2024
Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion
Mak A, Matouk C, Avery E, Behland J, Haider S, Frey D, Madai V, Vajkoczy P, Griessenauer C, Zand R, Hendrix P, Abedi V, Sanelli P, Falcone G, Petersen N, Sansing L, Sheth K, Payabvash S, Malhotra A. Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion. PLOS ONE 2024, 19: e0304962. PMID: 38870240, PMCID: PMC11175522, DOI: 10.1371/journal.pone.0304962.Peer-Reviewed Original ResearchConceptsDiffusion-weighted imagingLarge vessel occlusionIrreversible ischemic changesPoor functional outcomeFunctional outcomesIschemic changesInfarct volumeAlberta Stroke Program Early CT ScorePredicting poor functional outcomeVessel occlusionFollow-up diffusion-weighted imagingAnterior circulation LVO strokeCTA source imagesReceiver operating characteristic curveExpert human readersPredicting final infarctionASPECTS regionsAdmission CTANon-inferior performanceBaseline CTACT scoreFinal infarctEndovascular therapyHU attenuationValidation cohort
2023
Trends in Use of Intravenous Thrombolysis and Endovascular Thrombectomy in Patients With Acute Stroke With Large Vessel Occlusion 2016 to 2020 and Impact of COVID‐19 Pandemic
Khunte M, Chen H, Khunte A, Payabvash S, Gandhi D, Malhotra A. Trends in Use of Intravenous Thrombolysis and Endovascular Thrombectomy in Patients With Acute Stroke With Large Vessel Occlusion 2016 to 2020 and Impact of COVID‐19 Pandemic. Journal Of The American Heart Association 2023, 12: e029579. PMID: 37889182, PMCID: PMC10727381, DOI: 10.1161/jaha.122.029579.Peer-Reviewed Original Research
2022
Impact of collateral flow on cost-effectiveness of endovascular thrombectomy.
Khunte M, Wu X, Avery EW, Gandhi D, Payabvash S, Matouk C, Heit JJ, Wintermark M, Albers GW, Sanelli P, Malhotra A. Impact of collateral flow on cost-effectiveness of endovascular thrombectomy. Journal Of Neurosurgery 2022, 137: 1801-1810. PMID: 35535841, DOI: 10.3171/2022.2.jns212887.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioEndovascular thrombectomyIschemic stroke patientsCollateral statusPoor collateral statusBetter outcomesPoor collateralsCollateral circulationStroke patientsAcute ischemic stroke patientsModified Rankin Scale scorePoor collateral circulationRankin Scale scoreLarge vessel occlusionCollateral blood flowGood collateral blood flowCost-effectiveness ratioBase-case analysisProbabilistic sensitivity analysesEVT strategyEVT treatmentIschemic strokeMedical therapyMore patientsCollateral flowCost-effectiveness of thrombectomy in patients with minor stroke and large vessel occlusion: effect of thrombus location on cost-effectiveness and outcomes
Khunte M, Wu X, Koo A, Payabvash S, Matouk C, Heit JJ, Wintermark M, Albers GW, Sanelli PC, Gandhi D, Malhotra A. Cost-effectiveness of thrombectomy in patients with minor stroke and large vessel occlusion: effect of thrombus location on cost-effectiveness and outcomes. Journal Of NeuroInterventional Surgery 2022, 15: 39-45. PMID: 35022300, DOI: 10.1136/neurintsurg-2021-018375.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrain IschemiaCost-Benefit AnalysisEndovascular ProceduresHumansStrokeThrombectomyThrombosisTreatment OutcomeConceptsLarge vessel occlusionProximal M1 occlusionEndovascular thrombectomyMinor strokeM2 occlusionsIntravenous thrombolysisM1 occlusionMedical managementVessel occlusionRankin score 0Markov decision-analytic modelBase-case analysisDecision analytic modelProbabilistic sensitivity analysesProximal M1More patientsPoor outcomeThrombus locationDistal M1Occlusion siteObservational studyScore 0Significant disabilityBetter outcomesPatients
