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142 results on '"Mawad, Michel E."'

1. Intracranial Dural Arteriovenous Fistulas

Author

Abdalkader, Mohamad, additional, Nguyen, Thanh N., additional, Diana, Francesco, additional, Yaghi, Shadi, additional, Shu, Liqi, additional, Klein, Piers, additional, Mawad, Michel E., additional, and Kikano, Raghid, additional

Published
2023
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10. Quantitative imaging of lymph function

Author

Sharma, Ruchi, Wang, Wei, Rasmussen, John C., Joshi, Amit, Houston, Jessica P., Adams, Kristen E., Cameron, Arlin, Ke, Shi, Kwon, Sunkuk, Mawad, Michel E., and Sevick-Muraca, Eva M.

Subjects
Lymphatics -- Physiological aspects, Hyaluronic acid -- Properties, Lymphedema -- Diagnosis, Infrared imaging -- Usage, Biological sciences
Abstract

Functional lymphatic imaging was demonstrated in the abdomen and anterior hind-limb of anesthetized, intact Yorkshire swine by using near-infrared (NIR) fluorescence imaging following intradermal administration of 100-200 [micro]l of 32 [micro]M indocyanine green (ICG) and 64 [micro]M hyaluronan NIR imaging conjugate to target the lymph vacular endothelial receptor (LYVE)-1 on the lymph endothelium. NIR fluorescence imaging employed illumination of 780 nm excitation light (~2 mW/ [cm.sup.2]) and collection of 830 nm fluorescence generated from the imaging agents. Our results show the ability to image the immediate trafficking of ICG from the plexus, through the vessels and lymphangions, and to the superficial mammary, subiliac, and middle iliac lymph nodes, which were located as deep as 3 cm beneath the tissue surface. 'Packets' of ICG-transited lymph vessels of 2-16 cm length propelled at frequencies of 0.5-3.3 pulses/min and velocities of 0.23-0.75 cm/s. Lymph propulsion was independent of respiration rate. In the case of the hyaluronan imaging agent, lymph propulsion was absent as the dye progressed immediately through the plexus and stained the lymph vessels and nodes. Lymph imaging required 5.0 and 11.9 [micro]g of ICG and hyaluronan conjugate, respectively. Our results suggest that microgram quantities of NIR optical imaging agents and their conjugates have a potential to image lymph function in patients suffering from lymph-related disorders. optical imaging; indocyanine green; hyaluronan; lymphedema doi: 10.1152/ajpheart.01223.2006

Published
2007

14. Growth rate and rupture rate of unruptured intracranial aneurysms: a population approach

Author

Mawad Michel E and Jou Liang-Der

Subjects
Medical technology, R855-855.5
Abstract

Abstract Background Understanding aneurysm growth rate allows us to predict not only the current rupture risk, but also accumulated rupture risk in the future. However, determining growth rate of unruptured intracranial aneurysms often requires follow-up of patients for a long period of time so that significant growth can be observed and measured. We investigate a relationship between growth rate and rupture rate and develop a theoretical model that can predict average behavior of unruptured intracranial aneurysms based on existing clinical data. Methods A mathematical model is developed that links growth rate and rupture rate. This model assumes a stable aneurysm size distribution so the number of aneurysm ruptures is balanced by the growth of aneurysms. Annual growth rates and growth profiles are calculated from a hypothetical size distribution and data from a previous clinical study. Results Our model predicts a growth rate of 0.34–1.63 mm/yr for three different growth models when the rupture rate at 10 mm is 1%. The growth rate is 0.56–0.65 mm/yr if annual rupture rate averaged over all aneurysm sizes is assumed to be 2%. The peak of aneurysm size distribution coincides with a period of slow growth between 5 mm and 8 mm. Conclusion This mathematical model can be used to predict aneurysm growth rate, and the results are consistent with previous clinical studies. Predictions from both hypothetical and clinical cases agree very well. This model explains why some aneurysms may grow into a stable size and remain so without rupture.

Published
2009
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19. Stent-Assisted Coiling of Intracranial Aneurysms Aided by Virtual Parent Artery Reconstruction

Author

Karmonik, Christof, Strother, Charles M., Chen, Xiaoyan, Deinzer, Frank, Klucznik, Richard, and Mawad, Michel E.

Subjects
Imaging, Three-Dimensional, Interventional, Image Processing, Computer-Assisted, Angiography, Digital Subtraction, Humans, Intracranial Aneurysm, Stents, cardiovascular diseases, equipment and supplies, Radiography, Interventional, Embolization, Therapeutic, Cerebral Angiography
Abstract

Summary: The availability of stents designed specifically for use in the intracranial vasculature has increased the use of stent-assisted coiling for treatment of wide-necked and complex intracranial aneurysms. We present a technique for pretreatment planning and visualization of a virtual stent within the parent artery by using a virtual reconstruction of the parent artery across the aneurysm neck. As illustrated by 2 clinical examples, this method provides information not otherwise available regarding the location of portions of the stent that are not visible on fluoroscopy. During treatment, this information enhances the ability to determine the location of coils in relation to the stent boundaries and should thereby improve the ability to avoid parent artery compromise.

