Faculty - Dr. Syed Fazal Zaidi, M.D., FAHA, FSVIN
![Dr. Syed Fazal Zaidi Dr. Syed Fazal Zaidi](/med/depts/neurology/Images/syed-zaidi.jpg)
SPECIAL INTERESTS
Acute Stroke Diagnosis & Management
Brain Aneurysm
Cerebral & Spine Vascular Malformation
Carotid Artery Angioplasty & Stenting
EDUCATION
Vascular Neurology, University of Pittsburgh 2007-2008
PROFESSIONAL APPOINTMENTS
CERTIFICATIONS
LICENSURE
PROFESSIONAL AND SCIENTIFIC SOCIETY MEMBERSHIPS
HONORS AND AWARDS
selected PUBLICATIONS
Qureshi AI, Lodhi A, Akhtar IN, Ma X, Kherani D, Kwok CS, Ford DE, Hanley DF, Hassan AE, Nguyen TN, Spiotta AM, Zaidi SF. Mechanical thrombectomy with intra-arterial thrombolysis versus mechanical thrombectomy alone in patients with acute ischemic stroke: A systematic review and meta-analysis. Int J Stroke. 2023 Jul 8;:17474930231184369. doi: 10.1177/17474930231184369. [Epub ahead of print] Review. PubMed PMID: 37306490.
Kwok CS, Bains NK, Ford DE, Gomez CR, Hanley DF, Hassan AE, Nguyen TN, Siddiq F, Spiotta AM, Zaidi SF, Qureshi AI. Intra-arterial thrombolysis as adjunct to mechanical thrombectomy in acute ischemic stroke patients in the United States: A case control analysis. J Stroke Cerebrovasc Dis. 2023 Jul;32(7):107093. doi: 10.1016/j.jstrokecerebrovasdis.2023.107093. Epub 2023 May 5. PubMed PMID: 37149924.
Siegler JE, Qureshi MM, Nogueira RG, Tanaka K, Nagel S, Michel P, Vigilante N, Ribo M, Yamagami H, Yoshimura S, Abdalkader M, Haussen DC, Mohammaden MH, Nannoni S, Möhlenbruch MA, Henon H, Sheth SA, Ortega-Gutierrez S, Olive-Gadea M, Caparros F, Seker F, Zaidi S, Castonguay AC, Uchida K, Sakai N, Puri AS, Farooqui M, Toyoda K, Salazar-Marioni S, Takeuchi M, Farzin B, Masoud HE, Kuhn AL, Rana A, Morimoto M, Shibata M, Nonaka T, Klein P, Sathya A, Kiley NL, Cordonnier C, Strambo D, Demeestere J, Ringleb PA, Roy D, Zaidat OO, Jovin TG, Kaesmacher J, Fischer U, Raymond J, Nguyen TN. Endovascular vs Medical Management for Late Anterior Large Vessel Occlusion With Prestroke Disability: Analysis of CLEAR and RESCUE-Japan. Neurology. 2023 Feb 14;100(7):e751-e763. doi: 10.1212/WNL.0000000000201543. Epub 2022 Nov 4. PubMed PMID: 36332983; PubMed Central PMCID: PMC9969918.
Castonguay AC, Zoghi Z, Zaidat OO, Burgess RE, Zaidi SF, Mueller-Kronast N, Liebeskind DS, Jumaa MA. Predicting Functional Outcome Using 24-Hour Post-Treatment Characteristics: Application of Machine Learning Algorithms in the STRATIS Registry. Ann Neurol. 2023 Jan;93(1):40-49. doi: 10.1002/ana.26528. Epub 2022 Oct 29. PubMed PMID: 36214566; PubMed Central PMCID: PMC10091739.
Mohammaden MH, Haussen DC, Al-Bayati AR, Hassan AE, Tekle W, Fifi JT, Matsoukas S, Kuybu O, Gross BA, Lang M, Narayanan S, Cortez GM, Hanel RA, Aghaebrahim A, Sauvageau E, Farooqui M, Ortega-Gutierrez S, Zevallos CB, Galecio-Castillo M, Sheth SA, Nahhas M, Salazar-Marioni S, Nguyen TN, Abdalkader M, Klein P, Hafeez M, Kan P, Tanweer O, Khaldi A, Li H, Jumaa M, Zaidi SF, Oliver M, Salem MM, Burkhardt JK, Pukenas B, Kumar R, Lai M, Siegler JE, Peng S, Alaraj A, Nogueira RG. General anesthesia vs procedural sedation for failed NeuroThrombectomy undergoing rescue stenting: intention to treat analysis. J Neurointerv Surg. 2022 Dec 8;. doi: 10.1136/jnis-2022-019376. [Epub ahead of print] PubMed PMID: 36597943.