2021
Similar admission NIHSS may represent larger tissue-at-risk in patients with right-sided versus left-sided large vessel occlusion
Mak A, Matouk C, Avery EW, Behland J, Frey D, Madai VI, Vajkoczy P, Malhotra A, Karam A, Sanelli P, Falcone GJ, Petersen NH, Sansing L, Sheth KN, Payabvash S. Similar admission NIHSS may represent larger tissue-at-risk in patients with right-sided versus left-sided large vessel occlusion. Journal Of NeuroInterventional Surgery 2021, 14: 985-991. PMID: 34645705, DOI: 10.1136/neurintsurg-2021-017785.Peer-Reviewed Original ResearchMeSH KeywordsBrain IschemiaCerebral InfarctionHumansRetrospective StudiesStrokeThrombectomyTreatment OutcomeConceptsLarge vessel occlusionFinal infarct volumeLarger final infarct volumeWorse discharge outcomesInfarct volumeAdmission NIHSSDischarge outcomesVessel occlusionScale scoreMultivariate analysisAnterior large vessel occlusionLower admission NIHSS scoreHealth Stroke Scale scoreAdmission National InstitutesAdmission stroke severityPoor discharge outcomeStroke Scale scoreLarger infarct volumesAdmission NIHSS scoreRankin Scale scoreVoxel-wise analysisIncomplete reperfusionInfarct distributionOcclusion sideNIHSS scoreRapid Assessment of Blood Pressure Variability and Outcome After Successful Thrombectomy
Castro P, Ferreira F, Nguyen CK, Payabvash S, Tan C, Sorond F, Azevedo E, Petersen N. Rapid Assessment of Blood Pressure Variability and Outcome After Successful Thrombectomy. Stroke 2021, 52: e531-e535. PMID: 34311565, PMCID: PMC8384685, DOI: 10.1161/strokeaha.121.034291.Peer-Reviewed Original ResearchMeSH KeywordsBlood PressureBrain IschemiaHumansHypertensionOdds RatioProspective StudiesStrokeThrombectomyTreatment OutcomeConceptsBlood pressure variabilityEndovascular stroke therapyBP variabilityFunctional outcomeNeurological recoveryStroke therapyPressure variabilityAnterior circulation ischemic strokeHigh blood pressure variabilityLong-term functional outcomeBP variability measuresEarly clinical improvementEarly neurological recoveryPersonalized BP managementFavorable functional outcomeInitial clinical responsePoor functional outcomeRisk assessment toolSuccessful reperfusionClinical improvementClinical responseIschemic strokeRankin ScaleSuccessful thrombectomyPostreperfusion period
2020
Cost-effectiveness of endovascular thrombectomy in patients with acute stroke and M2 occlusion
Khunte M, Wu X, Payabvash S, Zhu C, Matouk C, Schindler J, Sanelli P, Gandhi D, Malhotra A. Cost-effectiveness of endovascular thrombectomy in patients with acute stroke and M2 occlusion. Journal Of NeuroInterventional Surgery 2020, 13: 784-789. PMID: 33077578, DOI: 10.1136/neurintsurg-2020-016765.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrain IschemiaCost-Benefit AnalysisEndovascular ProceduresHumansReperfusionStrokeThrombectomyTreatment OutcomeConceptsEndovascular thrombectomyMedical managementProbabilistic sensitivity analysesM2 occlusionsAcute strokeBranch occlusionEVT-treated patientsAcute ischemic strokeQuality-adjusted life yearsLifetime quality-adjusted life yearsDecision analytic modelDecision analytic studyIschemic strokeReperfusion techniquesLifetime horizonBetter outcomesPatientsLife yearsAge groupsPerfect healthSocietal perspectiveCost-effective strategyStrokeHealth benefitsOcclusion
2019
Comparative Effectiveness of Endovascular Thrombectomy in Elderly Stroke Patients