Published
2005

20. Aneurysms of the Posterior Cerebral Artery: Classification and Endovascular Treatment

Author

Ciceri, Elisa F., Klucznik, Richard P., Grossman, Robert G., Rose, James E., and Mawad, Michel E.

Subjects
Adult, Male, Interventional, Intracranial Aneurysm, Middle Aged, Embolization, Therapeutic, Magnetic Resonance Imaging, Cerebral Angiography, cardiovascular system, Humans, Female, cardiovascular diseases, Mortality, Aged, Follow-Up Studies, Retrospective Studies
Abstract

BACKGROUND AND PURPOSE: We present a retrospective review of our experience in the endovascular treatment of posterior cerebral artery (PCA) aneurysms. We detail the anatomic location of these aneurysms, the technique of endovascular treatment, morphologic results, and clinical outcome. We also discuss the segmental anatomy of the PCA as it relates to the various neurologic deficits that may result from occlusion of the parent artery. METHODS: From 1993 to 1998, 20 patients (12 female, eight male; mean age, 44 yrs) harboring a PCA aneurysm were treated via an endovascular approach. One patient had two aneurysms, comprising a total of 21 lesions. Fourteen (66%) of 21 aneurysms were saccular in nature, five (24%) were giant serpentine aneurysms, and two (10%) were posttraumatic. All aneurysms were treated using Guglielmi detachable coils (GDC) either by selective obliteration of the aneurysm sac or by parent artery occlusion. RESULTS: Fourteen (66%) of the 21 aneurysms were successfully treated with preservation of the parent artery. In the remaining seven (33%), the parent artery was permanently occluded. The overall complication rate in this series was 15%, with a permanent morbidity rate of 10% and a 0% mortality rate. CONCLUSION: Aneurysms of the PCA are rare compared with other locations in the intracranial circulation. Saccular PCA aneurysms can be treated effectively, by use of GDC, to obliterate the aneurysm yet preserve the parent artery. Fusiform and giant serpentine aneurysms of the PCA can effectively be treated by permanent occlusion of the parent artery; in these cases, thorough knowledge of the PCA segmental anatomy is crucial in order to select the site of occlusion and to avoid major neurologic deficits.

Published
2001

21. Metal coverage ratio of pipeline embolization device for treatment of unruptured aneurysms: Reality check.

Author

Jou, Liang-Der, Chintalapani, Gouthami, and Mawad, Michel E.

Subjects
THERAPEUTIC embolization, ANEURYSMS, VASCULAR diseases, PLATO'S cave (Allegory), PLATO'S line (Allegory)
Abstract

Background and purpose The metal coverage ratio (MCR) of a flow diverter influences the intra-aneurysmal hemodynamics; a high MCR will occlude an aneurysm early, while a low MCR may delay aneurysm occlusion. The true MCR of a pipeline embolization device (PED) could be lower due to oversize, device deformation, or aneurysm location. In this study deviation of the true MCR from the nominal MCR is assessed and whether their difference affects aneurysm occlusion rate is determined. Methods A total of 40 consecutive patients, each of them treated by one PED for their aneurysms at the internal carotid artery (ICA), were retrospectively analyzed. The DynaCT images of these deployed PEDs were used to determine their true dimensions and estimate three MCRs (local, mean, and nominal). These data were compared in two groups of patients who had different aneurysm outcomes at six months. Results The difference in the local MCR between two groups is small, but statistically significant (24.5% vs 21.6%, p = 05). The local MCR is consistently lower than the nominal MCRs (23.2% vs 30.2%, p < 0.001); however, the difference between the mean and local MCRs is small (23.9% vs 23.2%). Conclusions An expectation that a PED can achieve a MCR of 30% may not be reasonable. Device oversize and deformation during deployment lower the local MCR by 5–7%. A lowered MCR affects the aneurysm occlusion rate at six months. [ABSTRACT FROM AUTHOR]

Published
2016
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39. Imaging of Lymph Flow in Breast Cancer Patients after Microdose Administration of a Near-Infrared Fluorophore: Feasibility Study

Author

Sevick-Muraca, Eva M., primary, Sharma, Ruchi, additional, Rasmussen, John C., additional, Marshall, Milton V., additional, Wendt, Juliet A., additional, Pham, Hoang Q., additional, Bonefas, Elizabeth, additional, Houston, Jessica P., additional, Sampath, Lakshmi, additional, Adams, Kristen E., additional, Blanchard, Darlene Kay, additional, Fisher, Ronald E., additional, Chiang, Stephen B., additional, Elledge, Richard, additional, and Mawad, Michel E., additional

Published
2008
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