Filipe, João Pedro
Mayo Clinic
Department of Diagnostic and Interventional Neuroradiology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Citations 2
Baseline predictors of poor clinical outcome despite recanalization of distal middle cerebral artery occlusions
Chafai, Imene , Salim, Hamza , Musmar, Basel , Adeeb, Nimer , Yedavalli, Vivek , Tjoumakaris, Stavropoula , Henninger, Nils , Nedelcu, Simona , Sundararajan, Sri Hari , Kühn, Anna Luisa , Khalife, Jane , Tan, Benjamin Yong‐Qiang , Heit, Jeremy J. , Regenhardt, Robert W. , Puri, Ajit S , Dyzmann, Christian , Filipe, João Pedro , Marotta, Thomas R. , Spears, Julian , Biswas, Arundhati , Clarençon, Frédéric , Varela, Ricardo , Baker, Amanda , Altschul, David , Gonzalez, Nestor R. , Möhlenbruch, Markus , Costalat, Vincent , Stracke, Christian Paul , Shaikh, Hamza , Liebeskind, David S. , Alexandre, Andrea , Tancredi, Illario , Faizy, Tobias D. , Kalsoum, Erwah , Patel, Aman B. , Wang, Maud , Lubicz, Boris , Guenego, Adrien , ##, On behalf of the MAD MT Investigators, Tjoumakaris, Stavropoula , Ghozy, Sherief , Scarcia, Luca , Tan, Benjamin Yq , Heit, Jeremy J , Regenhardt, Robert W , Cancelliere, Nicole M , Bernstock, Joshua D , Rouchaud, Aymeric , Fiehler, Jens , Sheth, Sunil A , Essibayi, Muhammed Amir , Colasurdo, Marco , Marnat, Gaultier , Renieri, Leonardo , Filipe, João Pedro , Harker, Pablo , Alexandru Radu, Răzvan , Marotta, Thomas R , Spears, Julian , Ota, Takahiro , Mowla, Ashkan , Jabbour, Pascal , Clarençon, Frédéric , Nguyen, Thanh N , Varela, Ricardo , Altschul, David J , Gonzalez, Nestor R , Möhlenbruch, Markus A , Gory, Benjamin , Stracke, Paul , Hecker, Constantin , Shaikh, Hamza A , Liebeskind, David S. , Pedicelli, Alessandro , Alexandre, Andrea M , Tancredi, Illario , Faizy, Tobias D , Kalsoum, Erwah , Fahed, Robert , Wang, Maud , Mendes Pereira, Vitor , Lubicz, Boris , Dmytriw, Adam A , Guenego, Adrien , Kühn, Anna Luisa , Musmar, Basel , Salim, Hamza , Yedavalli, Vivek S , Henninger, Nils , Nedelcu, Simona , Ghozy, Sherief , Cancelliere, Nicole M , Bernstock, Joshua D. , Rouchaud, Aymeric , Fiehler, Jens , Essibayi, Muhammed Amir , Colasurdo, Marco , Renieri, Leonardo , Harker, Pablo , Radu, Răzvan Alexandru , Mowla, Ashkan , Jabbour, Pascal , Nguyen, Thanh N. , Baker, Amanda, Aziz‐Sultan, Mohammad Ali , Hecker, Constantin , Fahed, Robert , Dmytriw, Adam A. , ##, On behalf of the MAD MT Investigators
Interventional Neuroradiology | July 16, 2025 | Volume: No volume available | Issue: No issue available | Pages: No page available
Objective Mechanical thrombectomy (MT) is well-established for the treatment of acute ischemic stroke (AIS) from large vessel occlusion (LVO), with growing data supporting the expansion to distal and medium vessel occlusions (DMVO). Despite successful recanalization in DMVO, certain patients still experience poor long-term clinical outcomes, prompting our study to comprehensively explore pre-MT factors influencing outcome despite excellent recanalization (final modified Thrombolysis in Cerebral Infarction [mTICI] score ≥2c). Methods We retrospectively examined data from patients who consecutively underwent MT for a primary middle cerebral artery (MCA) DMVO across 37 centers in North America, Asia, and Europe. We identified baseline clinical and imaging factors associated with poor clinical outcome (defined as a modified Rankin Scale [mRS] score of 3–6) at 3 months, despite excellent recanalization using a multivariable model. Results Between September 2017 and July 2021, 623 patients achieved mTICI > 2b and they were included in our study. Among them, 198 (32%) experienced a poor clinical outcome (mRS 3–6). Predictors of poor clinical outcome included higher age (OR 1.05 [1.03–1.07], p < 0.001), higher NIHSS at admission (OR 1.12 [1.08–1.15], p < 0.001), higher baseline mRS (OR 1.77 [0.96–3.26], p = 0.067), and diabetes (OR 1.59 [1.01–2.48], p = 0.044). Higher ASPECTS was associated with a decreased risk of poor clinical outcome (OR 0.82 [0.71–0.94], p = 0.006). Conclusion Older age, diabetes, higher baseline mRS, and NIHSS were associated with poor clinical outcome in MCA DMVO despite excellent recanalization. Conversely, a higher ASPECTS decreased the probability of such an outcome.
