A5029062789- Acute Ischemic Stroke Management
- Stroke Rehabilitation and Recovery
- Cerebrovascular and Carotid Artery Diseases
- Venous Thromboembolism Diagnosis and Management
- Traumatic Brain Injury and Neurovascular Disturbances
- COVID-19 and healthcare impacts
- Long-Term Effects of COVID-19
- Trauma and Emergency Care Studies
- Peripheral Artery Disease Management
- Neurological Disorders and Treatments
- Clinical practice guidelines implementation
- Neurotransmitter Receptor Influence on Behavior
- Brain Metastases and Treatment
- Spine and Intervertebral Disc Pathology
- Radiopharmaceutical Chemistry and Applications
- Antiplatelet Therapy and Cardiovascular Diseases
- Climate Change and Health Impacts
- Cardiac Imaging and Diagnostics
- Advanced MRI Techniques and Applications
- Intracranial Aneurysms: Treatment and Complications
- Lung Cancer Treatments and Mutations
- Cancer Treatment and Pharmacology
- Advanced X-ray and CT Imaging
- Spinal Fractures and Fixation Techniques
- EEG and Brain-Computer Interfaces
Baptist Hospital of Miami
2015-2024
Baptist Health South Florida
2015-2024
University of Miami
2012-2023
Florida International University
2014-2023
American Heart Association
2023
University of South Florida
2023
Children's National
2023
Boston Medical Center
2021-2022
Boston University
2021-2022
Hospital de Clínicas de Porto Alegre
2021
Mechanical thrombectomy with stent-retrievers results in higher recanalization rates compared previous devices. Despite successful (Thrombolysis Cerebral Infarction (TICI) score ≥2b) of 70-83%, good outcomes by 90-day modified Rankin Scale (mRS) ≤2 are achieved only 40-55% patients. We evaluated predictors poor (mRS >2) despite (TICI the North American Solitaire Stent Retriever Acute Stroke (NASA) registry.Logistic regression was used to evaluate baseline characteristics and for association...
Background and Purpose— Although higher blood pressure variability (BPV) is associated with worse functional outcome after stroke, this association not as well established in large vessel occlusion strokes treated endovascular treatment (EVT). Methods— In post hoc analysis of BEST (Blood Pressure Endovascular Therapy for Ischemic Stroke), a prospective, multicenter cohort study anterior circulation acute ischemic stroke patients undergoing EVT, we determined the BPV poor or death (90-day...
Background and Purpose- To identify the specific post-endovascular stroke therapy (EVT) peak systolic blood pressure (SBP) threshold that best discriminates good from bad functional outcomes (a priori hypothesized to be 160 mm Hg), we conducted a prospective, multicenter, cohort study with prespecified analysis plan. Methods- Consecutive adult patients treated EVT for an anterior ischemic were enrolled November 2017 July 2018 at 12 comprehensive centers accross United States. All SBP values...
The pandemic caused by the novel coronavirus disease 2019 (COVID-19) has led to an unprecedented paradigm shift in medical care. We sought evaluate whether COVID-19 may have contributed delays acute stroke management at comprehensive centers.Pooled clinical data of consecutive adult patients from 14 US centers (January 1, 2019, July 31, 2020) were queried. rate thrombolysis for nontransferred within Target: Stroke goal 60 minutes was compared between admitted March and (pre-COVID-19), 2020,...
Background A better understanding of real‐world practice patterns in the endovascular treatment for large vessel occlusion acute ischemic stroke is needed. Here, we report methods and initial results Society Vascular Interventional Neurology (SVIN) Registry. Methods The SVIN Registry an ongoing prospective, multicenter, observational registry capturing patients with undergoing since November 2018. Participating sites also contributed pre‐SVIN data collected per institutional prospective...
Background and Purpose: The National Institutes of Health Stroke Scale (NIHSS) measured at an early time point is appealing surrogate marker for long-term functional outcome stroke patients treated with endovascular therapy. However, definitions analytical methods NIHSS-based measure that optimize power precision in clinical studies are not well-established. Methods: In this post-hoc analysis our prospective observational study enrolled therapy-treated 12 comprehensive centers across the US,...
Background and Purpose— Failure to recanalize predicts mortality in acute ischemic stroke. In the North American Solitaire Acute Stroke registry, we investigated parameters associated with successfully recanalized patients. Methods— Logistic regression was used evaluate baseline characteristics recanalization for association 90-day mortality. A multivariable model developed based on backward selection retention criteria of P <0.05 from factors at least marginal significance ( ≤0.10), then...
The increased severity of white matter disease is associated with worse outcomes and an rate intracerebral hemorrhage in patients ischemic stroke undergoing thrombolytic treatment. However, whether endovascular treatment remains unclear.In this prespecified exploratory analysis our prospective multi-institutional study that enrolled consecutive adult anterior circulation from November 2017 to September 2018, we compared the following between none-to-minimal (van Swieten score, 0-2)...
