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201. Total 1-year hospital cost of middle meningeal artery embolization compared to surgery for chronic subdural hematomas: a propensity-adjusted analysis

Author

Catapano, Joshua S, primary, Koester, Stefan W, additional, Srinivasan, Visish M, additional, Rumalla, Kavelin, additional, Baranoski, Jacob F, additional, Rutledge, Caleb, additional, Cole, Tyler S, additional, Winkler, Ethan A, additional, Lawton, Michael T, additional, Jadhav, Ashutosh P, additional, Ducruet, Andrew F, additional, and Albuquerque, Felipe C, additional

Published
2021
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205. Effects of Preoperative Embolization on Spetzler–Martin Grade I and II Arteriovenous Malformations: A Propensity-Adjusted Analysis

Author

Catapano, Joshua S., primary, Srinivasan, Visish M., additional, Rumalla, Kavelin, additional, Koester, Stefan W., additional, Kimata, Anna R., additional, Ma, Kevin L., additional, Labib, Mohamed A., additional, Baranoski, Jacob F., additional, Cole, Tyler S., additional, Rutledge, Caleb, additional, Ducruet, Andrew F., additional, Albuquerque, Felipe C., additional, Spetzler, Robert F., additional, and Lawton, Michael T., additional

Published
2021
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207. Intraventricular Tissue Plasminogen Activator and Shunt Dependency in Aneurysmal Subarachnoid Hemorrhage Patients With Cast Ventricles

Author

Catapano, Joshua S, primary, Rumalla, Kavelin, additional, Karahalios, Katherine, additional, Srinivasan, Visish M, additional, Labib, Mohamed A, additional, Cole, Tyler S, additional, Baranoski, Jacob F, additional, Rutledge, Caleb, additional, Rahmani, Redi, additional, Jadhav, Ashutosh P, additional, Ducruet, Andrew F, additional, Albuquerque, Felipe C, additional, Zabramski, Joseph M, additional, and Lawton, Michael T, additional

Published
2021
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208. Emerging therapeutic targets for cerebral edema

Author

Jha, Ruchira M., primary, Raikwar, Sudhanshu P., additional, Mihaljevic, Sandra, additional, Casabella, Amanda M., additional, Catapano, Joshua S., additional, Rani, Anupama, additional, Desai, Shashvat, additional, Gerzanich, Volodymyr, additional, and Simard, J. Marc, additional

Published
2021
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216. An evaluation of the SAFIRE grading scale as a predictor of long-term outcomes for patients in the Barrow Ruptured Aneurysm Trial

Author

Catapano, Joshua S., primary, Labib, Mohamed A., additional, Frisoli, Fabio A., additional, Cadigan, Megan S., additional, Baranoski, Jacob F., additional, Cole, Tyler S., additional, Zhou, James J., additional, Nguyen, Candice L., additional, Whiting, Alexander C., additional, Ducruet, Andrew F., additional, Albuquerque, Felipe C., additional, and Lawton, Michael T., additional

Published
2021
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217. A propensity-adjusted comparison of middle meningeal artery embolization versus conventional therapy for chronic subdural hematomas

Author

Catapano, Joshua S., primary, Ducruet, Andrew F., additional, Nguyen, Candice L., additional, Cole, Tyler S., additional, Baranoski, Jacob F., additional, Majmundar, Neil, additional, Wilkinson, D. Andrew, additional, Fredrickson, Vance L., additional, Cavalcanti, Daniel D., additional, Lawton, Michael T., additional, and Albuquerque, Felipe C., additional

Published
2021
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218. Adoption of advanced microneurosurgical technologies: an international survey

Author

Srinivasan, Visish M., primary, Shlobin, Nathan A., additional, Karahalios, Katherine, additional, Scherschinski, Lea, additional, Rahmani, Redi, additional, Graffeo, Christopher Salvatore, additional, Burkhardt, Jan-Karl, additional, Chaurasia, Bipin, additional, Catapano, Joshua S., additional, Labib, Mohamed A., additional, and Lawton, Michael T., additional

Published
2021
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220. Radiographic clearance of chronic subdural hematomas after middle meningeal artery embolization.

Author

Catapano, Joshua S., Ducruet, Andrew F., Srinivasan, Visish M., Rumalla, Kavelin, Nguyen, Candice L., Rutledge, Caleb, Cole, Tyler S., Baranoski, Jacob F., Lawton, Michael T., Jadhav, Ashutosh P., and Albuquerque, Felipe C.

