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Qureshi AI, Saeed O, Sahito S, Lobanova I, Liaqat J, Siddiq F, Gomez CR. Treatment Outcomes of Endovascular Embolization Only in Patients with Unruptured Brain Arteriovenous Malformations: A Subgroup Analysis of ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations). AJNR Am J Neuroradiol 2020; 41:676-680. [PMID: 32115419 DOI: 10.3174/ajnr.a6443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 01/20/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE Endovascular embolization only has been advocated for treatment of brain arteriovenous malformations in recent trials. Our aim was to evaluate the results of embolization only in a cohort of patients who were enrolled in the A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA) study at 39 clinical sites in 9 countries. MATERIALS AND METHODS We analyzed the rates and severity of stroke and death in patients who underwent embolization only. Events were identified through in-person neurologic follow-up visits performed at 6-month intervals during the first 2 years and annually, with telephone contact every 6 months thereafter. All event-related data were reviewed by independent adjudicators. RESULTS Among 30 patients who had embolization planned, 26 underwent embolization only. A total of 13 stroke events were reported in the follow-up period among 26 subjects (ischemic, hemorrhagic, or both in 4, 7, and 2 subjects, respectively). The adverse event occurred after the first embolization in 11 of 13 patients. One patient had a major motor deficit, and 2 patients developed major visual field deficits. One event was fatal. The modified Rankin Scale score was 0-2 at last follow-up in 11 of the 12 stroke survivors. Estimated stroke-free survival was 46% at 12 months. CONCLUSIONS Although the rates of stroke and/or death were high in patients treated with embolization only in ARUBA, the rates of favorable outcomes following stroke were high during follow-up.
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Affiliation(s)
- A I Qureshi
- From the Zeenat Qureshi Stroke Institute (A.I.Q., O.S., S.S., I.L., J.L.), St. Cloud, Minnesota .,Department of Neurology (A.I.Q., C.R.G.) and
| | - O Saeed
- From the Zeenat Qureshi Stroke Institute (A.I.Q., O.S., S.S., I.L., J.L.), St. Cloud, Minnesota.,Department of Neurology (O.S.), University of Tennessee Health Science Center, Memphis, Tennessee
| | - S Sahito
- From the Zeenat Qureshi Stroke Institute (A.I.Q., O.S., S.S., I.L., J.L.), St. Cloud, Minnesota.,Department of Neurology (S.S.), JFK Medical Center, Edison, New Jersey
| | - I Lobanova
- From the Zeenat Qureshi Stroke Institute (A.I.Q., O.S., S.S., I.L., J.L.), St. Cloud, Minnesota
| | - J Liaqat
- From the Zeenat Qureshi Stroke Institute (A.I.Q., O.S., S.S., I.L., J.L.), St. Cloud, Minnesota.,Pakistan Emirates Military Hospital (J.L.), Rawalpindi, Pakistan
| | - F Siddiq
- Division of Neurological Surgery (F.S.), University of Missouri, Colombia, Missouri
| | - C R Gomez
- Department of Neurology (A.I.Q., C.R.G.) and
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Norby K, Young M, Siddiq F. Use of stent retriever for treatment of iatrogenic intracranial vasospasm. Interv Neuroradiol 2019; 25:511-515. [PMID: 31088245 PMCID: PMC6777108 DOI: 10.1177/1591019919848771] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 04/03/2019] [Indexed: 12/22/2022] Open
Abstract
Cerebral vasospasm is a source of morbidity and mortality, not only associated with aneurysmal subarachnoid hemorrhage (SAH) but also with endovascular procedures. Treatment of vasospasm associated with SAH include trans-luminal balloon angioplasty and intra-arterial delivery of vasodilator medications. We present a case report of a patient who underwent a mechanical thrombectomy for stroke and suffered from vasospasm. This severe flow-limiting vasospasm was successfully treated with the Trevo stent device. Although stent retrievers have become more widespread for thrombectomy, vasospasm treatment has not been often described in the literature. Further study is needed to determine if this is a viable technique for treating resistant vasospasm.