Seker F, Qureshi MM, Möhlenbruch MA, Nogueira RG, Abdalkader M, Ribo M, Caparros F, Haussen DC, Mohammaden MH, Sheth SA, Ortega-Gutierrez S, Siegler JE, Zaidi SF, Olive-Gadea M, Henon H, Castonguay AC, Nannoni S, Kaesmacher J, Puri AS, Farooqui M, Salazar-Marioni S, Kuhn AL, Kiley NL, Farzin B, Boisseau W, Masoud HE, Lopez CY, Rana A, Abdul Kareem S, Sathya A, Klein P, Kassem MW, Cordonnier C, Gralla J, Fischer U, Michel P, Strambo D, Jovin TG, Raymond J, Zaidat OO, Ringleb PA, Nguyen TN, Nagel S. Reperfusion Without Functional Independence in Late Presentation of Stroke With Large Vessel Occlusion. Stroke. 2022 Dec;53(12):3594-3604. doi: 10.1161/STROKEAHA.122.039476. Epub 2022 Oct 14. PubMed PMID: 36252092.
Mohammaden MH, Haussen DC, Al-Bayati AR, Hassan A, Tekle W, Fifi J, Matsoukas S, Kuybu O, Gross BA, Lang MJ, Narayanan S, Cortez GM, Hanel RA, Aghaebrahim A, Sauvageau E, Farooqui M, Ortega-Gutierrez S, Zevallos C, Galecio-Castillo M, Sheth SA, Nahhas M, Salazar-Marioni S, Nguyen TN, Abdalkader M, Klein P, Hafeez M, Kan P, Tanweer O, Khaldi A, Li H, Jumaa M, Zaidi S, Oliver M, Salem MM, Burkhardt JK, Pukenas BA, Alaraj A, Peng S, Kumar R, Lai M, Siegler J, Nogueira RG. Stenting and Angioplasty in Neurothrombectomy: Matched Analysis of Rescue Intracranial Stenting Versus Failed Thrombectomy. Stroke. 2022 Sep;53(9):2779-2788. doi: 10.1161/STROKEAHA.121.038248. Epub 2022 Jun 30. PubMed PMID: 35770672.
Salahuddin H, Rao RR, Zaidi SF, Prologo-Richardson P, Khalid F, Saju L, Taqi MA, Burgess RR, Jumaa MA. First Pass Effect and Location of Occlusion in Recanalized MCA M1 Occlusions. Front Neurol. 2022;13:884235. doi: 10.3389/fneur.2022.884235. eCollection 2022. PubMed PMID: 35585846; PubMed Central PMCID: PMC9108282.
Nguyen TN, Abdalkader M, Nagel S, Qureshi MM, Ribo M, Caparros F, Haussen DC, Mohammaden MH, Sheth SA, Ortega-Gutierrez S, Siegler JE, Zaidi S, Olive-Gadea M, Henon H, Möhlenbruch MA, Castonguay AC, Nannoni S, Kaesmacher J, Puri AS, Seker F, Farooqui M, Salazar-Marioni S, Kuhn AL, Kaliaev A, Farzin B, Boisseau W, Masoud HE, Lopez CY, Rana A, Kareem SA, Sathya A, Klein P, Kassem MW, Ringleb PA, Cordonnier C, Gralla J, Fischer U, Michel P, Jovin TG, Raymond J, Zaidat OO, Nogueira RG. Noncontrast Computed Tomography vs Computed Tomography Perfusion or Magnetic Resonance Imaging Selection in Late Presentation of Stroke With Large-Vessel Occlusion. JAMA Neurol. 2022 Jan 1;79(1):22-31. doi: 10.1001/jamaneurol.2021.4082. PubMed PMID: 34747975; PubMed Central PMCID: PMC8576630.
