Publications by authors named "Stavros Matsoukas"
Article Synopsis
- Endovascular embolization is used as a supportive treatment for meningioma surgery, but evaluating its effectiveness is complicated because MRI scans are done before embolization and after the tumor is removed.
- Researchers conducted a study using preoperative MRI after embolization to better measure how effective the procedure was, grading the extent of tumor devascularization and analyzing differences based on tumor location and blood supply.
- The study found that the degree of devascularization correlated well with the volumetric extent of embolization, providing a clearer and more quantifiable way to assess the effectiveness of embolization before surgery.
Article Synopsis
- Preoperative embolization is an endovascular procedure that helps in the surgical removal of meningiomas but lacks a standardized system to measure its effectiveness during the procedure.
- Researchers developed an angiographic grading system to help assess and report the level of tumor devascularization achieved through this process, involving a scale from 0 (no embolization) to 4 (complete embolization).
- Analysis of data from 80 patients revealed that tumor location and the type of arterial feeders significantly influenced the success of embolization, with certain tumor types showing higher devascularization grades and a low complication rate of 2.5%.*
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.
Article Synopsis
- The study investigates the effectiveness of two anesthesia methods—general anesthesia (GA) and conscious sedation (non-GA)—for patients undergoing endovascular treatment for isolated posterior cerebral artery (PCA) occlusion stroke.
- Researchers analyzed data from the PLATO study focusing on patient outcomes such as the modified Rankin Scale scores after 90 days, as well as successful reperfusion rates and safety measures like intracranial hemorrhage.
- Results show that while both anesthesia methods had similar functional outcomes and safety profiles, GA was associated with significantly higher rates of successful reperfusion during treatment.
Article Synopsis
- Posterior cerebral artery occlusion (PCAo) can lead to long-term disabilities, and this study compares the effectiveness of endovascular thrombectomy (EVT), both with and without intravenous thrombolysis (IVT), against IVT alone for treating PCAo.
- The study analyzed data from 724 patients treated within 24 hours of PCAo onset, measuring outcomes like functional independence and early neurological improvement over a three-month period.
- Results indicated that EVT did not improve overall functional outcomes compared to IVT alone; however, it increased the likelihood of early improvement, but also raised risks of symptomatic intracranial hemorrhage and mortality.
Article Synopsis
- Endovascular treatment (EVT) is commonly used for proximal vessel occlusion strokes, but its effectiveness for distal medium vessel occlusions is uncertain; this study compares EVT with medical management (MM) for those occlusions.
- A retrospective analysis of 321 patients showed no significant differences between EVT and MM in terms of overall disability, good and excellent outcomes, or 90-day mortality.
- The study concluded that both treatment methods had similar safety profiles, with no notable differences in rates of symptomatic intracranial hemorrhage or mortality.
Article Synopsis
- A study was conducted to investigate the effects of different anesthesia types (general vs. non-general) during endovascular treatment for strokes caused by distal medium vessel occlusions (DMVO).
- Researchers analyzed data from multiple centers and focused on outcomes like disability after 90 days, successful blood vessel reperfusion, and rates of complications.
- Results showed no significant differences between the two anesthesia groups regarding disability, successful treatment, or safety measures, suggesting that anesthesia type may not impact clinical outcomes in DMVO strokes.
Article Synopsis
- The study investigates the effectiveness of endovascular treatment (EVT) versus medical management (MM) in patients with isolated posterior cerebral artery occlusion (iPCAO) during acute ischemic strokes, lacking prior randomized trial evidence.
- Results show that EVT leads to better functional outcomes for patients with more severe stroke symptoms (NIHSS >6), but not for those with milder symptoms (NIHSS ≤6).
- Additionally, while EVT improves outcomes, it is also linked to a higher occurrence of symptomatic intracranial hemorrhages, regardless of initial stroke severity.
Study Design: This study is a scoping review.
Objective: There is a broad variability in the definition of degenerative cervical myelopathy (DCM) and no standardized set of diagnostic criteria to date.
Methods: We interrogated the Myelopathy.
This video demonstrates use of the Synaptive 3D exoscope to enhance complex meningioma resection. The patient was a 58-year-old female who presented with new-onset seizures. Workup revealed a parasagittal meningioma over the bilateral cortices.
View Article and Find Full Text PDFTransforaminal lumbar interbody fusion (TLIF) is a universal surgical technique used to achieve lumbar fusion. Traditionally static cages have been used to restore the disc space after discectomy. However, newer technological advancements have brought up uniplanar expandable cages (UECs) and more recently bi-planar expandable cages (BECs), the latter with the hope of reducing the events of intra- or postoperative subsidence compared to UECs.
View Article and Find Full Text PDFStudy Design: Delayed diagnosis of degenerative cervical myelopathy (DCM) is associated with reduced quality of life and greater disability. Developing diagnostic criteria for DCM has been identified as a top research priority.
Objectives: This scoping review aims to address the following questions: What is the diagnostic accuracy and frequency of clinical symptoms in patients with DCM?
Methods: A scoping review was conducted using a database of all primary DCM studies published between 2005 and 2020.
Study Design: Delayed diagnosis of degenerative cervical myelopathy (DCM) is likely due to a combination of its subtle symptoms, incomplete neurological assessments by clinicians and a lack of public and professional awareness. Diagnostic criteria for DCM will likely facilitate earlier referral for definitive management.
