-6808
ISSN	0532-7466 ; 0091-3022
DOI	10.1016/j.yfrne.2014.02.002
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Zs.A 3423: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Progression of tremor in early stages of Parkinson's disease: a clinical and neuroimaging study.

Pasquini, Jacopo / Ceravolo, Roberto / Qamhawi, Zahi / Lee, Jee-Young / Deuschl, Günther / Brooks, David James / Bonuccelli, Ubaldo / Pavese, Nicola

Brain : a journal of neurology

2018 Volume 141, Issue 3, Page(s) 811–821

Abstract: Rest tremor is one of the cardinal signs of Parkinson's disease. Kinetic and postural tremors may also occur. The coexistence of these three types of tremor at disease onset and their subsequent progression could have important clinical and therapeutic ... ...

Abstract	Rest tremor is one of the cardinal signs of Parkinson's disease. Kinetic and postural tremors may also occur. The coexistence of these three types of tremor at disease onset and their subsequent progression could have important clinical and therapeutic implications but remain to be fully elucidated. We aimed to: (i) evaluate prevalence and progression of these three types of tremor in early stages of the disease; and (ii) investigate longitudinally the relationship between dopaminergic and serotonergic terminal dysfunction, rest tremor severity and its response to dopaminergic therapy. The Parkinson's Progressive Markers Initiative database provided the baseline and 2-year follow-up clinical ratings and 123ioflupane-fluoropropyl-carbomethoxy-3-beta-4-iodophenyltropane (123I-FP-CIT) single photon emission computed tomography images for this study. 123I-FP-CIT measured putamen dopamine transporter and median raphe serotonin transporter availability. A raphe/putamen uptake ratio was calculated for each patient as an index of relative involvement of these structures. Clinical analysis of tremor was conducted on 378 patients: 87.8% presented with tremor at baseline; rest tremor occurred in 69.6% of patients at baseline; and 67.9% at follow-up. Postural and kinetic tremors occurred in about 50% of patients at both baseline and follow-up. Over 20% of patients presenting with tremor did not exhibit a rest component at baseline. The number of patients with isolated rest tremor was halved at follow-up. In tremor predominant patients, rest tremor severity was inversely correlated with raphe serotonin transporter availability both at baseline and follow-up (baseline: constancy P < 0.05, tremor index P < 0.05; follow-up: amplitude P < 0.05, constancy P < 0.05, tremor index P < 0.05). In the entire cohort, more severe tremor scores correlated with lower raphe/putamen uptake ratio values, indicative of more severe raphe dysfunction (baseline: constancy P < 0.01, tremor index P < 0.05; follow-up: amplitude P < 0.01, constancy P < 0.001, tremor index P < 0.001). The percentage of improvement in rest tremor amplitude after acute dopaminergic therapy was smaller in patients with lower raphe/putamen uptake ratio values (P < 0.01). Rest tremor is the most represented type of tremor in early Parkinson's disease. However, postural and kinetic tremor can affect approximately half of these patients and can occur in absence of resting tremor. As disease progresses, both raphe serotonergic dysfunction and putamen dopamine depletion could contribute to the occurrence of rest tremor. The former is linked to more severe tremor scores and poorer response to dopaminergic therapy. Non-dopaminergic treatments might be beneficial for patients whose tremor is associated with a raphe-predominant dysfunction.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Brain/diagnostic imaging ; Brain/pathology ; Disease Progression ; Female ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Parkinson Disease/complications ; Parkinson Disease/diagnostic imaging ; Severity of Illness Index ; Tomography, Emission-Computed, Single-Photon/methods ; Tremor/diagnostic imaging ; Tremor/etiology ; Tropanes/pharmacokinetics
Chemical Substances	Tropanes ; 2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane (155797-99-2)
Language	English
Publishing date	2018-01-24
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80072-7
ISSN	1460-2156 ; 0006-8950
ISSN (online)	1460-2156
ISSN	0006-8950
DOI	10.1093/brain/awx376
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Article ; Online: Clinical correlates of raphe serotonergic dysfunction in early Parkinson's disease.

