2024
Endovascular thrombectomy versus medical management for patients with large vessel stroke and infective endocarditis
Chen H, Colasurdo M, Khunte M, Malhotra A, Gandhi D. Endovascular thrombectomy versus medical management for patients with large vessel stroke and infective endocarditis. Journal Of NeuroInterventional Surgery 2024, jnis-2024-022374. PMID: 39317440, DOI: 10.1136/jnis-2024-022374.Peer-Reviewed Original ResearchEfficacy of endovascular thrombectomyLarge vessel occlusionInfective endocarditisPropensity score matchingIntracerebral hemorrhageSubarachnoid hemorrhageMedical managementMultivariable adjustmentOdds of intracerebral hemorrhageEndovascular thrombectomyHome dischargeRate of intracerebral hemorrhageFavorable hospital outcomesRate of in-hospital deathAssociated with significantly higher oddsLarge vessel occlusion strokeIn-hospital mortalityRoutine home dischargeIn-hospital deathRate of subarachnoid hemorrhageRate of home dischargeSignificantly higher oddsRate of routine dischargePrimary outcomeSecondary outcomesHigher proceduralist stroke thrombectomy volume is associated with reduced inpatient mortality
Koo A, Renedo D, Ney J, Amllay A, Kanzler M, Stogniy S, Alawieh A, Sujijantarat N, Antonios J, Al Kasab S, Malhotra A, Hebert R, Matouk C, de Havenon A. Higher proceduralist stroke thrombectomy volume is associated with reduced inpatient mortality. Journal Of NeuroInterventional Surgery 2024, jnis-2024-022021. PMID: 39214687, DOI: 10.1136/jnis-2024-022021.Peer-Reviewed Original ResearchIn-hospital deathIn-hospital mortalityAcute ischemic strokeCut-pointsAbsolute risk of deathAssociated with lower oddsState Inpatient DatabasesFlorida State Inpatient DatabaseIn-hospital moralityRates of in-hospital mortalityDiagnosis of acute ischemic strokePrimary study outcomeRisk of deathStroke careOptimal cut-pointAssociated with reduced inpatient mortalityEndovascular thrombectomyRetrospective cohort studyLower oddsPotential confoundersAbsolute riskAcute ischemic stroke patientsInpatient mortalityCohort studyInpatient DatabasePost-Thrombectomy Subarachnoid Hemorrhage: Incidence, Predictors, Clinical Relevance, and Effect Modulators
Chen H, Colasurdo M, Khunte M, Malhotra A, Gandhi D. Post-Thrombectomy Subarachnoid Hemorrhage: Incidence, Predictors, Clinical Relevance, and Effect Modulators. Diagnostics 2024, 14: 1856. PMID: 39272641, PMCID: PMC11394096, DOI: 10.3390/diagnostics14171856.Peer-Reviewed Original ResearchSubarachnoid hemorrhageIntraparenchymal hemorrhageAssociated with higher oddsEndovascular thrombectomyFemale sexAssociated with increased odds of in-hospital mortalityHospital outcomesHigher oddsNon-SAH groupSite of vascular occlusionOdds of in-hospital mortalityMultivariate logistic regression modelEndovascular thrombectomy patientsIn-hospital mortalityAssociated with increased oddsOdds of routine dischargeClinical detrimentRegression modelsLogistic regression modelsVascular occlusionSelf-careVessel occlusionPatientsSignificant predictorsHemorrhageEndovascular thrombectomy versus medical management for acute basilar artery occlusion stroke in the elderly
Chen H, Colasurdo M, Khunte M, Malhotra A, Gandhi D. Endovascular thrombectomy versus medical management for acute basilar artery occlusion stroke in the elderly. American Journal Of Neuroradiology 2024, ajnr.a8473. PMID: 39181691, DOI: 10.3174/ajnr.a8473.Peer-Reviewed Original ResearchPropensity score matchingBasilar artery occlusionIntracranial hemorrhageAssociated with higher ratesIn-hospital mortalityEndovascular thrombectomyIntravenous thrombolysisMedical managementAssociated with increased risk of ICHTreated with medical managementPatients treated with endovascular thrombectomyRisk of intracranial hemorrhageSafety of endovascular thrombectomyBasilar artery occlusion strokeFavorable hospital outcomesTreated with intravenous thrombolysisHome dischargeAssociated with increased riskEndovascular thrombectomy groupArtery occlusion strokeNational Inpatient SampleNIH Stroke ScalePropensity score-matched controlsStroke patientsHigher ratesEndovascular thrombectomy versus medical management for moderate-to-severe anterior cerebral artery occlusion stroke
Chen H, Khunte M, Malhotra A, Gandhi D, Colasurdo M. Endovascular thrombectomy versus medical management for moderate-to-severe anterior cerebral artery occlusion stroke. Journal Of Neurology 2024, 271: 6247-6254. PMID: 39085619, DOI: 10.1007/s00415-024-12582-z.Peer-Reviewed Original ResearchAssociated with higher oddsAnterior cerebral arteryAssociated with higher ratesIntracranial hemorrhageEndovascular thrombectomyMedical managementHigher oddsEfficacy of endovascular thrombectomyFavorable short-term outcomesRetrospective cohort studyPatient selection criteriaShort-term outcomesEndovascular thrombectomy patientsIn-hospital mortalityMultivariate logistic regressionHome dischargeArtery occlusion strokeNational Inpatient SampleHigher ratesNeurological outcomeCohort studyPrimary outcomeCerebral arterySecondary outcomesOcclusion strokeThrombectomy vs Medical Management for Posterior Cerebral Artery Stroke: Systematic Review, Meta-Analysis, and Real-World Data.
