Aemaz Ur Rehman, Muhammad
Mayo Clinic
King Edward Medical University
Citations 2
Impaired Perfusion and Early Ischemic Stroke Recurrence in Symptomatic Intracranial Atherosclerosis: BIORISK ICAS Study
Yaghi, Shadi , Khan, Farhan , Lewis, Skylar, Stipanovich, Ava, Choi, Richard , Baker, Richard, Kasab, Sami Al , Qdais, Ahmad Abu, Yaddanapudi, Sridhara , Sultana, Sabiha , Khan, Muhib , Malik, Maarij , Klaas, James P. , Bakradze, Ekaterina , Ressler, Hadley W. , McCullough‐Hicks, Margy , Cooper, Dawson C , Pillai, Abhiram Parameswaran, Hariharan, Praveen , Alam, Shaista , Mayer, Morgan, Kugler, Irina, Almiri, William , Secchi, Thaís , Mantovani, Gabriel Paulo , Rothstein, Aaron , Krishnaiah, Balaji , Alfred, Linda Sherine , Vishnu, Venugopalan Y. , Chandu, Meena, Agarwal, Ayush , Marrone, Nicola , Vozzi, Stefano, Ghannam, Malik , Elshikh, Mohamed , Hou, Yan , Peshwe, Krithika Umesh, Tunguturi, Ajay, Frontera, Jennifer , Zaidat, Osama O. , Barakat, Benan , Khan, Niha, Sen, Shayak, Coelho, Mariana Lima , Sousa, João André , Sousa, Diana Aguiar de , Soares, Mafalda , Rodrigues, Amanda Cyntia Lima Fonseca , Jhaveri, Aditya , Bhati, S., Vassilopoulou, Sofia , Tountopoulou, Argyro , Muddasani, Varsha , Henninger, Nils , Tran, Hieu , Helenius, Johanna, Khasawneh, Mohammad W , Vellimana, Ananth K. , Apfel, Ryan , Molaie, Amir , Mannino, Marina , Terruso, Valeria, Halabi, Tarek El , Reda, Mahasen , Tamer, Christel, Shu, Liqi , Khatri, Pooja , Furie, Karen L. , Liebeskind, David S. , Al Kasab, Sami , Klaas, James P , Aemaz Ur Rehman, Muhammad , Leon Guerrero, Christopher R , Ressler, Hadley Walsh , Saleh Velez, Faddi , Owens, Cameron , McCullough-Hicks, Margy , Cooper, Dawson , Parameswaran Pillai, Abhiram , Hariharan, Praveen , Heldner, Mirjam R , Antonenko, Kateryna , Almiri, William , Martins, Sheila , Mantovani, Gabriel , Rothstein, Aaron , Sloane, Kelly L , Krishnaiah, Balaji , Elangovan, Cheran , Vishnu, Venugopalan Y , Chandu, Meena , Agarwal, Ayush , Romoli, Michele , Ghannam, Malik , Elshikh, Mohamed , Dibas, Mahmoud , Hou, Yan , Tunguturi, Ajay , Marto, João Pedro , Duarte Armindo, Rui , Frontera, Jennifer , Kuohn, Lindsey , Almajali, Mohammad , Zaidat, Osama O , Barakat, Benan , Simpkins, Alexis N , Coelho, Mariana , Sargento-Freitas, Joao , Sousa, Joao Andre , Aguiar de Sousa, Diana , Soares, Mafalda , Cyntia Lima Fonseca Rodrigues, Amanda , Jhaveri, Aditya , Morsi, Rami Z , Siegler, James E , Aziz, Yasmin , Harker, Pablo , Vassilopoulou, Sofia , Tountopoulou, Argyro , de Havenon, Adam H , Henninger, Nils , Tran, Hieu , Khasawneh, Mohammad , Vellimana, Ananth , Apfel, Ryan , Molaie, Amir , Mannino, Marina , Terruso, Valeria , Klein, Piers , Shu, Liqi , Khatri, Pooja , Furie, Karen L , Nguyen, Thanh N , Liebeskind, David S. , Prabhakaran, Shyam , Yaghi, Shadi , Choi, Richard , Khan, Farhan , Sultana, Sabiha, Rehman, Muhammad Aemaz Ur , Velez, Faddi G. Saleh , Pinto, Camila Bonin , Alam, Shaista, Mayer, Morgan, Heldner, Mirjam R. , Kugler, Irina, Elangovan, Cheran , Dibas, Mahmoud , Marto, João Pedro , Kuohn, Lindsey , Almajali, Mohammad , Khan, Niha, Simpkins, Alexis N. , Sen, Shayak, Morsi, Rami Z. , Siegler, James E. , Aziz, Yasmin , Harker, Pablo , Bhati, Sonia, Havenon, Adam de , Tamer, Christel, Klein, Piers , Nguyen, Thanh N. , Prabhakaran, Shyam
Stroke | October 23, 2025 | Volume: 57 | Issue: 1 | Pages: 96-106
BACKGROUND: Intracranial atherosclerosis (ICAS) is associated with an increased risk of early recurrent ischemic stroke. We evaluated whether biomarkers of impaired distal perfusion—specifically, anterior circulation borderzone infarct, and hypoperfusion mismatch volume—were associated with recurrent ischemic stroke within 90 days. METHODS: The BIORISK ICAS (Biomarkers and Recurrence Risk in Symptomatic Intracranial Atherosclerosis) is a multicenter retrospective international study (35 sites) that included hospitalized patients with symptomatic ICAS (50%–99% luminal stenosis of the intracranial vertebral, basilar, distal