Qamhawi, Zahi / Towey, David / Shah, Bina / Pagano, Gennaro / Seibyl, John / Marek, Kenneth / Borghammer, Per / Brooks, David James / Pavese, Nicola

Brain : a journal of neurology

2015 Volume 138, Issue Pt 10, Page(s) 2964–2973

Abstract: Post-mortem and neuroimaging studies suggest that the serotonergic system, which originates from the brainstem raphe nuclei, is disrupted in Parkinson's disease. This could contribute to the occurrence of non-motor symptoms and tremor, which are only ... ...

Abstract	Post-mortem and neuroimaging studies suggest that the serotonergic system, which originates from the brainstem raphe nuclei, is disrupted in Parkinson's disease. This could contribute to the occurrence of non-motor symptoms and tremor, which are only partially explained by dopamine loss. However, the level of involvement of the serotonergic raphe nuclei in early Parkinson's disease is still debated. (123)I-FP-CIT single photon emission computed tomography is a marker of dopamine and serotonin transporter availability. While (123)I-FP-CIT binds primarily to dopamine transporters in the striatum, its binding in the brainstem raphe nuclei reflects serotonin transporter availability. We interrogated baseline single photon emission computed tomography scans of subjects recruited by the Parkinson's Progression Markers Initiative to determine: (i) the integrity of the brainstem raphe nuclei in early Parkinson's disease; and (ii) whether raphe serotonin transporter levels correlate with severity of tremor and symptoms of fatigue, depression, and sleep disturbance. Three hundred and forty-five patients with early drug-naïve Parkinson's disease, 185 healthy controls, and 56 subjects with possible Parkinson's disease without evidence of dopaminergic deficit were included. In the Parkinson's disease cohort, 37 patients had a tremulous, 106 patients had a pure akinetic-rigid, and 202 had a mixed phenotype. Patients with Parkinson's disease had significantly lower serotonin transporter availability in the brainstem raphe nuclei compared to controls (P < 0.01) and subjects without evidence of dopaminergic deficit (P < 0.05). However, only 13% of patients with Parkinson's disease individually had reduced signals. Raphe serotonin transporter availability over the entire Parkinson's disease cohort were associated with rest tremor amplitude (β = -0.106, P < 0.05), rest tremor constancy (β = -0.109, P < 0.05), and index of rest tremor severity (β = -0.104, P < 0.05). The tremulous Parkinson's disease subgroup had significantly lower raphe serotonin transporter availability but less severe striatal dopaminergic deficits compared to akinetic-rigid patients with no resting tremor (P < 0.05). In tremulous patients, raphe serotonin transporter availability was also associated with rest tremor constancy (β = -0.380, P < 0.05) and index of rest tremor severity (β = -0.322, P < 0.05). There was no association between raphe serotonin transporter availability and fatigue, depression, excessive daytime sleepiness, or rapid eye movement sleep behaviour disorder in early Parkinson's disease. We conclude that the raphe nuclei are affected in a subgroup of early drug-naïve Parkinson's disease patients and that reduced raphe serotonin transporter availability is associated with the severity of resting tremor but not non-motor symptoms.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Analysis of Variance ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Occipital Lobe/diagnostic imaging ; Occipital Lobe/pathology ; Parkinson Disease/diagnostic imaging ; Parkinson Disease/pathology ; Raphe Nuclei/metabolism ; Serotonin/metabolism ; Serotonin Plasma Membrane Transport Proteins/metabolism ; Severity of Illness Index ; Statistics as Topic ; Statistics, Nonparametric ; Tomography, Emission-Computed, Single-Photon ; Tropanes/pharmacokinetics
Chemical Substances	Serotonin Plasma Membrane Transport Proteins ; Tropanes ; 2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane (155797-99-2) ; Serotonin (333DO1RDJY)
Language	English
Publishing date	2015-07-23
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80072-7
ISSN	1460-2156 ; 0006-8950
ISSN (online)	1460-2156
ISSN	0006-8950
DOI	10.1093/brain/awv215
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