Publications by authors named "Adnan H Siddiqui"
Article Synopsis
- Statin therapy during coil embolization for intracranial aneurysms (IAs) may lower the rates of aneurysm recurrence and the need for retreatment.
- A post hoc analysis of data from the Hydrogel Endovascular Aneurysm Treatment Trial showed that patients on statins had a recurrence rate of 3.8%, compared to 10.7% in those not on statins.
- Statin use was particularly effective in patients with unruptured aneurysms, significantly reducing recurrence compared to nonstatin users, while having no measurable benefit for ruptured aneurysms.
Background And Objectives: Histologic and transcriptomic analyses of retrieved stroke clots have identified features associated with patient outcomes. Previous studies have demonstrated the predictive capacity of histology or expression features in isolation. Few studies, however, have investigated how paired histologic image features and expression patterns from the retrieved clots can improve understanding of clot pathobiology and our ability to predict long-term prognosis.
View Article and Find Full Text PDFBackground: Subacute and chronic subdural hematomas are common and frequently recur after surgical evacuation. The effect of adjunctive middle meningeal artery embolization on the risk of reoperation remains unclear.
Methods: In a prospective, multicenter, interventional, adaptive-design trial, we randomly assigned patients with symptomatic subacute or chronic subdural hematoma with an indication for surgical evacuation to undergo middle meningeal artery embolization plus surgery (treatment group) or surgery alone (control group).
Background: The EXCELLENT registry aimed to evaluate the effectiveness of the EMBOTRAP Revascularization Device in an all-comer population in a real-world setting, with a focus on the composition of retrieved clots.
Methods: EXCELLENT is a prospective, global registry of patients with acute ischemic stroke treated with EMBOTRAP as the first-line mechanical thrombectomy device conducted at 34 sites (25 sites contributing clot) from September 2018 to March 2021, utilizing core imaging and central histology laboratories blinded to clinical data, independent 90-day modified Rankin Scale assessment and Clinical Events Committee.
Results: After screening 3799 patients, a total of 997 subjects (mean age, 70.
Background: The Woven EndoBridge (WEB) is a treatment modality available for the treatment of intracranial aneurysms, specifically beneficial in wide-necked bifurcation aneurysms. Conventional sizing methods rely on the manipulation of aneurysm width and height measurements. This results in frequent need for re-sizing after initial WEB insertion attempts.
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- * A retrospective analysis was conducted on 23 patients who received axolotl dermis patches after surgical procedures, with data collected on demographics, post-surgery complications, and comorbidities affecting wound healing.
- * Results showed that only 8.7% of patients experienced complications such as infection or wound dehiscence after using the patches, suggesting a promising alternative for chronic wound management.
Article Synopsis
- Heavily calcified carotid stenosis (HCCS) has traditionally been challenging to treat with carotid angioplasty and stenting (CAS), but this study explores the use of the Shockwave S intravascular lithotripsy (IVL) system as a potential solution.
- A retrospective analysis of 17 procedures combining IVL and CAS on patients with HCCS showed technical success in all cases and significant reductions in stenosis levels post-procedure.
- The results indicated that the combined approach is safe, with a low major adverse event (MAE) rate and a promising outcome in managing both symptomatic and asymptomatic patients with HCCS.
Background And Objectives: Multiple preferences exist for embolic materials selection in middle meningeal artery embolization (MMAE) for chronic subdural hematoma with limited comparative literature data. Herein, we compare different embolic materials.
Methods: Consecutive patients undergoing MMAE for chronic subdural hematoma at 14 North-American centers (2018-2023) were classified into 3 groups: (a) particles, (b) Onyx, (c) n-butyl cyanoacrylate (n-BCA).
Article Synopsis
- The study looked at whether a medical procedure called thrombectomy helps patients who have a large stroke as seen on a specific type of scan called a noncontrast CT within 24 hours of having the stroke.
- It involved 300 patients from different hospitals who were split into two groups; one group received the thrombectomy treatment, while the other only received regular care.
- The main goal was to see if those who had thrombectomy had better recovery after 90 days compared to those who didn’t, along with checking if there were any serious side effects.
Tortuosity and fragility of the intracranial vasculature have precluded the application of novel intravascular imaging modalities during the treatment of cerebrovascular pathologies. In other circulatory beds, these technologies have transformed clinical and therapeutic decision-making. A new report demonstrates the clinical use of high-resolution intravascular imaging in the human cerebrovasculature using neuro optical coherence tomography.
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- The study investigates the use of angio-based fractional flow (FF) derived from a single angiographic view to evaluate the hemodynamic status of intracranial atherosclerotic stenosis (ICAS), compared to wire-based FF as a standard.
- A total of 100 ICAS patients were analyzed, showing a strong correlation between angio-based FF and wire-based FF, with high diagnostic accuracy for determining critical thresholds.
- The findings suggest that angio-based FF is a viable and effective method for assessing the functional state of cerebral arterial stenosis.
1-Year outcomes of Resolute Onyx Zotarolimus-Eluting Stent for symptomatic intracranial atherosclerotic disease: A multicenter propensity score-matched comparison with stenting versus aggressive medical management for preventing recurrent stroke in intracranial stenosis trial.