Subjects
CHRONIC disease treatment, STATISTICS, CONFIDENCE intervals, CHRONIC diseases, MULTIPLE regression analysis, MULTIVARIATE analysis, THERAPEUTIC embolization, REGRESSION analysis, NIH Stroke Scale, MENINGEAL artery, TREATMENT effectiveness, SEVERITY of illness index, SUBDURAL hematoma, DESCRIPTIVE statistics, CHI-squared test, ODDS ratio, DATA analysis software
Abstract

Background Few reports discuss variables associated with improved outcomes after middle meningeal artery (MMA) embolization for chronic subdural hematomas (cSDHs). We analyzed radiographic evidence of cSDH clearance after MMA embolization to elucidate optimal techniques, hematoma clearance rates, and suitable length of follow-up. Methods Patients who underwent MMA embolization for cSDH from January 1, 2018 through December 31, 2020 were analyzed. Patient characteristics, demographics, and technical procedural details were examined. Outcomes for cSDHs analyzed included complete or near-complete resolution at 30, 90, and 180 days following embolization. A multivariable logistic regression analysis identified variables predictive of rapid clearance and resolution of hematomas at 90 days. Results The study cohort comprised 66 patients with 84 treated cSDHs. The mean (SD) cSDH size differed significantly at 30-day (8.8 (4.3) mm), 90-day (3.4 (3.0) mm), and 180-day (1.0 (1.7) mm) follow-up (p<0.001). More cSDHs had complete or near-complete resolution at 180 days (92%, 67/73) than at 90 (63%, 45/72) and 30 days (18%, 15/84) post-embolization (p<0.001). Only distal embolysate penetration was independently associated with rapid clearance (OR 3.9, 95% CI 1.4 to 11.1; p=0.01) and resolution of cSDHs at 90 days (OR 5.0, 95% CI 1.7 to 14.6; p=0.003). Conclusion Although 63% of cSDHs with MMA embolization had complete or near-complete resolution by 90 days post-procedure, 92% reached this stage by 180 days. Therefore, 90-day follow-up may be insufficient to determine the effectiveness of MMA embolization for cSDHs, particularly compared with surgical evacuation alone. Also, distal MMA penetration may be associated with more rapid hematoma clearance. [ABSTRACT FROM AUTHOR]

Published
2022
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221. Endovascular treatment of ruptured anterior communicating aneurysms: a 17-year institutional experience with coil embolization.

Author

Catapano, Joshua S., Karahalios, Katherine, Rumalla, Kavelin, Srinivasan, Visish M., Rutledge, Caleb, Baranoski, Jacob F., Cole, Tyler S., Jadhav, Ashutosh P., Ducruet, Andrew F., and Albuquerque, Felipe C.

Subjects
ANEURYSM surgery, THERAPEUTIC embolization, RETROSPECTIVE studies, TREATMENT effectiveness, DESCRIPTIVE statistics, REOPERATION, ENDOVASCULAR surgery
Abstract

Background Ruptured anterior communicating artery (ACoA) aneurysms can be challenging to treat via an endovascular procedure. This study analyzed retreatment rates and neurological outcomes associated with ruptured ACoA aneurysms treated via endovascular coiling. Methods All patients with a ruptured ACoA aneurysm treated with endovascular coiling from 2003 to 2019 were retrospectively analyzed at a single center. Two comparisons were performed: no retreatment versus retreatment and coil embolization versus balloon-assisted coil embolization. Outcomes included retreatment and neurological outcome assessed via modified Rankin Scale (mRS). Results During the study period, 186 patients with ruptured ACoA aneurysms underwent coil embolization. Treatment included standard coil embolization (68.3%, n=127), balloon-assisted coiling (28.5%, n=53), and stent-assisted embolization (2.7%, n=5). Angiographic outcomes were as follows: class I, 65.1% (n=121); class II, 28.5% (n=53); and class III, 6.5% (n=12). There were no aneurysm reruptures after the index procedure. The mean (SD) mRS score was 2.7 (2.0) at last follow-up (mortality, 19 (10%)). Retreatment occurred in 9.7% (n=18). Patients with retreatment were younger with lower-grade subarachnoid hemorrhage and more favorable functional status at discharge. Patients with aneurysms >7 mm (n=36) were significantly more likely to have recurrence (22.2% vs 6.7%, P=0.005). Conclusions Endovascular treatment of ruptured ACoA aneurysms is safe and is associated with low mortality and retreatment rates. Younger patients with favorable functional status and larger aneurysm size are more likely to be retreated. Ruptured aneurysms <4 mm, although prevalent in the study (29%), never required retreatment. [ABSTRACT FROM AUTHOR]