Malhotra A, Wu X, Payabvash S, Matouk CC, Forman HP, Gandhi D, Sanelli P, Schindler J. Comparative Effectiveness of Endovascular Thrombectomy in Elderly Stroke Patients. Stroke 2019, 50: 963-969. PMID: 30908156, DOI: 10.1161/strokeaha.119.025031.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsIntravenous thrombolysisEndovascular thrombectomyLarge vessel occlusionAge 80 yearsEVT strategyVessel occlusionModified Rankin Scale scorePoststroke functional outcomeAcute ischemic strokeRankin Scale scoreElderly stroke patientsMarkov decision-analytic modelYears of ageDecision analytic modelMultiple sensitivity analysesPurpose- StrokeAcute strokeBaseline disabilityElderly patientsIschemic strokeStroke patientsFunctional outcomeHealthy patientsAdvanced age
2017
Multivariate Prognostic Model of Acute Stroke Combining Admission Infarct Location and Symptom Severity: A Proof-of-Concept Study
Payabvash S, Benson JC, Tyan AE, Taleb S, McKinney AM. Multivariate Prognostic Model of Acute Stroke Combining Admission Infarct Location and Symptom Severity: A Proof-of-Concept Study. Journal Of Stroke And Cerebrovascular Diseases 2017, 27: 936-944. PMID: 29198948, DOI: 10.1016/j.jstrokecerebrovasdis.2017.10.034.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overArea Under CurveBrainBrain IschemiaBrain MappingDatabases, FactualDecision Support TechniquesDiffusion Magnetic Resonance ImagingDisability EvaluationFemaleHumansLogistic ModelsMaleMesencephalonMiddle AgedMultivariate AnalysisOdds RatioPatient AdmissionPonsPredictive Value of TestsProof of Concept StudyReproducibility of ResultsRetrospective StudiesRisk FactorsROC CurveSeverity of Illness IndexStrokeTime FactorsTreatment OutcomeConceptsDisability/deathMidbrain/ponsAcute ischemic stroke patientsIschemic stroke patientsAdmission NIHSS scoreStroke patientsNIHSS scoreIndependent predictorsInfarct locationScale scoreHealth Stroke Scale scoreHigher admission NIHSS scoresModified Rankin Scale scoreSymptom severityAdmission stroke severityBaseline functional disabilityLarger infarct volumesStroke Scale scoreRankin Scale scoreHours of onsetAcute ischemic infarctMultivariate prognostic modelMajor arterial occlusionHypothesis-generating studyVoxel-based analysis
2016
The Effects of DWI‐Infarct Lesion Volume on DWI‐FLAIR Mismatch: Is There a Need for Size Stratification?
Payabvash S, Taleb S, Benson JC, Rykken JB, Oswood MC, McKinney AM, Hoffman B. The Effects of DWI‐Infarct Lesion Volume on DWI‐FLAIR Mismatch: Is There a Need for Size Stratification? Journal Of Neuroimaging 2016, 27: 392-396. PMID: 27878926, DOI: 10.1111/jon.12407.Peer-Reviewed Original ResearchConceptsDWI-FLAIR mismatchPositive predictive valueDWI lesion volumeLesion volumeNegative predictive valueStroke onsetAcute infarctsStroke patientsInfarct lesionsPredictive valueFluid-attenuated inversion recovery hyperintensityAcute ischemic stroke patientsInfarct lesion volumeIschemic stroke patientsHours of onsetInversion recovery hyperintensityContralateral normal sideIdentification of strokePotential imaging biomarkerMultivariate regression analysisIdentification of infarctionSymptom onsetTherapy timeNormal sideImaging biomarkersProminent cortical and medullary veins on susceptibility-weighted images of acute ischaemic stroke