Background Dual antiplatelet therapy (DAP) is necessary to prevent thromboembolic events during carotid stenting, stent-assisted coil embolization, and implant of flow diverters (FD). However, DAP in the acute phase may be challenging. An intravenous alternative, cangrelor, has rapid onset, short plasma half-life, more reliable action for interventions. The study objective was evaluate feasibility safety IV cangrelor neuroendovascular surgery procedures. Methods We performed a retrospective...
ABSTRACT BACKGROUND AND PURPOSE The 2018 AHA guidelines recommend perfusion imaging to select patients with acute large vessel occlusion (LVO) for thrombectomy in the extended window. However, relationship between noncontrast CT and has not been sufficiently characterized >6 hours after last known normal (LKN). METHODS From a multicenter prospective cohort of consecutive adults who underwent anterior LVO 0–24 LKN, we correlated baseline core volume (rCBF < 30%) Alberta Stroke Program...
Unprecedented workflow shifts during the coronavirus disease 2019 (COVID-19) pandemic have contributed to delays in acute care delivery, but whether it adversely affected endovascular thrombectomy metrics large vessel occlusion (LVO) is unknown.We performed a retrospective review of observational data from 14 comprehensive stroke centers nine US states with LVO. EVT were compared between March July against 2020 (primary analysis), and state-specific pre-peak peak COVID-19 months (secondary...
Abstract Background Early palliative/pre-emptive intervention improves clinical outcomes and quality of life for patients with metastatic cancer. A previous signal-seeking randomized controlled trial (RCT) demonstrated that early upfront radiotherapy to asymptomatic or minimally symptomatic high-risk osseous metastases led reduction in skeletal-related events (SREs), a benefit driven primarily by subgroup spine metastasis. The current RCT aims determine whether high-risk, will lead fewer...
Abstract BACKGROUND Because of the overwhelming benefit thrombectomy for highly selected trial patients with large vessel occlusion (LVO), some trial-ineligible are being treated in practice. OBJECTIVE To determine safety and efficacy DAWN/DEFUSE-3-ineligible patients. METHODS Using a multicenter prospective observational study consecutive anterior circulation LVO who underwent late thrombectomy, we compared symptomatic intracerebral hemorrhage (sICH) good outcome (90-d mRS 0-2) among to...
Individuals with greater nicotine-reactivity may be more likely to initiate and maintain cigarette-smoking behavior than individuals less nicotine-reactivity. In rats, behavioral sensitization reflects a progressive increase in the psychomotor response drugs of abuse thought result from neuroplasticity brain regions that mediate their motivational effects. Studying nicotine rats differential preference intake, such as Lewis Fischer provide clues about role tobacco use. Rat strain differences...
Objective Giant intracranial aneurysms (GIAs) are associated with a high risk of rupture and have mortality rate when they (65-100%). The traditional microsurgical approach to secure these lesions is challenging, as such endovascular embolization has been increasingly selected treatment option. Methods We performed retrospective analysis consecutive patients ruptured unruptured GIAs at three medical centers from October 2008 April 2016. Clinical follow-up digital subtraction angiography were...
The startle response of <i>Pantodon buchholzi</i>, the African butterfly fish, is a complete or incomplete ballistic jump resulting from abduction pectoral fins. This study analyzed neuromuscular basis for such by recording in vivo electromyograms (emgs) muscles abduction, muscularis abductor superficialis (MAS) and profundus (MAP). motor neurons innervating MAS muscle were localized retrograde transport biocytin. latency between stimulus evoked emg was less than 5 ms; MAP about...
Background Elevated systolic blood pressure (SBP) in the acute phase after endovascular therapy (EVT) is associated with worse outcome. However, association between reduction (SBPr) and outcome of EVT not well understood. Objective To determine SBPr clinical outcomes a prospective multicenter cohort. Methods A post hoc analysis Blood Pressure Endovascular Stroke Therapy (BEST) observational cohort study was carried out. defined as absolute difference admission SBP mean first 24 hours EVT....
Cortical screws offer a less invasive alternative compared to traditional pedicle screws. These are inserted in an inferomedial superolateral trajectory achieving greater cortical bone purchase. Similar fusion rates, pain relief, and decreased surgical morbidity at 12-month follow-up have been documented when Using intra-operative imaging, neuronavigation, individual neurophysiological monitoring of each screw, we showed that this is safe approach. Institutional review board (IRB) approved...
Background Recanalization of the occluded artery is a powerful predictor good outcome in acute ischemic stroke secondary to large occlusions. Mechanical thrombectomy with stent-trievers results higher recanalization rates and better outcomes compared previous devices. However, despite successful (Treatment Cerebral Infarction, TICI, score ≥ 2b) between 70 90%, clinical assessed by modified Rankin Scale (mRS 2 present 40–50% patients. We aimed evaluate predictors poor 2) (TICI patients...