Published
2022
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224. Delays in presentation and mortality among Black patients with mechanical thrombectomy after large-vessel stroke at a US hospital

Author

Catapano, Joshua S., primary, Rumalla, Kavelin, additional, Srinivasan, Visish M., additional, Nguyen, Candice L., additional, Farhadi, Dara S., additional, Ngo, Brandon, additional, Rutledge, Caleb, additional, Rahmani, Redi, additional, Baranoski, Jacob F., additional, Cole, Tyler S., additional, Jadhav, Ashutosh P., additional, Ducruet, Andrew F., additional, and Albuquerque, Felipe C., additional

Published
2021
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227. Assessing the volume–outcome relationship of carotid artery stenting in nationwide administrative data: a challenge of patient population bias

Author

Koester, Stefan W, Cole, Tyler S, Kimata, Anna R, Ma, Kevin L, Benner, Dimitri, Catapano, Joshua S, Rumalla, Kavelin, Lawton, Michael T, Ducruet, Andrew F, and Albuquerque, Felipe C

Abstract

BackgroundStudies have shown an association between surgical treatment volume and improved quality metrics. This study evaluated nationwide results in carotid artery stenting (CAS) procedural readmission rates, costs, and length of stay based on hospital treatment volume.MethodsWe used the Nationwide Readmissions Database for carotid stenosis from 2010 to 2015. Patients receiving CAS were matched based on demographics, illness severity, and relevant comorbidities. Patients were matched 1:1 between low- and high-volume centers using a non-parametric preprocessing matching program to adjust for parametric causal inferences. Nearest-neighbor propensity score matching was performed using logit distance.ResultsLow- and high-volume centers admitted a mean (SD) of 4.68 (3.79) and 25.10 (16.86) patients undergoing CAS per hospital, respectively. Comorbidities were significantly different and initially could not be adequately matched. Because of significant differences in baseline patient population characteristics after attempted matching between low- and high-volume centers, we used propensity adjustment with multivariate analysis. Using this alternative approach, no significant differences were observed between low- and high-volume centers for the presence of any complication, postoperative stroke, postoperative myocardial infarction, and readmission at 30 days.ConclusionIn 1:1 nearest-neighbor matching with a high number of patients, our analysis did not result in well-matched cohorts for the effect of case volume on outcomes. Comparing analytical techniques for various outcomes highlights that outcome disparities may not be related to quality differences based on hospital size, but rather variability in patient populations between low- and high-volume institutions.

Published
2023
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228. Relationship between cerebral vasospasm vascular territory and functional outcome after aneurysmal subarachnoid hemorrhage

Author

Cole, Tyler S, Rudy, Robert F, Faridmoayer, Erfan, Gandhi, Sirin, Cavallo, Claudio, Catapano, Joshua S, Jadhav, Ashutosh P, Lawton, Michael T, Albuquerque, Felipe C, and Ducruet, Andrew F

Abstract

BackgroundVasospasm following aneurysmal subarachnoid hemorrhage (SAH) contributes significant morbidity and mortality after brain aneurysm rupture. However, the association between vascular territory of vasospasm and clinical outcome has not been studied. We present a hypothesis-generating study to determine whether the location of vasospasm within the intracranial circulation is associated with functional outcome after SAH.MethodsA retrospective analysis of a prospective, intention-to-treat trial for aneurysmal SAH was performed to supplement trial outcomes with in-hospital angiographic imaging and treatment variables regarding vasospasm. The location of vasospasm and the position on the vessel (distal vs proximal) were evaluated. Modified Rankin scale (mRS) outcomes were assessed at discharge and 6 months, and predictive models were constructed.ResultsA total of 406 patients were included, 341 with follow-up data at 6 months. At discharge, left-sided vasospasm was associated with poor outcome (odds ratio (OR), 2.37; 95% CI, 1.25 to 4.66; P=0.01). At 6 months, anterior cerebral artery (ACA) vasospasm (OR, 3.87; 95% CI, 1.29 to 11.88; P=0.02) and basilar artery (BA) vasospasm (OR, 6.22; 95% CI, 1.54 to 27.11; P=0.01) were associated with poor outcome after adjustment. A model predicting 6-month mRS score and incorporating vasospasm variables achieved an area under the curve of 0.85 and a net improvement in reclassification of 13.2% (P<0.01) compared with a previously validated predictive model for aneurysmal SAH.ConclusionsIn aneurysmal SAH, left-sided vasospasm is associated with worse discharge functional status. At 6 months, both ACA and BA vasospasm are associated with unfavorable functional status.