Kaesmacher J, Meinel TR, Kurmann C, Zaidat OO, Castonguay AC, Zaidi SF, Mueller-Kronast N, Kappelhof M, Dippel DWJ, Soudant M, Bracard S, Hill MD, Goyal M, Strbian D, Heiferman DM, Ashley W, Anadani M, Spiotta AM, Dobrocky T, Piechowiak EI, Arnold M, Goeldlin M, Seiffge D, Mosimann PJ, Mordasini P, Gralla J, Fischer U. Safety and efficacy of intra-arterial fibrinolytics as adjunct to mechanical thrombectomy: a systematic review and meta-analysis of observational data. J Neurointerv Surg. 2021 Dec;13(12):1073-1080. doi: 10.1136/neurintsurg-2020-016680. Epub 2021 Jan 29. PubMed PMID: 33514609; PubMed Central PMCID: PMC8606438.
Jumaa MA, Castonguay AC, Salahuddin H, Jadhav AP, Limaye K, Farooqui M, Zaidi SF, Mueller-Kronast N, Liebeskind DS, Zaidat OO, Ortega-Gutierrez S. Middle Cerebral Artery M2 Thrombectomy in the STRATIS Registry. Stroke. 2021 Nov;52(11):3490-3496. doi: 10.1161/STROKEAHA.120.033951. Epub 2021 Jul 27. PubMed PMID: 34311566.
Salahuddin H, Dawod G, Zaidi SF, Shawver J, Burgess R, Jumaa MA. Safety of Low Dose Intravenous Cangrelor in Acute Ischemic Stroke: A Case Series. Front Neurol. 2021;12:636682. doi: 10.3389/fneur.2021.636682. eCollection 2021. PubMed PMID: 34149590; PubMed Central PMCID: PMC8211882.
Zaidi SF, Castonguay AC, Zaidat OO, Mueller-Kronast N, Liebeskind DS, Salahuddin H, Jumaa MA. Intra-Arterial Thrombolysis after Unsuccessful Mechanical Thrombectomy in the STRATIS Registry. AJNR Am J Neuroradiol. 2021 Apr;42(4):708-712. doi: 10.3174/ajnr.A6962. Epub 2021 Jan 28. PubMed PMID: 33509921; PubMed Central PMCID: PMC8040984.
Ravindra VM, Alexander M, Taussky P, Bollo RJ, Hassan AE, Scoville JP, Griauzde J, Awad AW, Jumaa M, Zaidi S, Lee JJ, Hafeez MU, Nascimento FA, LoPresti MA, Couldwell WT, Hetts SW, Lam SK, Kan P, Grandhi R. Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke: A Multi-Institutional Experience of Technical and Clinical Outcomes. Neurosurgery. 2020 Dec 15;88(1):46-54. doi: 10.1093/neuros/nyaa312. PubMed PMID: 32761237; PubMed Central PMCID: PMC8660626.
Salahuddin H, Afreen E, Sheikh IS, Lateef S, Dawod G, Daboul J, Karim N, Gharaibeh K, Al-Chalabi M, Park S, Castonguay AC, Assaly R, Safi F, Matal M, Sheikh A, Tietjen G, Malaiyandi D, James E, Ali I, Zaidi SF, Abdelwahed A, Kung V, Burgess R, Jumaa MA. Neurological Predictors of Clinical Outcomes in Hospitalized Patients With COVID-19. Front Neurol. 2020;11:585944. doi: 10.3389/fneur.2020.585944. eCollection 2020. PubMed PMID: 33193048; PubMed Central PMCID: PMC7662675.
Jovin TG, Desai SM, Aghaebrahim A, Ducruet AF, Giurgiutiu DV, Gross BA, Hammer M, Jankowitz BT, Jumaa MA, Kenmuir C, Linares G, Reddy V, Rocha M, Starr M, Totoraitis V, Wechsler L, Zaidi S, Jadhav AP. Neurothrombectomy for Acute Ischemic Stroke Across Clinical Trial Design and Technique: A Single Center Pooled Analysis. Front Neurol. 2020;11:1047. doi: 10.3389/fneur.2020.01047. eCollection 2020. PubMed PMID: 33071935; PubMed Central PMCID: PMC7543690.
