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Afat, Saif,Brockmann, Carolin,Nikoubashman, Omid,Mü,ller, Marguerite,Thierfelder, Kolja M.,Brockmann, Marc A.,Nikolaou, Konstantin,Wiesmann, Martin,Kim, Jong Hyo,Othman, Ahmed E. Radiological Society of North America 2018 Radiology Vol.287 No.2
<P>Conclusion: The results suggest that radiation dose reduction to 40% of original dose levels (tube current-time product, 72 mAs) may be performed in VP CT imaging of patients with aneurysmal subarachnoid hemorrhage without compromising the diagnostic accuracy regarding detection of cerebral perfusion impairment indicating vasospasm. (C)RSNA, 2018</P>
The Aspirations of Direct Aspiration for Thrombectomy in Ischemic Stroke: A Critical Analysis
Tommy Andersson,Martin Wiesmann,Omid Nikoubashman,Anil Gopinathan,Pervinder Bhogal,Leonard L.L. Yeo 대한뇌졸중학회 2019 Journal of stroke Vol.21 No.1
The treatment of acute ischemic stroke by mechanical thrombectomy has been revolutionary, however most of the clinical trials were done with the use a stent retriever. At the same time, an alternative technique of thrombectomy through direct aspiration with a large bore distal access catheter at the face of the clot is rapidly gaining popularity. Nonetheless, the data supporting this new technique is not yet as mature as that available on stent retrievers. This review is a critical analysis of the evidence supporting the principle of direct aspiration thrombectomy and a discussion of its potential strengths and weaknesses in comparison to the available studies on stent retrievers. While this is by no means a conclusive review, it should serve as a yardstick of where the science is currently, and what are the next trials that are necessary.
Wolfgang G. Kunz,Peter B. Sporns,Marios N. Psychogios,Jens Fiehler,René Chapot,Franziska Dorn,Astrid Grams,Andrea Morotti,Patricia Musolino,Sarah Lee,André Kemmling,Hans Henkes,Omid Nikoubashman,Marti 대한뇌졸중학회 2022 Journal of stroke Vol.24 No.1
Background and Purpose The Save ChildS Study demonstrated that endovascular thrombectomy (EVT) is a safe treatment option for pediatric stroke patients with large vessel occlusions (LVOs) with high recanalization rates. Our aim was to determine the long-term cost, health consequences and cost-effectiveness of EVT in this patient population. Methods In this retrospective study, a decision-analytic Markov model estimated lifetime costs and quality-adjusted life years (QALYs). Early outcome parameters were based on the entire Save ChildS Study to model the EVT group. As no randomized data exist, the Save ChildS patient subgroup with unsuccessful recanalization was used to model the standard of care group. For modeling of lifetime estimates, pediatric and adult input parameters were obtained from the current literature. The analysis was conducted in a United States setting applying healthcare and societal perspectives. Probabilistic sensitivity analyses were performed. The willingness-to-pay threshold was set to $100,000 per QALY. Results The model results yielded EVT as the dominant (cost-effective as well as cost-saving) strategy for pediatric stroke patients. The incremental effectiveness for the average age of 11.3 years at first stroke in the Save ChildS Study was determined as an additional 4.02 lifetime QALYs, with lifetime cost-savings that amounted to $169,982 from a healthcare perspective and $254,110 when applying a societal perspective. Acceptability rates for EVT were 96.60% and 96.66% for the healthcare and societal perspectives. Conclusions EVT for pediatric stroke patients with LVOs resulted in added QALY and reduced lifetime costs. Based on the available data in the Save ChildS Study, EVT is very likely to be a cost-effective treatment strategy for childhood stroke.