Browsing by Author "Fragata, Isabel"
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- Early Prediction of Delayed Ischemia and Functional Outcome in Acute Subarachnoid Hemorrhage: Role of Diffusion Tensor Imaging.Publication . Fragata, Isabel; Alves, Marta; Papoila, Ana Luísa; Nunes, Ana Paiva; Ferreira, Patrícia; Canto-Moreira, Nuno; Canhão, PatríciaBackground and purpose: Diffusion tensor imaging (DTI) parameters are markers of cerebral lesion in some diseases. In patients with acute subarachnoid hemorrhage (SAH), we investigated whether DTI parameters measured at <72 hours might be associated with delayed cerebral ischemia (DCI) and with poor functional outcome at 3 months (modified Rankin Scale score ≥3). Methods: DTI was performed in a prospective cohort of 60 patients with nontraumatic SAH at <72 hours. Association of fractional anisotropy and apparent diffusion coefficient values at <72 hours with the occurrence of DCI and outcome at 3 months was evaluated with logistic regression models, adjusting for known predictors of prognosis. Results: At <72 hours after SAH, fractional anisotropy values at the cerebellum were associated with DCI occurrence (78% less odds of DCI for each 0.1 increase in fractional anisotropy; P=0.019). Early apparent diffusion coefficient values were not associated with DCI. After adjusting for confounding variables, an increase of 10 U in apparent diffusion coefficient at the frontal centrum semiovale corresponded to 15% increased odds of poor outcome (P=0.061). Conclusions: DTI parameters at <72 hours post-SAH are independently associated with the occurrence of DCI and functional outcome. These preliminary results suggest the role of DTI parameters as surrogate markers of prognosis in nontraumatic SAH.
- Outcomes and Differences by Occluded Vessel after Endovascular Thrombectomy for Isolated Medium Vessel OcclusionsPublication . Matsukawa, Hidetoshi; Uchida, Kazutaka; Cunningham, Conor; Sowlat, Mohammad-Mahdi; Elawady, Sameh Samir; Maier, Ilko; Jabbour, Pascal; Kim, Joon-Tae; Wolfe, Stacey Quintero; Rai, Ansaar; Starke, Robert; Psychogios, Marios-Nikos; Shaban, Amir; Arthur, Adam; Cuellar, Hugo; Howard, Brian; Alawieh, Ali; Romano, Daniele; Tanweer, Omar; Mascitelli, Justin; Fragata, Isabel; Polifka, Adam; Osbun, Joshua; Crosa, Roberto; Matouk, Charles; Park, Min; Brinjikji, Waleed; Moss, Mark; Williamson, Richard; Navia, Pedro; Kan, Peter; Leacy, Reade; Chowdhry, Shakeel; Ezzeldin, Mohamad; Spiotta, Alejandro; Levitt, Michael; Yoshimura, Shinichi; Stroke Thrombectomy and Aneurysm Registry (STAR) Collaborators; ElsevierBackground: The outcomes of endovascular thrombectomy (EVT) for medium vessel occlusions (MeVOs) of specific vascular territories remain unknown. We aimed to investigate EVT outcomes by MeVO locations using the data from an ongoing international multicenter registry. Methods: Patients with isolated MeVO who underwent EVT between January 2013 and December 2022 were retrospectively analyzed. Isolated MeVO was defined as an occlusion of the A2 or A3 (A2/A3), M2 or M3, and P2 or P3 (P2/P3). Outcomes included a 90-day modified Rankin score (mRS) of 0-2, successful recanalization (modified Thrombolysis in Cerebral Infarction score ≥ 2b), early neurological deterioration (END) or improvement (ENI), and 90-day mortality. END was defined as a worsening of ≥4 points from the baseline National Institutes of Health Stroke Scale (NIHSS) score within 24 h of EVT, while ENI was defined as an improvement of ≥4 points from the baseline NIHSS score within 24 h of EVT. Results: 1744 MeVOs included. Compared to M2 occlusions (n = 1542, 88.4%), A2/A3 (n = 36, 2.1%) occlusions had lower odds of 90-day mRS 0-2 (adjusted odds ratio [aOR] 0.30, 95% confidence interval [CI] 0.11-0.80), and P2/P3 occlusions (n = 49, 2.8%) had lower odds of successful recanalization (aOR 0.19, 95% CI 0.07-0.50), and higher odds of END (aOR 3.53, 95% CI 1.35-9.25). Other outcomes showed no significant differences. Conclusions: A2/A3 occlusions were more likely to have worse outcomes compared to M2 occlusions after EVT for patients with isolated MeVOs.