Pandey AS, Daou BJ, Tsai JP, Zaidi SF, Salahuddin H, Gemmete JJ, Oliver MJ, Singer J, Elder TA, Mbabuike N, Adel JG, Gujrati Y, Saleemi MA, Siddiqui FM, Elias AE, Rehman MF, Marin H, Chebl AB, Kole M, Wilseck JM, Kazmierczak CD, Mick JM, Majjhoo AQ, Naravetla BR, Rayes M, Luqman AW, Richards BF, Kelkar P, Burgess R, Thompson BG, Chaudhary N, Mazaris PA, Qahwash O, Razak MA, Jumaa MA. Letter: COVID-19 Pandemic-The Bystander Effect on Stroke Care in Michigan. Neurosurgery. 2020 Sep 1;87(3):E397-E399. doi: 10.1093/neuros/nyaa252. PubMed PMID: 32496518; PubMed Central PMCID: PMC7313842.
Salahuddin H, Castonguay AC, Zaidi SF, Burgess R, Jadhav AP, Jumaa MA. Interventional Stroke Care in the Era of COVID-19. Front Neurol. 2020;11:468. doi: 10.3389/fneur.2020.00468. eCollection 2020. PubMed PMID: 32574245; PubMed Central PMCID: PMC7225772.
Jumaa MA, Castonguay AC, Salahuddin H, Shawver J, Saju L, Burgess R, Kung V, Slawski DE, Tietjen G, Lindstrom D, Parquette B, Korsnack A, Cole K, Afreen E, Bafna K, Zaidi SF. Long-term implementation of a prehospital severity scale for EMS triage of acute stroke: a real-world experience. J Neurointerv Surg. 2020 Jan;12(1):19-24. doi: 10.1136/neurintsurg-2019-014997. Epub 2019 Jul 2. PubMed PMID: 31266858; PubMed Central PMCID: PMC6996096.
Castonguay AC, Jumaa MA, Zaidat OO, Haussen DC, Jadhav A, Salahuddin H, Zaidi SF. Insights Into Intra-arterial Thrombolysis in the Modern Era of Mechanical Thrombectomy. Front Neurol. 2019;10:1195. doi: 10.3389/fneur.2019.01195. eCollection 2019. PubMed PMID: 31798521; PubMed Central PMCID: PMC6863970.
Castonguay AC, Jumaa MA, Zaidi SF. Response by Castonguay et al to Letter Regarding Article "Intraarterial Thrombolysis as Rescue Therapy for Large Vessel Occlusions". Stroke. 2019 Jul;50(7):e218. doi: 10.1161/STROKEAHA.119.025820. Epub 2019 Jun 12. PubMed PMID: 31185825.
Salahuddin H, Siddiqui NS, Castonguay AC, Johnson M, Zaidi SF, Jumaa MA. Recent Trends in Electively Treated Unruptured Intracranial Aneurysms. J Stroke Cerebrovasc Dis. 2019 Jul;28(7):2011-2017. doi: 10.1016/j.jstrokecerebrovasdis.2019.03.010. Epub 2019 Apr 12. PubMed PMID: 30982717.
Zaidi SF, Castonguay AC, Jumaa MA, Malisch TW, Linfante I, Marden FA, Abraham MG, Chebl AB, Novakovic R, Taqi MA, Nogueira RG, Martin CO, Holloway WE, Mueller-Kronast N, English JD, Dabus G, Bozorgchami H, Xavier A, Rai AT, Froehler MT, Badruddin A, Nguyen TN, Yoo AJ, Shaltoni H, Janardhan V, Chen PR, Britz GW, Kaushal R, Nanda A, Gupta R, Zaidat OO. Intraarterial Thrombolysis as Rescue Therapy for Large Vessel Occlusions. Stroke. 2019 Apr;50(4):1003-1006. doi: 10.1161/STROKEAHA.118.024442. PubMed PMID: 30791829.
Slawski DE, Salahuddin H, Saju L, Shawver J, Korsnack A, Tietjen G, Papadimos TJ, Castonguay AC, Kung V, Burgess R, Zaidi SF, Jumaa MA. Monitored Anesthesia Care by Sedation-Trained Providers in Acute Stroke Thrombectomy. Front Neurol. 2019;10:296. doi: 10.3389/fneur.2019.00296. eCollection 2019. PubMed PMID: 30984101; PubMed Central PMCID: PMC6447680.
