Citations 2
Treatment outcomes of successful M1 versus M2 thrombectomy for low-ASPECTS stroke patients
Chen, Huanwen , Colasurdo, Marco , Maier, Ilko , Jabbour, Pascal , Kim, Joon-Tae , Wolfe, Stacey Q , Rai, Ansaar , Starke, Robert M. , Psychogios, Marios‐Nikos, Yoshimura, Shinichi , Alaraj, Ali , Ezzeldin, Mohamad , Tanweer, Omar , Polifka, Adam , Siddiqui, Fazeel , Crosa, Roberto , Levitt, Michael R, Brinjikji, Waleed , Moss, Mark, Dağlıoğlu, Ergün , Williamson, Richard , Chowdhry, Shakeel , Altschul, David , Spiotta, Alejandro M , Kan, Peter, Jabbour, Pascal , Wolfe, Stacey Quintero , Yoshimura, Shinichi , Cuellar-Saenz, Hugo H , Alaraj, Ali , Ezzeldin, Mohamad , Fragata, Isabel , Grandhi, Ramesh , Matouk, Charles , Altschul, David J , Crosa, Roberto , Colasurdo, Marco , Matsukawa, Hidetoshi , Cunningham, Conor M. , Shaban, Amir , Goyal, Nitin , Cuellar, Hugo , Howard, Brian M , Alawieh, Ali , Romano, Daniele Giuseppe , Mascitelli, Justin R , Fragata, Isabel , Osbun, Joshua W , Grandhi, Ramesh , Matouk, Charles , Park, Min S. , Navía, Pedro
Interventional Neuroradiology | June 18, 2025 | Volume: No volume available | Issue: No issue available | Pages: No page available
Background The effectiveness of endovascular thrombectomy (EVT) for low Alberta Stroke Program Early CT score (ASPECTS) stroke patients with occlusion of the second segment of the middle cerebral artery (M2) is unclear. Methods This was a multicenter retrospective study. Patients with M1 or M2 occlusions and low ASPECTS (<6) who underwent successful EVT (modified treatment in cerebral ischemia score of 2b or higher) were included. Primary outcome was futile EVT reperfusion (defined as 90-day modified Rankin scale of 5 or 6). Other outcomes of interest include acceptable outcomes (modified Rankin scale of 3 or less) and intracranial hemorrhage (ICH), and all-cause 90-day mortality. Outcomes for M1 patients were compared to M2 patients with multivariable logistic regression models accounting for potential confounders. Results 173 patients with M1 or M2 occlusions and low ASPECTS (<6) who underwent successful EVT were identified. After multivariable adjustments, M2 patients had significantly higher odds of futile reperfusion (OR 5.48 [95%CI 1.91 to 15.7], p = 0.002), lower odds of acceptable outcomes (OR 0.33 [95%CI 0.12 to 0.89], p = 0.028), and higher odds of all-cause mortality (OR 4.90 [95%CI 1.65 to 14.5], p = 0.004). These findings suggest that EVT's efficacy for low-ASPECTS stroke patients may be diminished for patients with M2 occlusions. M2 occlusion was not significantly associated with ICH. Conclusions Among low-ASEPCTS stroke patients who underwent successful EVT, those with M2 occlusions had significantly higher odds of poor outcome compared to those with M1 occlusions.
Outcomes of arteriovenous malformation patients with multiple versus single feeders: A multicenter retrospective study with propensity-score matching
Musmar, Basel , Adeeb, Nimer , Abdalrazeq, Hammam , Tjoumakaris, Stavropoula I, Salim, Hamza , Kondziolka, Douglas, Sheehan, Jason P. , Ogilvy, Christopher S. , Riina, Howard A. , Naamani, Kareem El, Ironside, Natasha , Ataoglu, Cagdas , Keleş, Abdullah , Muram, Sandeep , Sconzo, Daniel , Rezai, Arwin, Alwakaa, Omar , Erginoğlu, Ufuk , Sen, Rajeev , Griessenauer, Christoph J., Burkhardt, Jan-Karl, Starke, Robert M., Başkaya, Mustafa K. , Levitt, Michael R, Altschul, David , McAvoy, Malia , Aslan, Assala , Abushehab, Abdallah, Swaid, Christian, Abla, Adib A. , Sizdahkhani, Saman , Koduri, Sravanthi , Atallah, Elias , Karadimas, Spyridon, Gooch, M Reid, Rosenwasser, Robert H. , Stapleton, Christopher J. , Koch, Matthew J. , Srinivasan, Visish M. , Cochran, Joseph, Pukenas, Bryan , Smith, Edward, Patel, Aman B. , Cuellar, Hugo H, Lawton, Michael T. , Guthikonda, Bharat , Ogilvy, Christopher S. , Alaraj, Ali , Smith, Edward R. , Salim, Hamza , Essibayi, Muhammed Amir , Alwakaa, Omar , Mosimann, Pascal J , Jabbour, Pascal , Alaraj, Ali , Abla, Adib , Altschul, David J , Musmar, Basel , Ogilvy, Christopher S , Keles, Abdullah , Erginoglu, Ufuk , Smith, Edward , Burkhardt, Jan‐Karl , Roy, Joanna M. , Tjoumakaris, Stavropoula , Kandregula, Sandeep , Dmytriw, Adam A. , Naamani, Kareem El , Abdelsalam, Ahmed , Kumbhare, Deepak , Essibayi, Muhammed Amir , Rezai, Arwin, Tos, Salem M , Pöppe, Johannes , Sen, Rajeev D, Griessenauer, Christoph J. , Sekhar, Laligam N. , Karadimas, Spyridon K. , Gooch, Michael Reid , Chen, Peng R , Blackburn, Spiros , Choudhri, Omar , Orbach, Darren B. , Aziz‐Sultan, Mohammad Ali , Morcos, Jacques J. , Jabbour, Pascal
European Stroke Journal | February 15, 2025 | Volume: 10 | Issue: 3 | Pages: 946-960
Abstract Introduction The impact of multiple feeding arteries on clinical outcomes of cerebral arteriovenous malformations (AVMs) is not well understood. This study aims to compare outcomes between AVMs with multiple versus single feeding arteries. Patients and Methods Data from the Multicenter International Study for Treatment of Brain AVMs (MISTA) consortium were analyzed. Propensity score matching (PSM) was used to balance cohorts. Subgroup analysis was conducted for ruptured and unruptured AVMs and different treatment options, and multivariable logistic regression was applied to assess the impact of feeding artery origin. Results Among 953 patients, 661(69.4%) had multiple feeding arteries, and 292 (30.6%) had a single feeding artery. After PSM, which included 422 matched patients (211 in each group), the differences in obliteration rates (68.7% vs 74.8%, OR 0.73, 95% CI: 0.48–1.12, p = 0.16) and symptomatic complications (15.6% vs 11.8%, OR 1.37, 95% CI: 0.78–2.41, p = 0.25) were not significant. Subgroup analysis comparing ruptured and unruptured AVMs and different treatment options showed no significant differences across all subgroups. Multivariable analysis identified PICA feeders as significantly associated with increased odds of all complications (OR 7.33, 95% CI: 2.14–25.1, p = 0.002). Discussion and Conclusion AVMs with a single feeding artery were more likely to present with rupture, but no significant differences in obliteration rates or complications were observed between the groups after PSM. These findings suggest that while the number of feeding arteries may influence the initial presentation, it does not appear to impact overall treatment success or patient prognosis. Further prospective studies are needed to confirm these findings.