Published
2023
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229. Direct puncture of the superior ophthalmic vein for carotid cavernous fistulas: a 21-year experience

Author

Catapano, Joshua S, Srinivasan, Visish M, De La Peña, Nicole M, Singh, Rohin, Cole, Tyler S, Wilkinson, D Andrew, Baranoski, Jacob F, Rutledge, Caleb, Pacult, Mark A, Winkler, Ethan A, Jadhav, Ashutosh P, Ducruet, Andrew F, and Albuquerque, Felipe C

Abstract

BackgroundDirect puncture of the superior ophthalmic vein (SOV) is an alternative approach to traversing the inferior petrosal sinus for embolization of carotid cavernous fistulas (CCFs).ObjectiveTo analyze direct SOV puncture for the treatment of CCFs and review the literature.MethodsAll patients at a single center, treated for a CCF with direct SOV cannulation between January 1, 2000, and December 31, 2020, were retrospectively analyzed. An additional review of the literature for all case series for direct puncture of the SOV for treatment of CCF was performed.ResultsDuring the 21-year study period, direct cannulation of the SOV for treatment of a CCF was attempted for 19 patients, with the procedure aborted for one patient because of an inability to navigate the wire into the distal aspect of the cavernous sinus. In 18 patients with direct SOV CCF treatment, 1 experienced a minor complication with an asymptomatic postoperative hemorrhage. Angiographic cure and improvement of symptoms were achieved in 17 patients with a mean (SD) follow-up of 6 (5.2) months. In the review of the literature, an additional 45 patients were reported to have direct cannulation of the SOV for CCF treatment, with angiographic cure in 43 (96%) and decreased objective visual acuity in 1 (2%).ConclusionDirect SOV cannulation to treat CCFs is safe and effective. Although it is typically used after other endovascular approaches have failed, SOV access for CCF treatment may be warranted as a first-line treatment for select patients.

Published
2023
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232. Omeprazole-clopidogrel interaction and neurovascular complications after flow-diverter device placement

Author

Catapano, Joshua S, primary, Srinivasan, Visish M, additional, Wakim, Andre A, additional, Lundberg, Jaclyn N, additional, Rutledge, Caleb, additional, Cole, Tyler S, additional, Baranoski, Jacob F, additional, Fredrickson, Vance L, additional, Rahmani, Redi, additional, Albuquerque, Felipe C, additional, and Ducruet, Andrew F, additional

Published
2021
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233. Length of hospital stay in aneurysmal subarachnoid hemorrhage patients without vasospasm on angiography: potential for a fast-track discharge cohort

Author

Catapano, Joshua S, primary, Srinivasan, Visish M, additional, Rumalla, Kavelin, additional, Labib, Mohamed A, additional, Nguyen, Candice L, additional, Cole, Tyler S, additional, Baranoski, Jacob F, additional, Rutledge, Caleb, additional, Rahmani, Redi, additional, Lawton, Michael T, additional, Ducruet, Andrew F, additional, and Albuquerque, Felipe C, additional

Published
2021
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237. Microsurgical treatment of ruptured aneurysms beyond 72 hours after rupture: implications for advanced management.

Author

Srinivasan, Visish M., Koester, Stefan W., Karahalios, Katherine, Nguyen, Candice L., Rumalla, Kavelin, Catapano, Joshua S., Rahmani, Redi, Labib, Mohamed A., Ducruet, Andrew F., Albuquerque, Felipe C., and Lawton, Michael T.

Subjects
RUPTURED aneurysms, INTRACRANIAL aneurysm ruptures, GLASGOW Coma Scale, SUBARACHNOID hemorrhage, TREATMENT delay (Medicine), CEREBRAL vasospasm, ACHILLES tendon rupture
Abstract