Slawski DE, Jumaa MA, Salahuddin H, Shawver J, Humayun MJ, Russell T, Seiwert A, Paolini D, Abbas J, Nazzal M, Tietjen GE, Espinosa-Morales A, Korsnack A, Zaidi SF. Emergent carotid endarterectomy versus stenting in acute stroke patients with tandem occlusion. J Vasc Surg. 2018 Oct;68(4):1047-1053. doi: 10.1016/j.jvs.2017.12.077. Epub 2018 May 19. PubMed PMID: 29789214.
Slawski DE, Salahuddin H, Shawver J, Kenmuir CL, Tietjen GE, Korsnack A, Zaidi SF, Jumaa MA. Mechanical Thrombectomy in Elderly Stroke Patients with Mild-to-Moderate Baseline Disability. Interv Neurol. 2018 Apr;7(5):246-255. doi: 10.1159/000487333. Epub 2018 Mar 20. PubMed PMID: 29765394; PubMed Central PMCID: PMC5939652.
Salahuddin H, Ramaiah G, Slawski DE, Shawver J, Buehler M, Zaidi SF, Jumaa M. Mechanical thrombectomy of M1 and M2 middle cerebral artery occlusions. J Neurointerv Surg. 2018 Apr;10(4):330-334. doi: 10.1136/neurintsurg-2017-013159. Epub 2017 Jul 13. PubMed PMID: 28705890.
Salahuddin H, Tietjen G, Jumaa M, Zaidi SF. Ischemic stroke due to retrograde thromboembolism during arteriovenous graft thrombectomy. J Vasc Access. 2018 Mar;19(2):201-202. doi: 10.5301/jva.5000766. Epub 2018 Feb 19. PubMed PMID: 28777414.
Salahuddin H, Espinosa A, Buehler M, Khuder SA, Khan AR, Tietjen G, Zaidi S, Jumaa MA. Mechanical Thrombectomy for Middle Cerebral Artery Division Occlusions: A Systematic Review and Meta-Analysis. Interv Neurol. 2017 Oct;6(3-4):242-253. doi: 10.1159/000477589. Epub 2017 Aug 17. PubMed PMID: 29118802; PubMed Central PMCID: PMC5662958.
Zaidi SF, Shawver J, Espinosa Morales A, Salahuddin H, Tietjen G, Lindstrom D, Parquette B, Adams A, Korsnack A, Jumaa MA. Stroke care: initial data from a county-based bypass protocol for patients with acute stroke. J Neurointerv Surg. 2017 Jul;9(7):631-635. doi: 10.1136/neurintsurg-2016-012476. Epub 2016 Jun 24. PubMed PMID: 27342763; PubMed Central PMCID: PMC5520240.
Ribo M, Molina CA, Jankowitz B, Tomasello A, Zaidi S, Jumaa M, Coscojuela P, Oakley J, Alvarez-Sabín J, Jovin T. Stentrievers versus other endovascular treatment methods for acute stroke: comparison of procedural results and their relationship to outcomes. J Neurointerv Surg. 2014 May;6(4):265-9. doi: 10.1136/neurintsurg-2013-010748. Epub 2013 May 28. PubMed PMID: 23716720.
Jankowitz BT, Bodily LM, Jumaa M, Syed ZF, Jovin TG. Manual aspiration thrombectomy for cerebral venous sinus thrombosis. J Neurointerv Surg. 2013 Nov;5(6):534-8. doi: 10.1136/neurintsurg-2012-010476. Epub 2012 Sep 19. PubMed PMID: 22993242.
Amorim E, Shih MM, Koehler SA, Massaro LL, Zaidi SF, Jumaa MA, Reddy VK, Hammer MD, Jovin TG, Wechsler LR. Impact of telemedicine implementation in thrombolytic use for acute ischemic stroke: the University of Pittsburgh Medical Center telestroke network experience. J Stroke Cerebrovasc Dis. 2013 May;22(4):527-31. doi: 10.1016/j.jstrokecerebrovasdis.2013.02.004. Epub 2013 Mar 13. PubMed PMID: 23489955.
Jumaa MA, Aghaebrahim A, Zaidi SF, Jankowitz B, Jovin TG, Horowitz MB. Is a head CT necessary after uncomplicated coiling of unruptured intracranial aneuryms?. J Neuroimaging. 2013 Apr;23(2):185-6. doi: 10.1111/j.1552-6569.2011.00683.x. Epub 2012 Jan 13. PubMed PMID: 22243992.