Objectives: This systematic review aims to determine (i) the diagnostic accuracy of various clinical signs and (ii) the association between clinical signs and disease severity in DCM?
Methods: A search was performed to identify studies on adult patients that evaluated the diagnostic accuracy of a clinical sign used for diagnosing DCM.
Article Synopsis
- * Results indicated that patients who underwent RS after failed MT had significantly lower disability levels and better functional outcomes at 90 days compared to those who didn't receive RS, as well as a lower mortality rate.
- * Safety metrics, including rates of symptomatic intracranial hemorrhage and procedural complications, were similar between both groups, suggesting that RS is a viable option for improving patient outcomes after failed MT.
Article Synopsis
- * Data from 334 LVO patients showed that those undergoing MT had better outcomes, including higher rates of functional independence at 90 days and lower mortality compared to those receiving SMT.
- * Key factors influencing positive outcomes from MT included age, baseline NIHSS score, Alberta Stroke Program Early Computed Tomography (ASPECTS) score, and collateral scores, indicating these should be considered in treatment decisions.
Article Synopsis
- A study comparing endovascular therapy (EVT) and medical management (MM) for patients with isolated posterior cerebral artery occlusion found no significant difference in disability outcomes at 90 days.
- EVT showed a greater likelihood of achieving a substantial improvement on the National Institutes of Health Stroke Scale and better overall recovery, despite higher risks of symptomatic intracranial hemorrhage (SICH) and mortality.
- The findings suggest that while EVT may lead to better recovery, it comes with increased risks, indicating the need for careful patient selection in treatment decisions.
Objective: Odontoid fractures can be managed surgically when indicated. The most common approaches are anterior dens screw (ADS) fixation and posterior C1-C2 arthrodesis (PA). Each approach has theoretical advantages, but the optimal surgical approach remains controversial.
View Article and Find Full Text PDFBackground: Although the benefits of aspiration thrombectomy for treating acute ischemic stroke caused by proximal large vessel occlusion have been established, fewer data are available for evaluating aspiration thrombectomy of distal occlusion. The objective of this study was to evaluate, by means of prospectively collected data, the safety and efficacy of aspiration thrombectomy in patients with M2 middle cerebral artery (MCA) occlusion.
Methods: This study is a subset analysis of a global prospective multicenter observational registry that included patients who presented with either anterior or posterior large vessel occlusion and were eligible for mechanical thrombectomy using the Penumbra System including the Penumbra 3D Revascularization Device.
Article Synopsis
- * Out of 72 patients, successful recanalization was achieved in 90%, with a median of 2 attempts needed for treatment, and only 16% experienced intracranial hemorrhage.
- * The findings suggest that EVT is a safe and effective procedure for DVO strokes, with over half of the patients showing favorable outcomes at 90 days, although baseline NIHSS scores were identified as a predictor of worse results.
Objective: Using the Jenkins classification, we propose a strategy of shaving down hypertrophic bone, unilateral fusion, or bilateral fusion procedures to achieve pain reduction and improve quality of life for patients with Bertolotti syndrome.
Methods: We reviewed 103 patients from 2012 through 2021 who had surgically treated Bertolotti syndrome. We identified 56 patients with Bertolotti syndrome and at least 6 months of follow-up.
Importance: Approximately 10% to 20% of large vessel occlusion (LVO) strokes involve tandem lesions (TLs), defined as concomitant intracranial LVO and stenosis or occlusion of the cervical internal carotid artery. Mechanical thrombectomy (MT) may benefit patients with TLs; however, optimal management and procedural strategy of the cervical lesion remain unclear.
Objective: To evaluate the association of carotid artery stenting (CAS) vs no stenting and medical management with functional and safety outcomes among patients with TL-LVOs.
Introduction: Artificial intelligence (AI) software is increasingly applied in stroke diagnostics. Viz LVO (large vessel occlusion) is an AI-based software that is FDA-approved for LVO detection in CT angiography (CTA) scans. We sought to investigate differences in transfer times (from peripheral [spoke] to central [hub] hospitals) for LVO patients between spoke hospitals that utilize Viz LVO and those that do not.
View Article and Find Full Text PDFBackground: Artificial intelligence (AI)-based algorithms have been developed to facilitate rapid and accurate computed tomography angiography (CTA) assessment in proximal large vessel occlusion (LVO) acute ischemic stroke, including internal carotid artery and M1 occlusions. In clinical practice, however, the detection of medium vessel occlusion (MeVO) represents an ongoing diagnostic challenge in which the added value of AI remains unclear.
Purpose: To assess the diagnostic performance of AI platforms for detecting M2 occlusions.
Article Synopsis
- The study compares the effectiveness of three comorbidity scales—mFI-5, mFI-11, and CCI—in predicting clinical outcomes for patients with traumatic brain injury (TBI) using data from the National Trauma Data Bank from 2017-2018.!* -
- All three scales demonstrated reasonable internal consistency, but mFI-5 and mFI-11 showed similar predictive accuracy for complications, discharge outcomes, and mortality, while CCI performed notably worse.!* -
- Given that mFI-5 is simpler and equally accurate as the other scales, it may be the best option for practical use in clinical settings and future research involving TBI patients.*