Payabvash S, Benson JC, Taleb S, Rykken JB, Hoffman B, Oswood MC, McKinney AM. Prominent cortical and medullary veins on susceptibility-weighted images of acute ischaemic stroke. British Journal Of Radiology 2016, 89: 20160714. PMID: 27805839, PMCID: PMC5604931, DOI: 10.1259/bjr.20160714.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeLarger infarct volumesMedullary veinsIschemic strokeInfarct volumeArterial occlusionSusceptibility-weighted imagesConsecutive patientsClinical outcomesCortical veinsProminent cortical veinsPosterior circulation territoryPoor clinical outcomeSeverity of symptomsFair interobserver agreementSWI seriesAcute strokeSymptom onsetIndependent predictorsClinical variablesSWI scansPatientsStrokeImaging implicationsProminent veins
2015
Detection of Intraparenchymal Hemorrhage After Endovascular Therapy in Patients with Acute Ischemic Stroke Using Immediate Postprocedural Flat‐Panel Computed Tomography Scan
Payabvash S, Khan AA, Qureshi MH, Saeed O, Suri MF, Qureshi AI. Detection of Intraparenchymal Hemorrhage After Endovascular Therapy in Patients with Acute Ischemic Stroke Using Immediate Postprocedural Flat‐Panel Computed Tomography Scan. Journal Of Neuroimaging 2015, 26: 213-218. PMID: 26282065, DOI: 10.1111/jon.12277.Peer-Reviewed Original ResearchConceptsMultidetector CT studiesNegative predictive valueIschemic stroke patientsIntraparenchymal hemorrhageCT scanEndovascular treatmentHyperdense lesionParenchymal lesionsStroke patientsPredictive valueCT studiesMultidetector CTAcute ischemic stroke patientsAcute ischemic strokeAcute stroke patientsMultidetector CT scanPositive predictive valueEndovascular therapyIschemic strokePost procedureTomography scanSeparate cohortSuch lesionsPatientsDiagnostic valueMiddle Cerebral Artery Residual Contrast Stagnation on Noncontrast CT Scan Following Endovascular Treatment in Acute Ischemic Stroke Patients
Payabvash S, Qureshi MH, Taleb S, Pawar S, Qureshi AI. Middle Cerebral Artery Residual Contrast Stagnation on Noncontrast CT Scan Following Endovascular Treatment in Acute Ischemic Stroke Patients. Journal Of Neuroimaging 2015, 25: 946-951. PMID: 25684437, DOI: 10.1111/jon.12211.Peer-Reviewed Original ResearchConceptsAcute ischemic stroke patientsMCA M1 occlusionIschemic stroke patientsIntraparenchymal hemorrhageEndovascular treatmentContrast stagnationCT scanPostprocedural CT scanNoncontrast CT scanStroke patientsM1 occlusionContralateral arteryHounsfield unitsAverage HU valueM1 segmentRelative riskNoncontrast CTPatientsScansArteryTreatmentAttenuation differenceHU valuesOcclusionRisk
2014
Differentiating intraparenchymal hemorrhage from contrast extravasation on post-procedural noncontrast CT scan in acute ischemic stroke patients undergoing endovascular treatment
Payabvash S, Qureshi MH, Khan SM, Khan M, Majidi S, Pawar S, Qureshi AI. Differentiating intraparenchymal hemorrhage from contrast extravasation on post-procedural noncontrast CT scan in acute ischemic stroke patients undergoing endovascular treatment. Neuroradiology 2014, 56: 737-744. PMID: 24925217, DOI: 10.1007/s00234-014-1381-8.Peer-Reviewed Original ResearchConceptsPost-procedural CT scanAcute ischemic stroke patientsIschemic stroke patientsContrast extravasationIntraparenchymal hemorrhageEndovascular treatmentStroke patientsCT scanNoncontrast CT scanHyperdense lesionHounsfield unitsParenchymal lesionsImaging recordsIntroductionThis studyHemorrhagePatientsExtravasationLesionsScansHyperdensityHyperdenseTreatmentAverage attenuationCharacteristic analysisResultsOf
2012
Improved Outcome Prediction Using CT Angiography in Addition to Standard Ischemic Stroke Assessment: Results from the STOPStroke Study