Zaidi SF, Aghaebrahim A, Urra X, Jumaa MA, Jankowitz B, Hammer M, Nogueira R, Horowitz M, Reddy V, Jovin TG. Final infarct volume is a stronger predictor of outcome than recanalization in patients with proximal middle cerebral artery occlusion treated with endovascular therapy. Stroke. 2012 Dec;43(12):3238-44. doi: 10.1161/STROKEAHA.112.671594. Epub 2012 Nov 15. PubMed PMID: 23160876.
Jankowitz B, Aghaebrahim A, Zirra A, Spataru O, Zaidi S, Jumaa M, Ruiz-Ares G, Horowitz M, Jovin TG. Manual aspiration thrombectomy: adjunctive endovascular recanalization technique in acute stroke interventions. Stroke. 2012 May;43(5):1408-11. doi: 10.1161/STROKEAHA.111.646117. Epub 2012 Mar 1. PubMed PMID: 22382156.
Zaidi SF, Jumma MA, Urra XN, Hammer M, Massaro L, Reddy V, Jovin T, Lin R, Wechsler LR. Telestroke-guided intravenous tissue-type plasminogen activator treatment achieves a similar clinical outcome as thrombolysis at a comprehensive stroke center. Stroke. 2011 Nov;42(11):3291-3. doi: 10.1161/STROKEAHA.111.625046. Epub 2011 Sep 1. PubMed PMID: 21885843.
Aleu A, Hussain MV, Lin R, Gupta R, Jankowitz BT, Vora NA, Jumaa MA, Zaidi SF, Anderson WD, Horowitz MB, Jovin T. Endovascular therapy for cardiac catheterization associated strokes. J Neuroimaging. 2011 Jul;21(3):247-50. doi: 10.1111/j.1552-6569.2010.00494.x. Epub 2011 Jan 31. PubMed PMID: 21281378.
Malik AM, Vora NA, Lin R, Zaidi SF, Aleu A, Jankowitz BT, Jumaa MA, Reddy VK, Hammer MD, Wechsler LR, Horowitz MB, Jovin TG. Endovascular treatment of tandem extracranial/intracranial anterior circulation occlusions: preliminary single-center experience. Stroke. 2011 Jun;42(6):1653-7. doi: 10.1161/STROKEAHA.110.595520. Epub 2011 Apr 21. PubMed PMID: 21512175.
Uchino K, Lin R, Zaidi SF, Kuwabara H, Sashin D, Bircher N, Chang YF, Hammer MD, Reddy V, Jovin TG, Vora N, Jumaa M, Massaro L, Billigen J, Boada F, Yonas H, Nemoto EM. Increased cerebral oxygen metabolism and ischemic stress in subjects with metabolic syndrome-associated risk factors: preliminary observations. Transl Stroke Res. 2010 Sep 1;1(3):178-83. doi: 10.1007/s12975-010-0028-2. PubMed PMID: 22034586; PubMed Central PMCID: PMC3201728.
Jumaa MA, Zhang F, Ruiz-Ares G, Gelzinis T, Malik AM, Aleu A, Oakley JI, Jankowitz B, Lin R, Reddy V, Zaidi SF, Hammer MD, Wechsler LR, Horowitz M, Jovin TG. Comparison of safety and clinical and radiographic outcomes in endovascular acute stroke therapy for proximal middle cerebral artery occlusion with intubation and general anesthesia versus the nonintubated state. Stroke. 2010 Jun;41(6):1180-4. doi: 10.1161/STROKEAHA.109.574194. Epub 2010 Apr 29. PubMed PMID: 20431082.
Lin R, Vora N, Zaidi S, Aleu A, Jankowitz B, Thomas A, Gupta R, Horowitz M, Kim S, Reddy V, Hammer M, Uchino K, Wechsler LR, Jovin T. Mechanical approaches combined with intra-arterial pharmacological therapy are associated with higher recanalization rates than either intervention alone in revascularization of acute carotid terminus occlusion. Stroke. 2009 Jun;40(6):2092-7. doi: 10.1161/STROKEAHA.108.544783. Epub 2009 Apr 23. PubMed PMID: 19390066.