Interv Neuroradiol
September 2024
Article Synopsis
- Intracranial atherosclerotic disease (ICAD) is a major cause of strokes, and while endovascular treatments like the Resolute Onyx Zotarolimus-Eluting Stent (RO-ZES) are promising, results can be mixed.
- A study analyzed data from seven stroke centers, comparing outcomes of 104 patients treated with RO-ZES to those from a previous trial (SAMMPRIS) using percutaneous angioplasty and stenting (S-PTAS).
- The results indicated that the one-year rate of stroke, intracranial hemorrhage (ICH), or death was significantly lower in the RO-ZES group (11.5%) versus the S-PTAS group (28.1
Article Synopsis
- Head position strongly impacts cerebral venous pressures and intracranial pressures in patients with cerebral venous outflow disorders (CVD).
- In a study of 22 patients, significant increases in superior sagittal sinus (SSS) pressures and lumbar puncture opening pressures were observed when the head was rotated.
- The findings emphasize the importance of using dynamic venography for better diagnosis and treatment of CVD and related intracranial hypertension issues.
A man in his early 70s presented to the emergency department about 3.5 hours after acute onset right sided hemiplegia and aphasia. CT angiography confirmed an acute occlusion of the M1 segment of the left middle cerebral artery and severe, but stable, dissection of the aortic arch and a large dissecting aortic aneurysm extending into the innominate artery and beyond into the descending aorta.
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- Intraoperative 2D quantitative angiography (QA) for detecting intracranial aneurysms faces accuracy challenges due to inconsistencies in hand-injection techniques, prompting the exploration of singular value decomposition (SVD) algorithms as a potential solution.
- This study aims to adapt SVD-based deconvolution methods from computed tomography perfusion (CTP) to improve the reliability and accuracy of hemodynamic assessments in 2D QA, independent of variable injection conditions.
- By analyzing virtual angiograms from internal carotid aneurysm cases, the research applies various SVD methods to extract key flow parameters and evaluate the effects of injection duration and inlet velocity on QA outcomes.
Objective: The authors sought to quantify the role of social media-related academic activity through use of the Altmetric score (a composite score based on social media attention from a variety of sources) and investigate its potential impact on the number of citations received at 3 years postpublication (articles published between January 2019 and December 2019).
Methods: Articles published in the top 12 neurosurgical journals according to Google Scholar (based on 5-year Web of Science impact factors, 2017-2021) were identified. Data collected included days since publication, Altmetric scores, and total number of tweets (posts), and 3-year citations were obtained from Google Scholar.
Background: The optimal duration for dual antiplatelet therapy (DAPT) after stent-assisted coiling (SAC) of intracranial aneurysms is unclear. Longer-term therapy may reduce thrombotic complications but increase the risk of bleeding complications.
Methods: A retrospective review of prospectively maintained data at 12 institutions was conducted on patients with unruptured intracranial aneurysms who underwent SAC between January 1, 2016 and December 31, 2020, and were followed ≥6 months postprocedure.
Background: Utilizing an endovascular rat glioma model, this study aimed to analyze the efficacy of intra-arterial (IA) carboplatin and bevacizumab delivery with blood-brain barrier breakdown (BBBB) for glioblastoma treatment.
Methods: C6-glioma cells were stereotactically injected into the left frontal lobe of Wistar rats. Tumor growth was confirmed on day 8 via MRI.
Article Synopsis
- The study investigates the impact of decompressive craniectomy (DC) on patients with symptomatic intracerebral hemorrhage (sICH) following acute ischemic stroke, comparing outcomes between those who had surgery and those treated medically.
- It analyzed data from 85 patients across 8 stroke centers, revealing that DC patients were younger, had longer ICU stays, and showed better functional outcomes at 90 days compared to non-DC patients, especially if they were younger and did not have a history of cancer.
- The results indicate that the DC group had lower in-hospital mortality rates and came out with improved scores on the modified Rankin Scale, suggesting a potential benefit of surgery for select patients with severe sICH.
Background And Objective: Ambulatory surgery centers (ASCs) are increasingly common venues for same-day neurosurgical procedures, allowing for cost-effective, high-quality patient care. We present the first and largest series of patients undergoing diagnostic cerebral angiography at an ASC to demonstrate the effectiveness, safety, and efficiency of outpatient endovascular care.
Methods: We retrospectively reviewed data for consecutive patients who underwent diagnostic cerebral angiography at our ASC between January 1, 2024, and May 29, 2024.
Article Synopsis
- - The study compared the effectiveness and safety of four first-generation flow diverters (FDs) used for treating sidewall ICA intracranial aneurysms, which include Pipeline, Silk, FRED, and Surpass devices, using data from 444 patients across 18 institutions from 2009-2016.
- - Analysis revealed no significant differences in retreatment rates or complications among the devices; however, the Surpass device showed the highest probability of achieving effective occlusion at follow-up, followed by FRED, Pipeline, and Silk.
- - Although all devices had good clinical outcomes, the study highlights the need for prospective research to further clarify the differences and long-term effects of these flow diverters.