Background: Aneurysmal subarachnoid hemorrhage (aSAH) patients admitted to primary stroke centers are often transferred to neurosurgical and endovascular services at tertiary centers. The effect on microsurgical outcomes of the resultant delay in treatment is unknown. We evaluated microsurgical aSAH treatment > 72 h after the ictus. Methods: All aSAH patients treated at a single tertiary center between August 1, 2007, and July 31, 2019, were retrospectively reviewed. The additional inclusion criterion was the availability of treatment data relative to time of bleed. Patients were grouped based on bleed-to-treatment time as having acute treatment (on or before postbleed day [PBD] 3) or delayed treatment (on or after PBD 4). Propensity adjustments were used to correct for statistically significant confounding covariables. Results: Among 956 aSAH patients, 92 (10%) received delayed surgical treatment (delayed group), and 864 (90%) received acute endovascular or surgical treatment (acute group). Reruptures occurred in 3% (26/864) of the acute group and 1% (1/92) of the delayed group (p = 0.51). After propensity adjustments, the odds of residual aneurysm (OR = 0.09; 95% CI = 0.04–0.17; p < 0.001) or retreatment (OR = 0.14; 95% CI = 0.06–0.29; p < 0.001) was significantly lower among the delayed group. The OR was 0.50 for rerupture, after propensity adjustments, in the delayed setting (p = 0.03). Mean Glasgow Coma Scale scores at admission in the acute and delayed groups were 11.5 and 13.2, respectively (p < 0.001). Conclusions: Delayed microsurgical management of aSAH, if required for definitive treatment, appeared to be noninferior with respect to retreatment, residual, and rerupture events in our cohort after adjusting for initial disease severity and significant confounding variables. [ABSTRACT FROM AUTHOR]

Published
2022
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238. A two-stage combined anterolateral and endoscopic endonasal approach to the petroclival region: an anatomical study and clinical application.

Author

Labib, Mohamed A., Zhao, Xiaochun, Houlihan, Lena Mary, Abramov, Irakliy, Inoue, Mizuho, Martinez-Perez, Rafael, Catapano, Joshua S., Lawton, Michael T., Preul, Mark C., and Youssef, A. Samy

Subjects
BRAIN stem, CLINICAL medicine, CRANIAL nerves, STANDARD deviations, DACRYOCYSTORHINOSTOMY, CEREBRAL sulci
Abstract

Object: The pretemporal transcavernous anterior petrosal (PTAP) approach and the combined petrosal (CP) approach have been used to resect petroclival meningiomas (PCMs). In this cadaveric anatomical study, a two-stage combined PTAP and endoscopic endonasal far medial (EEFM) approach (the PTAPE approach) was compared morphometrically to the CP approach. A case study provides a clinical example of using the PTAPE approach to treat a patient with a PCM. The key elements of the approach selection process are outlined. Methods: Five cadaveric specimens underwent a CP approach and 5 underwent a PTAPE approach. The area of drilled clivus, length of multiple cranial nerves (CNs), and the area of brain stem exposure were measured, reported as means (standard deviations) by group, and compared. Results: The total area of the clivus drilled in the PTAPE group (695.3 [121.7] mm2) was greater than in the CP group (88.7 [17.06] mm2, P < 0.01). Longer segments of CN VI were exposed via the PTAPE than the CP approach (35.6 [9.07] vs. 16.3 [6.02] mm, P < 0.01). CN XII (8.8 [1.06] mm) was exposed only in the PTAPE group. Above the pontomedullary sulcus, the total area of brain stem exposed was greater with the PTAPE than the CP approach (1003.4 [219.5] mm2 vs. 437.6 [83.7] mm2, P < 0.01). Similarly, the total exposure of the medulla was greater after the PTAPE than the CP exposure (240.2 [57.06] mm2 vs. 48.1 [19.9] mm2, P < 0.01). Conclusion: A combined open-endoscopic paradigm is proposed for managing large PCMs. This approach incorporates the EEFM approach to address the limitations of the PTAP and the CP approach in a systematic fashion. Understanding the anatomical findings of this study will aid in tailoring surgical approaches to patients with these complex lesions. [ABSTRACT FROM AUTHOR]

Published
2022
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241. Endovascular treatment of vertebral artery dissecting aneurysms : a 20-year institutional experience

Author

Catapano, Joshua S, primary, Ducruet, Andrew F, additional, Cadigan, Megan S, additional, Farhadi, Dara S, additional, Majmundar, Neil, additional, Nguyen, Candice L, additional, Baranoski, Jacob F, additional, Cole, Tyler S, additional, Wilkinson, D Andrew, additional, Fredrickson, Vance L, additional, Srinivasan, Visish M, additional, and Albuquerque, Felipe C, additional

Published
2021
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242. Chronic headaches and middle meningeal artery embolization

Author

Catapano, Joshua S, primary, Karahalios, Katherine, additional, Srinivasan, Visish M, additional, Baranoski, Jacob F, additional, Rutledge, Caleb, additional, Cole, Tyler S, additional, Ducruet, Andrew F, additional, Albuquerque, Felipe C, additional, and Jadhav, Ashutosh P, additional

Published
2021
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248. Commentary

Author

Lin, Michelle, primary, Catapano, Joshua S, additional, and Fredrickson, Vance L, additional

Published
2021
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