A5058413004- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Intracranial Aneurysms: Treatment and Complications
- Stroke Rehabilitation and Recovery
- Venous Thromboembolism Diagnosis and Management
- Traumatic Brain Injury and Neurovascular Disturbances
- Vascular Malformations Diagnosis and Treatment
- Peripheral Artery Disease Management
- Intracerebral and Subarachnoid Hemorrhage Research
- Neurosurgical Procedures and Complications
- Moyamoya disease diagnosis and treatment
- Aortic aneurysm repair treatments
- Neurological Disorders and Treatments
- Meningioma and schwannoma management
- Aortic Disease and Treatment Approaches
- Cerebrospinal fluid and hydrocephalus
- COVID-19 and healthcare impacts
- Long-Term Effects of COVID-19
- Surgical Simulation and Training
- Spinal Fractures and Fixation Techniques
- Vascular Procedures and Complications
- Cerebral Venous Sinus Thrombosis
- Central Venous Catheters and Hemodialysis
- Cardiac, Anesthesia and Surgical Outcomes
- Cardiovascular Health and Disease Prevention
Semmes Murphey Foundation
2016-2025
University of Tennessee at Knoxville
2016-2025
Neurological Surgery
1997-2025
University of Tennessee Health Science Center
2016-2025
Murphy Oil Corporation (United States)
2014-2024
Centre Hospitalier Universitaire de Reims
2024
Swedish Medical Center
2024
Jackson Memorial Hospital
2024
Rhode Island Hospital
2024
Swedish Medical Center
2024
Introduction The Woven EndoBridge Intrasaccular Therapy (WEB-IT) Study is a pivotal, prospective, single-arm, investigational device exemption study designed to evaluate the safety and effectiveness of WEB for treatment wide-neck bifurcation aneurysms. Methods One-hundred fifty patients with aneurysms were enrolled at 21 US six international centers. Angiograms from index procedure, 6-month 1-year follow-up visits all reviewed by core laboratory. All adverse events adjudicated clinical...
Objective Flexible large lumen aspiration catheters and stent retrievers have recently become available in the USA for revascularization of vessel occlusions presenting within context acute ischemic stroke (AIS). We describe a multicenter experience using combined retrieval technique thrombectomy. Design A retrospective analysis to identify patients receiving manual treatment AIS between August 2012 April 2013 at six high volume centers was conducted. Outcome variables, including...
<h3>Objective:</h3> There are limited data evaluating the effect of post mechanical thrombectomy (MT) blood pressure (BP) levels on early outcomes patients with large vessel occlusions (LVO). We sought to investigate association BP course following MT in LVO. <h3>Methods:</h3> Consecutive LVO treated during a 3-year period were evaluated. Hourly systolic (SBP) and diastolic (DBP) values recorded for 24 hours maximum SBP DBP identified. complete reperfusion stratified 3 groups based post-MT...
The COVID-19 pandemic has disrupted established care paths worldwide. Patient awareness of the and executive limitations imposed on public life have changed perception when to seek for acute conditions in some cases. We sought study whether there is a delay presentation ischemic stroke patients first month US.The interval between last-known-well (LKW) time 710 consecutive presenting with strokes 12 centers across US were extracted from prospectively maintained quality database. analyzed...
BackgroundPatients receiving standard treatment for chronic subdural hematoma have a high risk of failure. The effect adjunctive middle meningeal artery embolization on the failure in this population remains unknown.MethodsWe randomly assigned patients with symptomatic to undergo as an adjunct (embolization group) or receive alone (control group). Either surgical nonsurgical had been chosen each patient before randomization. primary efficacy outcome was composite following events: recurrent...
ARISE (Aneurysm/AVM/cSDH Roundtable Discussion With Industry and Stroke Experts) organized a one-and-a-half day meeting workshop brought together representatives from academia, industry, government to discuss the most promising approaches improve outcomes for patients with chronic subdural hematoma (cSDH). The emerging role of middle meningeal artery embolization in clinical practice design current potential future trials were primary focuses discussion. Existing evidence imaging,...
Objective To summarize the current literature regarding initial hospital management of patients with acute ischemic stroke (AIS) secondary to emergent large vessel occlusion (ELVO), and offer recommendations designed decrease time endovascular treatment (EVT) for appropriately selected stroke. Methods Using guidelines evidenced-based medicine proposed by Stroke Council American Heart Association, a critical review all available medical supporting best AIS ELVO was performed. The purpose...