internal carotid, or proximal middle cerebral artery) from January 2019 to June 2024. The primary outcome was recurrent ischemic stroke in the territory of the symptomatic artery within 90 days. In the primary analysis, the exposure was an acute anterior circulation borderzone infarct. In secondary analysis of the subset with presentation within 72 hours of last known normal and perfusion imaging completed, the exposure of interest was prespecified as hypoperfusion mismatch volume at T max (time to maximum) threshold of 6 seconds, dichotomized at the Youden index. We performed multivariable Cox regression to test associations between exposure variables and the outcome, adjusting for clinically relevant variables and those associated with the outcome ( P <0.1). RESULTS: Of 2050 patients with symptomatic ICAS, 1737 (84.7%) presented within 72 hours of symptom onset, among whom 509 (29.3%) underwent perfusion imaging. The primary analysis included 1891 patients; 174 (9.2%) patients had recurrent ischemic stroke in the symptomatic arterial territory. In adjusted Cox regression models, there was an association between anterior circulation borderzone infarct and recurrent ischemic stroke at 90 days (adjusted hazard ratio, 1.40 [95% CI, 1.02–1.93]). In the perfusion imaging analysis, hypoperfusion mismatch of ≥10 mL was associated with recurrent ischemic stroke (adjusted hazard ratio, 1.83 [95% CI, 1.03–3.28]). CONCLUSIONS: Biomarkers of impaired distal perfusion, anterior circulation borderzone infarct, and hypoperfusion mismatch were associated with increased risk of recurrent ischemic stroke. These findings support the use of perfusion imaging in ICAS as well as future trials investigating early reperfusion in high-risk patients with ICAS.
Efficacy and safety of transradial versus transfemoral access for mechanical thrombectomy in acute ischemic stroke: A systematic review and meta-analysis
Rehman, Muhammad Aemaz Ur , Rehman, Muhammad Ebaad Ur , Ali, Hamza , Rehman, Muhammad , Ghozy, Sherief , Tariq, Muhammad Bilal , Kallmes, David F. , Aemaz Ur Rehman, Muhammad , Rehman, Mohammad Ammar Ur , Ghozy, Sherief , Kallmes, David F
Interventional Neuroradiology | May 21, 2025 | Volume: No volume available | Issue: No issue available | Pages: No page available
Background Mechanical thrombectomy for ischemic stroke has traditionally been performed via transfemoral access (TFA). However, newer literature on the subject suggests that transradial access (TRA) may be equally efficacious. Methods Online databases (including PubMed, Google Scholar, Embase, and Cochrane) were queried from inception until May 2024. Abstracts and full texts were screened according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Risk of bias assessment was performed using standardized screening tools. All dichotomous outcomes were reported as odds ratio (OR) with 95% confidence interval (CI). RevMan was used to perform the statistical analysis. Results Thirteen observational studies and one randomized clinical trial (RCT) were included in this meta-analysis. The total sample size was 4973, 4074 patients (81.2%) were in the TFA group, and 899 (18.8%) were in the TRA group. No significant differences were observed between the two groups in terms of successful recanalization (OR = 0.92; 95% CI 0.66–1.27; p = 0.60), first-pass recanalization (OR = 0.84; 95% CI 0.69–1.01, p = 0.06), access to reperfusion time (mean difference −2.99 min; 95% CI −8.33 to 2.44, p = 0.27), and favorable functional outcome. Mortality and rates of intracranial hemorrhage were comparable between the two groups, but access site complications were significantly lower in the TRA group (OR = 0.57; 95% CI 0.37–0.88; p = 0.01). Conclusion TRA for thrombectomy in large vessel ischemic strokes is comparable to TFA in terms of efficacy and has a lower incidence of access site complications. RCT data comparison of the two techniques is limited, underscoring the importance of conducting trials.