Nima Kashani
A5063907171- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Venous Thromboembolism Diagnosis and Management
- Stroke Rehabilitation and Recovery
- Traumatic Brain Injury and Neurovascular Disturbances
- Peripheral Artery Disease Management
- Health Systems, Economic Evaluations, Quality of Life
- Intracranial Aneurysms: Treatment and Complications
- Cardiac Imaging and Diagnostics
- Healthcare Systems and Practices
- Intracerebral and Subarachnoid Hemorrhage Research
- Advanced X-ray and CT Imaging
- Vascular Malformations Diagnosis and Treatment
- Artificial Intelligence in Healthcare and Education
- Anatomy and Medical Technology
- Vagus Nerve Stimulation Research
- Cardiac, Anesthesia and Surgical Outcomes
- Medical and Biological Sciences
- Surgical Simulation and Training
- Advanced MRI Techniques and Applications
- Intravenous Infusion Technology and Safety
- Climate Change and Health Impacts
- COVID-19 and healthcare impacts
- Long-Term Effects of COVID-19
- Acute Kidney Injury Research
University of Manitoba
2024
University of Calgary
2018-2024
Kelowna General Hospital
2024
University of British Columbia
2024
Royal University Hospital
2022-2024
University of Saskatchewan
2022-2024
United Nations Economic and Social Commission for Asia and the Pacific
2021-2024
Children's National
2024
Saskatoon City Hospital
2024
Foothills Medical Centre
2020-2023
Available data on the clinical course of patients with acute ischemic stroke due to medium vessel occlusion (MeVO) are mostly limited those M2 segment occlusions. Outcomes generally better compared more proximal occlusions, but many will still suffer from severe morbidity. We aimed determine MeVO and without intravenous alteplase treatment.Patients (M2/M3/A2/A3/P2/P3 occlusion) INTERRSeCT (The Identifying New Approaches Optimize Thrombus Characterization for Predicting Early Recanalization...
Importance Age is a leading predictor of poor outcomes after brain injuries like stroke. The extent to which age associated with preexisting burdens changes, visible on neuroimaging but rarely considered in acute decision-making or trials, unknown. Objectives To explore the mediation functional outcome by markers frailty (hereinafter frailty) patients ischemic stroke receiving endovascular thrombectomy (EVT). Design, Setting, and Participants This cohort study was post hoc analysis Safety...
<h3>BACKGROUND AND PURPOSE:</h3> Endovascular therapy in acute ischemic stroke is rapidly evolving. We explored physicians' treatment attitudes and practice patients with due to M2 occlusion, given the absence of Level-1 guidelines. <h3>MATERIALS METHODS:</h3> conducted an international multidisciplinary survey among physicians involved care. Respondents were presented 10 22 case scenarios (4 proximal occlusions 1 a small-branch occlusion) asked about their approach under A) current local...
Background and Purpose— Little is known about the real-life factors that clinicians use in selection of patients would receive endovascular treatment (EVT) real world. We sought to determine patient, practitioner, health system associated with therapeutic decisions around treatment. Methods— conducted a multinational cross-sectional web-based study comprising 607 interventionalists from 38 countries who are directly involved acute stroke care. Participants were randomly allocated 10 pool 22...
Background The effect of infarct pattern on functional outcome in acute ischemic stroke is incompletely understood. Purpose To investigate the association qualitative and quantitative variables at 24-hour follow-up noncontrast CT diffusion-weighted MRI with 90-day clinical outcome. Materials Methods Safety Efficacy Nerinetide Subjects Undergoing Endovascular Thrombectomy for Stroke, or ESCAPE-NA1, randomized controlled trial enrolled patients large-vessel-occlusion undergoing mechanical...
Baseline CTP sometimes overestimates the size of infarct core ("ghost core" phenomenon). We investigated how often compared with 24-hour imaging, and aimed to characterize patient subgroup in whom a ghost is most likely occur. Data are from randomized controlled ESCAPE-NA1 trial, which patients acute ischemic stroke undergoing endovascular treatment were intravenous nerinetide or placebo. Patients available baseline follow-up imaging included analysis. Ghost was defined as volume minus > 10...
<h3>Importance</h3> Some patients have poor outcomes despite small infarcts after endovascular therapy (EVT), while others with large do well. Understanding why these discrepancies occur may help to optimize EVT outcomes. <h3>Objective</h3> To validate exploratory findings from the Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion Emphasis on Minimizing CT Recanalization Times (ESCAPE) trial regarding pretreatment, treatment-related, posttreatment factors...
Some patients with ischemic stroke have poor outcomes despite small infarcts after endovascular thrombectomy, while others large sometimes fare better.We explored factors associated such discrepancies between post-treatment infarct volume (PIV) and functional outcome.We identified PIV (volume ≤ 25th percentile) ≥ 75th on 24-48-h CT/MRI in the ESCAPE randomized-controlled trial. Demographics, comorbidities, baseline, severity (NIHSS), location, treatment type, post-stroke complications, other...