González RG, Lev MH, Goldmacher GV, Smith WS, Payabvash S, Harris GJ, Halpern EF, Koroshetz WJ, Camargo EC, Dillon WP, Furie KL. Improved Outcome Prediction Using CT Angiography in Addition to Standard Ischemic Stroke Assessment: Results from the STOPStroke Study. PLOS ONE 2012, 7: e30352. PMID: 22276182, PMCID: PMC3262833, DOI: 10.1371/journal.pone.0030352.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBrain IschemiaCerebral AngiographyFemaleHumansMaleMiddle AgedStrokeTomography, X-Ray ComputedConceptsPoor outcomeCT angiographyStroke assessmentOdds ratioNoncontrast CTAdmission NIH Stroke Scale scoreAlberta Stroke Program Early CT ScoreBoston Acute Stroke Imaging ScaleScale scoreModified Rankin Scale scoreNIH Stroke Scale scoreOutcome predictionAcute stroke assessmentAdmission CT angiographyProximal middle cerebralStroke Scale scoreAcute ischemic strokeRankin Scale scoreDistal internal carotidIndependent outcome predictorsStroke outcome predictionSignificant clinical toolNCCT ASPECTSIschemic strokeMiddle cerebral
2011
CT Perfusion Mean Transit Time Maps Optimally Distinguish Benign Oligemia from True “At-Risk” Ischemic Penumbra, but Thresholds Vary by Postprocessing Technique
Kamalian S, Kamalian S, Konstas AA, Maas MB, Payabvash S, Pomerantz SR, Schaefer PW, Furie KL, González RG, Lev MH. CT Perfusion Mean Transit Time Maps Optimally Distinguish Benign Oligemia from True “At-Risk” Ischemic Penumbra, but Thresholds Vary by Postprocessing Technique. American Journal Of Neuroradiology 2011, 33: 545-549. PMID: 22194372, PMCID: PMC3746025, DOI: 10.3174/ajnr.a2809.Peer-Reviewed Original ResearchConceptsAcute stroke patientsLarge vessel occlusionBenign oligemiaStroke patientsIschemic penumbraCTP parametersRelative cerebral blood flowConsecutive stroke patientsHours of onsetCerebral blood flowMean transit time mapsCharacteristic curve analysisTransit time mapsUninvolved hemisphereRadiographic evidenceThrombolytic therapyFinal infarctVessel occlusionRelative MTTBlood flowCTP mapsPerfusion parametersOligemiaReperfusionPatientsCT Cerebral Blood Flow Maps Optimally Correlate With Admission Diffusion-Weighted Imaging in Acute Stroke but Thresholds Vary by Postprocessing Platform
Kamalian S, Kamalian S, Maas MB, Goldmacher GV, Payabvash S, Akbar A, Schaefer PW, Furie KL, Gonzalez RG, Lev MH. CT Cerebral Blood Flow Maps Optimally Correlate With Admission Diffusion-Weighted Imaging in Acute Stroke but Thresholds Vary by Postprocessing Platform. Stroke 2011, 42: 1923-1928. PMID: 21546490, PMCID: PMC3125441, DOI: 10.1161/strokeaha.110.610618.Peer-Reviewed Original ResearchConceptsDiffusion-weighted imagingCT perfusion parametersAcute strokeCT perfusionInfarct coreAdmission diffusion-weighted imagingPerfusion parametersCerebral blood flowCerebral blood flow mapsCerebral blood volumeCharacteristic curve analysisAdmission CT perfusionBlood flow mapsUninvolved hemisphereRegional Ischemic Vulnerability of the Brain to Hypoperfusion
Payabvash S, Souza LC, Wang Y, Schaefer PW, Furie KL, Halpern EF, Gonzalez RG, Lev MH. Regional Ischemic Vulnerability of the Brain to Hypoperfusion. Stroke 2011, 42: 1255-1260. PMID: 21493917, PMCID: PMC3090217, DOI: 10.1161/strokeaha.110.600940.Peer-Reviewed Original ResearchConceptsIschemic vulnerabilityStroke patientsInfarct coreRCBF thresholdAdmission diffusion-weighted imagingCerebral blood flow reductionAcute stroke patientsIschemic stroke onsetBlood flow reductionAdmission CT perfusionDiffusion-weighted imagingCT perfusion mapsStroke onsetRCBF reductionCT perfusionBrain lesionsInferior frontal gyrusParacentral lobuleCaudate bodyInsular ribbonPerfusion parameter mapsHypoperfusionSubcortical regionsPatientsRCBF