Publications by authors named "Colasurdo M"
Introduction: Mechanical thrombectomy (MT) efficacy in medium vessel occlusion (MeVO) stroke, particularly in patients with low Alberta Stroke Program Early Computed Tomography Score (ASPECTS), remains less explored.
Methods: This retrospective study analyzed data from 443 AIS patients treated with MT for MeVO and low ASPECTS (4-7) at 37 centers across North America, Asia, and Europe, from September 2017 to July 2021. Patients were categorized into ASPECTS of 4-5 and 6-7.
Background: While endovascular thrombectomy (EVT) has become standard of care for patients' acute ischemic stroke (AIS) due to large vessel occlusion (LVO), many patients still suffer profound neurological disability, also termed futile recanalization (FR). The BAND score, which incorporates baseline disability, age, stroke severity, and treatment time window, is derived as a simple tool for upfront prediction of FR prior to EVT. This study aims to externally validate the BAND score and to incorporate upfront imaging biomarkers into the prediction tool.
View Article and Find Full Text PDFObjectives: Moyamoya disease (MMD) is a rare cerebrovascular condition, and it is a well-known risk factor of acute ischemic stroke (AIS). While IV thrombolysis (IVT) is an established treatment for patients with AIS, its efficacy and safety for patients with MMD is largely unknown.
Methods: This was a large retrospective analysis of the 2016-2021 Nationwide Readmissions Database in the United States.
Background: Endovascular arterial embolization (EAE) is an effective treatment for severe epistaxis refractory to conservative management with nasal packing. However, contemporary real-world data are lacking, as are data on head-to-head comparisons of EAE versus nasal packing alone.
Methods: This was a retrospective cohort study of the Nationwide Readmissions Database (NRD) from 2016 to 2021 in the United States.
Article Synopsis
- The study examined the effectiveness of endovascular therapy (EVT) versus best medical therapy (BMT) for isolated anterior cerebral artery occlusions (ACAo) in acute stroke patients.
- The analysis involved 108 patients from various countries, comparing outcomes like functional independence at 90 days, with results showing no significant difference in success rates between EVT and BMT.
- Conclusions indicate that while EVT had a high success rate in procedures, it did not lead to better functional outcomes or lower mortality compared to BMT, suggesting a need for more randomized trials.
Flow cytometry is a high-throughput, high-dimensional technique that generates large sets of single-cell data. Prior to analyzing this data, it is common to exclude any events that contain two or more cells, multiplets, to ensure downstream analysis and quantification is of single-cell events, singlets, only. The process of singlet discrimination is critical yet fundamentally subjective and time-consuming; it is performed manually by the user, where the proper exclusion of multiplets depends on the user's expertise and often varies from experiment to experiment.
View Article and Find Full Text PDFArticle Synopsis
- Chronic subdural hematoma (cSDH) is becoming increasingly common and often requires surgical intervention to relieve symptoms, but drainage alone may lead to high recurrence rates.
- New techniques like middle meningeal artery embolization (MMAE) show promise in reducing these recurrence risks but raise questions about their integration into standard care.
- This review examines current cSDH management practices and explores the potential and uncertainties surrounding the use of MMAE.
Background And Purpose: Recent randomized trials have suggested that endovascular thrombectomy (EVT) is superior to medical management (MM) for stroke patients with large infarcts. However, whether or how perfusion metrics should be used to guide optimal patient selection for treatment is largely unknown.
Materials And Methods: This was a meta-analysis of randomized controlled trials reporting the effectiveness of EVT for large infarcts stratified by perfusion mismatch profiles.
Background: Despite the proven effectiveness of endovascular therapy (EVT) in acute ischemic strokes (AIS) involving anterior circulation large vessel occlusions, isolated posterior cerebral artery (PCA) occlusions (iPCAo) remain underexplored in clinical trials. This study investigates the comparative effectiveness and safety of EVT against medical management (MM) in patients with iPCAo.
Methods: This multinational, multicenter propensity score-weighted study analyzed data from the Multicenter Analysis of primary Distal medium vessel occlusions: effect of Mechanical Thrombectomy (MAD-MT) registry, involving 37 centers across North America, Asia, and Europe.
MR-guided Focused Ultrasound Thalamotomy for Chronic Pain.
Magn Reson Imaging Clin N Am
November 2024
MR-guided focused ultrasound (FUS) represents a promising alternative for patients with chronic neuropathic who have failed medical management and other treatment options. Early single-center experience with chronic neuropathic pain and trigeminal neuralgia has demonstrated favorable long-term outcomes. Excellent safety profile with low risk of motor and sensory complications and so far anecdotal permanent neurologic deficits make FUS a powerful tool to treat patients who are otherwise hopeless.
View Article and Find Full Text PDFBackground: The safety and efficacy of endovascular thrombectomy (EVT) for large vessel occlusion (LVO) strokes associated with infective endocarditis (IE) compared with medical management (MM) is unclear.
Methods: In this nationwide analysis of hospitalizations in the United States, we assessed the outcomes of EVT versus medical management (MM) for patients with LVO and IE. Primary outcome was routine home discharge with self-care.
Article Synopsis
- The study evaluates the effectiveness of a new thrombus removal method called Contact Aspiration Mechanical Thrombectomy (CAMT) using specialized catheters (FreeClimb 88 and Tenzing 8) in treating large vessel occlusions in the brain.
- A retrospective analysis of 53 patients showed a high success rate for delivering the FreeClimb 88 catheter to the occlusion site, with 94.3% successful deliveries and a first-pass success rate of 67.9% for restoring blood flow.