<h3>BACKGROUND AND PURPOSE:</h3> Accurate and reliable detection of medium-vessel occlusions is important to establish the diagnosis acute ischemic stroke initiate appropriate treatment with intravenous thrombolysis or endovascular thrombectomy. However, are often challenging detect, especially for unexperienced readers. We aimed evaluate accuracy interrater agreement using single-phase multiphase CTA. <h3>MATERIALS METHODS:</h3> Single-phase CTA 120 patients (20 no occlusion, 44...
Background: Infarct in a new territory (INT) is known complication of endovascular stroke therapy. We assessed the incidence INT, outcomes after and impact concurrent treatments with intravenous thrombolysis nerinetide. Methods: Data are from ESCAPE-NA1 trial (Safety Efficacy Nerinetide [NA-1] Subjects Undergoing Endovascular Thrombectomy for Stroke), multicenter, international randomized study that efficacy nerinetide subjects acute ischemic who underwent thrombectomy within 12 hours onset....
Although reperfusion is associated with improved outcomes in patients acute ischemic stroke undergoing endovascular treatment, many still do poorly. We investigated whether CTP modifies the effect of near-complete on clinical outcomes, ie, poor despite can be partly or fully explained by findings. Data are from Safety and Efficacy Nerinetide Subjects Undergoing Endovascular Thrombectomy for Stroke (ESCAPE-NA1) trial. Admission was processed using RAPID software, generating relative CBF CBV...
Patient age and baseline Alberta Stroke Program Early CT score (ASPECTS) are both independent predictors of outcome in acute ischemic stroke patients treated with endovascular therapy (EVT). We assessed the combined effect ASEPCTS on clinical LVO without EVT, EVT treatment different age/ASPECTS subgroups.The HERMES collaboration pooled data seven randomized controlled trials that tested efficacy EVT. Adjusted logistic regression was performed to test for multiplicative interaction ASPECTS...
Background Nerinetide treatment was associated with better clinical outcomes among patients stroke undergoing endovascular who were not treated concurrent alteplase in the randomized ESCAPE‐NA1 (Efficacy and Safety of for Treatment Acute Ischemic Stroke) trial. In receiving alteplase, no such effect seen due to an inactivation nerinetide by plasmin – product tissue plasminogen activation. We hypothesized that improved no‐alteplase reduced infarct growth, a radiological correlate outcomes....
Hemorrhagic transformation can occur as a complication of endovascular treatment for acute ischemic stroke. This study aimed to determine whether ischemia depth measured by admission CTP metrics predict the development hemorrhagic at 24 hours. Patients with baseline and 24-hour follow-up imaging from ESCAPE-NA1 trial were included. RAPID software was used generate volume maps relative CBF, CBV, time-to-maximum different thresholds. Hemorrhage on classified according Heidelberg system,...
We aimed to explore the preference of stroke physicians treat patients with primary medium vessel occlusion (MeVO) immediate endovascular treatment (EVT) in an international cross-sectional survey, as there is no clear guideline recommendation for EVT these patients.In survey MeVO-Finding Rationales and Objectifying New Targets IntervEntional Revascularization Stroke (MeVO-FRONTIERS), participants were shown four cases MeVOs (six scenarios per case) asked whether they would those EVT....
Background The optimal treatment and prognosis for stroke patients with tandem cervical carotid occlusion are unclear. We analyzed outcomes strategies of in the ESCAPE-NA1 trial. Methods was a multicenter international randomized trial nerinetide versus placebo 1105 acute ischemic who underwent endovascular treatment. defined occlusions as complete internal artery (ICA) on catheter angiography, addition to proximal ipsilateral intracranial large vessel occlusion. Baseline characteristics...
Background The benefit of endovascular treatment (EVT) is highly time-dependent, and delays reduce patients’ chances to achieve a good outcome. In this survey-based study, we aimed evaluate current in-hospital EVT workflow characteristics across different countries hospital settings, quantify the time-savings that could be achieved by optimizing particular steps. Methods multinational survey, neurointerventionalists were asked provide specific information about workflows in their working...
Although a decrease in stroke admissions during the SARS-CoV-2 pandemic has been observed, detailed analyses of evolution metrics are lacking. We analyzed changes presentation, in-hospital systems-of-care, and treatment time at two representative Comprehensive Stroke Centers (CSCs) first year Coronavirus disease 2019 pandemic. From January 2018 to May 2021, data from presentations CSCs were obtained. The study duration was split into: period 0 (prepandemic), 1 (Wave 1), 2 (Lull), 3 2). Acute...