A multicenter, propensity score-matched analysis of functional outcomes and recanalization success with or without Trevo for Medium and distal vessel occlusion
Siegler, James E. , Koneru, Manisha , Shaikh, Hamza, Salim, Hamza , Musmar, Basel , Adeeb, Nimer , Yedavalli, Vivek , Tjoumakaris, Stavropoula , Henninger, Nils , Sundararajan, Sri Hari , Tan, Benjamin Yong‐Qiang , Heit, Jeremy J , Regenhardt, Robert W. , Kass‐Hout, Tareq , Fiehler, Jens, Puri, Ajit S , Dyzmann, Christian , Barreau, Xavier, Renieri, Leonardo, Filipe, João Pedro , Harker, Pablo, Marotta, Thomas R. , Spears, Julian , Biswas, Arundhati , Clarençon, Frédéric, Abdalkader, Mohamad , Varela, Ricardo , Baker, Amanda , Altschul, David , Gonzalez, Nestor R. , Möhlenbruch, Markus A, Costalat, Vincent, Gory, Benjamin, Stracke, Christian Paul , Hecker, Constantin, Liebeskind, David S. , Alexandre, Andrea , Tancredi, Illario , Faizy, Tobias D. , Kalsoum, Erwah , Lubicz, Boris , Patel, Aman B. , Khalife, Jane, Rana, Ankit, Guenego, Adrien , Investigators, for the MAD MT, Heit, Jeremy J. , Salim, Hamza , Tjoumakaris, Stavropoula , Henninger, Nils , Kühn, Anna Luisa , Ghozy, Sherief , Scarcia, Luca , Regenhardt, Robert W , Morsi, Rami Z , Vigilante, Nicholas , Rouchaud, Aymeric , Essibayi, Muhammed Amir , Dyzmann, Christian , Colasurdo, Marco , Filipe, João Pedro , Alexandru Radu, Răzvan , Ota, Takahiro , Jabbour, Pascal , Klein, Piers , Nguyen, Thanh N , Altschul, David J , Gonzalez, Nestor R , Griessenauer, Christoph J , Liebeskind, David S. , Tancredi, Illario , Guenego, Adrien , Dmytriw, Adam A , Heit, Jeremy J , Musmar, Basel , Yedavalli, Vivek S , Siegler, James E , Tan, Benjamin Yq , Alexandre, Andrea M , Varela, Ricardo , Daraghma, Motaz , Kühn, Anna Luisa , Ghozy, Sherief , Morsi, Rami Z. , Cancelliere, Nicole M , Bernstock, Joshua D. , Rouchaud, Aymeric , Sheth, Sunil A , Essibayi, Muhammed Amir , Colasurdo, Marco , Barreau, Xavier , Renieri, Leonardo , Harker, Pablo , Radu, Răzvan Alexandru , Mowla, Ashkan , Jabbour, Pascal , Clarençon, Frédéric , Klein, Piers , Nguyen, Thanh N. , Möhlenbruch, Markus , Costalat, Vincent , Gory, Benjamin , Hecker, Constantin , Griessenauer, Christoph J. , Pedicelli, Alessandro , Mendes Pereira, Vitor , Khalife, Jane , Dmytriw, Adam A. , Investigators, for the MAD MT
Interventional Neuroradiology | May 21, 2025 | Volume: No volume available | Issue: No issue available | Pages: No page available
Background Endovascular therapy (EVT) for stroke due to distal or medium vessel occlusion (DMVO) is safe. Due to the distinct anatomical characteristics of DMVOs, further evaluation of EVT is crucial to determine which devices may yield better outcomes. Methods A retrospective analysis of adults with DMVO treated in 37 centers (11 countries) was queried. The primary outcome of favorable shift in 90-day modified Rankin Scale (mRS) was compared between patients treated with Trevo versus other devices on first pass using 1:1 propensity score matching (PSM) with multivariable adjustment. Secondary outcomes included the number of pass attempts, final thrombolysis in cerebral infarction (TICI) score 2b-3, symptomatic intracranial hemorrhage (sICH), improvement in National Institutes of Health Stroke Scale (NIHSS) at 24h, and 90-day mortality. Results Of the 1115 included patients, 264 (24%) were treated with Trevo (PSM cohort of 261 per group). Trevo use was not associated with a favorable 90-day mRS shift (proportional odds ratio [OR] 1.10, 95% confidence interval [CI] 0.80–1.51). Trevo was associated with fewer passes (adjusted β=-0.25, 95% CI −0.48 - −0.03), higher odds of TICI 2b-3 (adjusted OR 1.97, 95% CI 1.11–3.49), and a greater 24h NIHSS improvement (adjusted β= −1.74, 95% CI −3.11 - −0.36), with no difference in sICH or mortality (p>0.05). Results were similar in sensitivity analyses. Conclusions We observed no safety concerns with Trevo as compared to other EVT devices for DMVO recanalization. There was a signal of better technical efficacy and early clinical improvement.