Chen H, Khunte M, Colasurdo M, Malhotra A, Gandhi D. Thrombectomy vs Medical Management for Posterior Cerebral Artery Stroke: Systematic Review, Meta-Analysis, and Real-World Data. Neurology 2024, 102: e209315. PMID: 38626383, PMCID: PMC11175628, DOI: 10.1212/wnl.0000000000209315.Peer-Reviewed Original ResearchConceptsSymptomatic intracranial hemorrhagePosterior cerebral arteryAssociated with higher oddsNational Inpatient SampleEndovascular thrombectomyHigher oddsMedical managementCohort studyFunctional independencePosterior cerebral artery strokeSafety of endovascular thrombectomyOdds of symptomatic intracranial hemorrhageAssociated with significantly higher ratesOxford Centre for Evidence-Based Medicine criteriaRates of in-hospital mortalityCentre for Evidence-Based Medicine criteriaMeta-analysisRate of ICHAssociated with different oddsHigher odds of deathRate of subarachnoid hemorrhageIn-hospital mortalityAssociated with lower ratesClass III evidenceLevel of evidence
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 ResearchIntravenous thrombolysis prior to endovascular thrombectomy in elderly stroke patients: An analysis of the National Inpatient Sample database
Chen H, Khunte M, Colasurdo M, Malhotra A, Gandhi D. Intravenous thrombolysis prior to endovascular thrombectomy in elderly stroke patients: An analysis of the National Inpatient Sample database. Journal Of The Neurological Sciences 2023, 454: 120842. PMID: 37856997, DOI: 10.1016/j.jns.2023.120842.Peer-Reviewed Original ResearchConceptsNational Inpatient Sample databaseHospital mortalityHemorrhagic complicationsIntravenous thrombolysisEndovascular thrombectomyEVT patientsIVT treatmentThrombectomy centreElderly patientsMultivariable logistic regression modelSample databaseStroke risk factorsElderly stroke patientsCross-sectional studyLarge-scale cross-sectional studyOutcomes of interestHigh rateLogistic regression modelsPatients 80Medical comorbiditiesOnly patientsPatient demographicsStroke etiologyThrombolytic treatmentHemorrhagic riskO-007 Bridging thrombolysis yields diminished benefit among elderly stroke patients treated with endovascular thrombectomy
Chen H, Khunte M, Colasurdo M, Malhotra A, Gandhi D. O-007 Bridging thrombolysis yields diminished benefit among elderly stroke patients treated with endovascular thrombectomy. 2023, a6-a7. DOI: 10.1136/jnis-2023-snis.7.Peer-Reviewed Original ResearchLetter to the Editor Re “Endovascular thrombectomy or bridging therapy in minor ischemic stroke with large vessel occlusion”
Malhotra A, Khunte M, Wu X, Radmard M. Letter to the Editor Re “Endovascular thrombectomy or bridging therapy in minor ischemic stroke with large vessel occlusion”. Thrombosis Research 2023, 232: 145. PMID: 36739257, DOI: 10.1016/j.thromres.2023.01.008.Peer-Reviewed Original Research
2022
Associations of Osteoarthritis With Thrombectomy Utilization and Outcomes for Large Vessel Acute Ischemic Stroke
Chen H, Khunte M, Colasurdo M, Jindal G, Malhotra A, Gandhi D, Chaturvedi S. Associations of Osteoarthritis With Thrombectomy Utilization and Outcomes for Large Vessel Acute Ischemic Stroke. Stroke 2022, 54: 518-526. PMID: 36541211, DOI: 10.1161/strokeaha.122.041749.Peer-Reviewed Original ResearchConceptsMultivariable logistic regression modelEndovascular thrombectomyAssociation of osteoarthritisLogistic regression modelsHospital mortalityMedical comorbiditiesIschemic strokeRisk factorsLower oddsLarge vessel acute ischemic strokeNational Inpatient Sample databaseMultivariable logistic regression analysisLarge-vessel ischemic strokeIntravenous thrombolysis treatmentStroke risk factorsAcute ischemic strokeIschemic stroke patientsPresence of osteoarthritisCause of disabilityCross-sectional studyLogistic regression analysisPatient selection practicesLarge-scale cross-sectional studyDirect risk factorEVT treatment
2020
Implications of achieving TICI 2b vs TICI 3 reperfusion in patients with ischemic stroke: a cost-effectiveness analysis
Wu X, Khunte M, Gandhi D, Matouk C, Hughes DR, Sanelli P, Malhotra A. Implications of achieving TICI 2b vs TICI 3 reperfusion in patients with ischemic stroke: a cost-effectiveness analysis. Journal Of NeuroInterventional Surgery 2020, 12: 1161-1165. PMID: 32457225, DOI: 10.1136/neurintsurg-2020-015873.Peer-Reviewed Original ResearchConceptsQuality-adjusted life yearsLarge vessel occlusionTICI 3 reperfusionEndovascular thrombectomyTICI 2bTICI 3Stroke patientsHealth benefitsAge groupsAcute stroke patientsDegree of recanalizationDegree of reperfusionLifetime quality-adjusted life yearsCost-effectiveness analysisDecision analytic studyUnited States settingsIncomplete reperfusionIschemic strokeComplete reperfusionPatient selectionReperfusionPatientsHealth outcomesLife yearsCost savings
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