- The procedure was found to be safe, with no complications or symptomatic hemorrhages, indicating that this technique could be a reliable option for treating these severe blockages.
Introduction: Women are at higher risk of stroke mimics; however, the underlying reasons are unclear.
Methods: In this retrospective cohort study of the 2016-2020 National Inpatient Sample database, we identified patients treated with intravenous thrombolysis (IVT). Demographic information, vascular risk factors, comorbidities, and presence of known risk factors for stroke mimics (seizures, migraines, demyelinating diseases, psychiatric illnesses, and functional neurological disorders [FND]) were identified using ICD-10 codes.
Background: Subarachnoid hemorrhage (SAH) following endovascular thrombectomy (EVT) is a poorly understood phenomenon, and whether it is associated with clinical detriment is unclear.
Methods: This was an explorative analysis of a national database of real-world hospitalizations in the United States. Patients who underwent EVT were included.
Article Synopsis
- Medium vessel occlusion (MeVO) strokes, especially in the M2 segment of the middle cerebral artery, are a significant challenge in stroke management, necessitating effective prediction of patient outcomes after mechanical thrombectomy (MT).
- This study analyzed data from the MAD-MT registry to evaluate the relationship between follow-up infarct volume (FIV) and 90-day functional outcomes, using the modified Rankin Scale (mRS) as a measurement.
- Results showed that FIV is a strong predictor of outcomes, with specific volume thresholds indicating favorable prognosis; notably, an FIV of ≤15 ml had the best predictive capability, outperforming traditional recanalization scores.
Article Synopsis
- The study investigates the effectiveness and safety of two treatment methods for acute ischemic stroke (AIS) caused by distal medium vessel occlusion (DMVO): intravenous thrombolysis (IVT) with mechanical thrombectomy (MT) versus IVT alone.
- Data was collected from 37 centers worldwide, involving over 1,000 patients, with the primary focus on functional independence at 90 days and secondary outcomes including mortality and intracerebral hemorrhage.
- Findings suggest that both treatment options yield similar functional and mortality outcomes for DMVO patients, but the MT-IVT approach carries a higher risk of hemorrhagic complications, indicating that it may not provide significant advantages over IVT alone for every patient.
Background And Purpose: The efficacy and safety of endovascular thrombectomy (EVT) for elderly basilar artery occlusion (BAO) stroke patients is unclear.
Materials And Methods: This was an explorative retrospective analysis of the 2016-21 National Inpatient Sample in the United States. Elderly BAO stroke patients (80 years or older) with NIH stroke scale of at least 5 were included.
Article Synopsis
- * Data from 670 patients revealed that while IVT may improve some outcomes, such as higher chances of achieving a modified Rankin Scale score of 0-2 in univariable analysis, this benefit was not consistently observed in more rigorous multivariable analyses.
- * Overall, the findings suggest that adjunctive IVT may not significantly enhance clinical outcomes or safety compared to MT alone for this patient population.
Background: There are no established patient selection criteria for endovascular thrombectomy (EVT) for anterior cerebral artery (ACA) stroke.
Methods: This was a retrospective cohort study of the 2016-2020 National Inpatient Sample in the United States. Isolated ACA-occlusion stroke patients with moderate-to-severe stroke symptoms (NIH stroke scale [NIHSS] ≥ 6) were included.
Background: Acute ischemic stroke (AIS) from primary medium vessel occlusions (MeVO) is a prevalent condition associated with substantial morbidity and mortality. Despite the common use of mechanical thrombectomy (MT) in AIS, predictors of poor outcomes in MeVO remain poorly characterized.
Methods: In this prospectively collected, retrospectively reviewed, multicenter, multinational study, data from the MAD-MT (Multicenter Analysis of primary Distal medium vessel occlusions: effect of Mechanical Thrombectomy) registry were analyzed.
Article Synopsis
- A study was conducted to compare the safety and effectiveness of endovascular treatment (EVT) versus best medical management (BMM) for patients with acute ischaemic stroke caused by distal medium vessel occlusion (DMVO).
- The analysis involved 2,125 patients, showing no significant difference in achieving functional independence at 90 days between EVT and BMM, despite EVT being associated with higher rates of hemorrhagic complications.
- The results suggest that EVT does not provide better functional outcomes than BMM in DMVO cases while increasing the risk of bleeding, indicating the need for cautious use of EVT and further research to improve treatment approaches.
Article Synopsis
- Acute ischemic stroke (AIS) from distal medium vessel occlusions (DMVOs) is common, and while IV thrombolysis is standard, mechanical thrombectomy (MT) is becoming more prevalent for treatment.
- A study reviewed data from 1708 DMVO patients treated with MT, finding that 8.7% experienced symptomatic intracerebral hemorrhage (sICH) and identified several risk factors, including older age, distal occlusion location, prior antiplatelet use, lower ASPECT scores, higher pre-op blood glucose, more passes during MT, and successful recanalization status.
- Understanding these risk factors can help healthcare providers better assess and manage the risk of sICH in patients undergoing MT for DM
Article Synopsis
- Mechanical thrombectomy is the standard treatment for large vessel occlusions, but there's limited evidence for its effectiveness in treating distal and medium vessel occlusions, particularly for patients with low stroke scale scores (≤6).
- A study analyzed data from 41 academic centers, comparing outcomes of low versus higher stroke scale score patients who underwent thrombectomy, revealing high successful reperfusion rates in both groups.
- Results showed that patients with lower stroke scale scores experienced better functional outcomes and lower mortality rates, but the treatment's effectiveness compared to intravenous thrombolysis (IVT) is still uncertain.