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Affiliation(s)
- K Norby
- 5024 Preservation Ave, Colleyville,
USA
| | - M Young
- 5128 Chessie Circle, Haltom City,
USA
| | - F Siddiq
- University of Missouri, Columbia,
USA
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Siddiq F, Faisal M, Mahmood A, Muzaffar H, Hussain J, Aslam J. Mirco-RNA and Wnt signaling cascade up regulate CTNNB1 gene in colorectal carcinoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx679.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Jagadeesan B, Siddiq F, Grande A, Tummala R. E-077 Aneurysm coiling with balloon remodelling of the neck of the aneurysm using a single co-axial dual lumen balloon micro catheter : Initial Experience. J Neurointerv Surg 2013. [DOI: 10.1136/neurintsurg-2013-010870.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Tekle W, Jagadeesan B, Siddiq F, Khan A, Grande A, Tummala R. E-018 Embolisation of Intracranial Arteriovenous Malformations and Dural Arteriovenous Fistulae Using a Novel Low Profile Distal Access Microcatheter: Initial experience. J Neurointerv Surg 2013. [DOI: 10.1136/neurintsurg-2013-010870.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Siddiq F, Chaudhry S, Das P, Khatri R, Rodriguez G, Qureshi A. Occurrence and Prognostic Significance of Pseudodissection Phenomenon Associated with Acute Distal Internal Carotid Artery Occlusion (P07.011). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Siddiq F, Chaudhry S, Watanabe M, Khatri R, Rodriguez G, Tummala R, Suri M, Qureshi A. Rate of Post-Procedural Stroke and Death in SAMMPRIS Trial Eligible Patients Treated with Intracranial Angioplasty and/or Stent Placement in Practice (P06.208). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p06.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Tariq N, Hassan A, Siddiq F, Tekle W, Chaudhry S, Majidi S, Watanabe M, Suri M, Qureshi A. Endovascular Surgical Neuroradiology Simulator Is of Benefit in the Acquisition of Basic and Intermediate Skills by Novice Fellows (P05.262). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Chaudhry S, Siddiq F, Tummala R, Suri M, Qureshi A. Factors and Outcomes Associated with Early and Delayed Aneurysm Treatment in Subarachnoid Hemorrhage Patients in United States (P04.071). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Siddiq F, Tomita M, Santoro TJ. 59 ENHANCED 5-LIPOXYGENASE ACTIVITY IN THE HIPPOCAMPUS IN SYSTEMIC LUPUS ERYTHEMATOSUS. J Investig Med 2004. [DOI: 10.1136/jim-52-suppl2-59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
We studied periventricular/intraventricular type intracranial hemorrhage (ICH) by cranial ultrasonography in 82 low-birth-weight (LBW) newborn infants with admission hypothermia against the gestational-age-matched 82 normothermic neonates. The incidence of ICH was higher in the hypothermic infants during the 1st week of life (34/82 vs 20/82, P less than 0.02). Although the distribution of individual grades of ICH was not significantly different between the groups, the first ultrasound scan showed higher incidence of major ICH (grades 3 and 4) in the hypothermic infants. Most of the minor ICH (grades 1 and 2) after the first ultrasound appeared in infants who were small for their gestational age. Our data do not support the contention that admission hypothermia can precipitate the development of IVH in LBW infants. However, the detection of admission hypothermia in a LBW neonate should make one suspect the possibility of ICH and regard it as a manifestation of the severity of ICH rather than the cause. Most likely, this close relationship between hypothermia and neonatal ICH originates from perinatal asphyxia and the cumulative adverse effects of asphyxia-related events.
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Affiliation(s)
- M Y Dincsoy
- Department of Pediatrics, Nassau County Medical Center, East Meadow, NY
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Dincsoy MY, Kim YM, Siddiq F, Garcia MG, Williams H. Intracranial hemorrhage in small-for-gestational-age neonates: comparison with weight-matched appropriate-for-gestational-age infants. Clin Pediatr (Phila) 1988; 27:21-6. [PMID: 3275519 DOI: 10.1177/000992288802700104] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
In a comparative study of 93 small-for-gestational-age (SGA) infants against 93 weight-matched, appropriate-for-gestational-age (AGA) neonates, the SGA group exhibited a significantly lower incidence of periventricular-intraventricular type intracranial hemorrhage (ICH) at the first ultrasound scan than did the AGA neonates (9/93 vs 21/93; p less than 0.02). This apparent advantage was no longer maintained in later scans of the first week (16/93 vs 27/93; NS), despite the fact that the SGA group were 4 weeks advanced in gestational age and had fewer respiratory problems than the AGA controls. It is prudent, therefore, to follow SGA infants closely for ICH by repeat ultrasound examinations even if the first scan is negative. Evaluation of the subgroup of SGA infants with ICH against the total SGA population revealed lower admission body temperature and Apgar scores, and higher incidence of asphyxia, resuscitation, and mortality. The above observations in SGA infants with ICH and the lack of a similar trend between the AGA infants with ICH and the total AGA population suggest that SGA status, hypothermia, and ICH are interrelated. Hypothermia, therefore, can be used as a convenient marker for the possibility of ICH in low birth weight SGA infants. The authors' data is consistent with the view that hypothermia and ICH are both the consequences of perinatal asphyxia in SGA infants and probably reflect the magnitude of stormy perinatal events.
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Affiliation(s)
- M Y Dincsoy
- Department of Pediatrics, Nassau County Medical Center, East Meadow, New York
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Polowczyk D, Tejani N, Lauersen N, Siddiq F. Evaluation of seven- to nine-year-old children exposed to ritodrine in utero. Obstet Gynecol 1984; 64:485-8. [PMID: 6483295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Twenty children who had been exposed to ritodrine in the management of preterm labor between 24 and 34 weeks' gestational age were examined at seven to nine years of life and compared with matched control subjects. No significant differences were detected in factors of growth, neurologic findings, and psychometric testing.
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