Background and Purpose— Patients with posterior circulation strokes have been excluded from recent randomized endovascular stroke trials. We reviewed the multicenter experience treatment of to identify clinical, radiographic, procedural predictors successful recanalization good neurological outcomes. Methods— performed a retrospective analysis consecutive patients strokes, who underwent thrombectomy stent retrievers or primary aspiration (including A Direct Aspiration First Pass Technique...
<h3>Background</h3> Unruptured intracranial aneurysms (UIAs) are increasingly diagnosed and commonly treated using endovascular treatment or microsurgical clipping. The safety efficacy of treatments have not been compared in a randomised trial. How to treat patients with UIAs suitable for both options remains unknown. <h3>Methods</h3> We randomly allocated clipping coiling one more 3–25 mm judged treatable ways. primary outcome was failure, defined as: initial failure aneurysm treatment,...
Introduction The Woven EndoBridge (WEB) represents a novel intrasaccular therapeutic option for the treatment of intracranial wide-necked bifurcation aneurysms (WNBAs). WEB-IT Study is pivotal Investigational Device Exemption (IDE) study to determine safety and effectiveness WEB device WNBAs located in anterior posterior circulations. We present patient demographics, procedural characteristics, 30-day adverse event data US study. Methods prospective multicenter single-arm interventional...
Utilization of the Pipeline embolization device (PED) in complex ruptured aneurysms has not been well studied. We evaluated safety and effectiveness data from five participating US centers.Records patients with cerebral who underwent PED treatment between 2011 2013 were retrospectively reviewed.26 (mean age 51.4 ± 13.2 years;16 women). At presentation, 8 (30.8%) had a Hunt-Hess grade IV or above; 11 required extraventricular drain placement. Aneurysm morphologies were: dissecting,...
Background and Purpose- The purpose of this study is to evaluate the relationship between neutrophil-to-lymphocyte ratio (NLR) at admission with safety efficacy outcomes in acute stroke patients large vessel occlusion after mechanical thrombectomy. Methods- Consecutive treated thrombectomy during a 4-year period were evaluated. Outcome measures included symptomatic intracranial hemorrhage, 3-month mortality, successful reperfusion (modified Thrombolysis Cerebral Infarction score 2b/3),...
Background Vessel perforation during stent retriever thrombectomy is a rare complication; typically only single instances have been reported. Objective To report on series of patients whose was complicated by intraprocedural vessel and discuss its potential mechanisms, rescue treatment strategies, clinical significance. Methods Cases with perforation, where used either as primary approach or part direct aspiration first pass technique (ADAPT), were included in the final analysis. Clinical...
BACKGROUND: Utilization of the Pipeline embolization device (PED) to treat distal carotid circulation aneurysms has not been well studied. OBJECTIVE: To report collective experience using PED anterior aneurysms. METHODS: We retrospectively reviewed clinical and radiographic records all patients who underwent at 10 US neurosurgical centers between 2011 2013. RESULTS: Twenty-eight (mean age 51.7 years; 18 women) with 28 were included in analyses. Fifteen fusiform, 5 dissecting, 8 saccular....
Background Blood blister aneurysms (BBA) are a rare subset of intracranial that represent therapeutic challenge from both surgical and endovascular perspective. Objective To report multicenter experience with flow diversion exclusively for BBA, located at non-branching segments along the anteromedial wall supraclinoidal internal carotid artery (ICA). Methods Consecutive cases BBA ICA treated were included in final analysis. Results 49 patients 51 devices to achieve effect identified. 43 45...
Acute ischemic stroke (AIS) due to emergent large-vessel occlusion (ELVO) has a poor prognosis.To examine the hypothesis that better collateral score on pretreatment CT angiography (CTA) would correlate with smaller final infarct volume and more favorable clinical outcome after endovascular therapy (EVT).A retrospective chart review of University Tennessee AIS database from February 2011 2013 was conducted. All patients CTA-proven LVO treated EVT were included. Recanalization defined by...
Higher admission serum glucose levels have been associated with poor outcomes in patients acute ischemic stroke (AIS) treated IV thrombolysis. We sought to evaluate the association of early emergent large vessel occlusion (ELVO) mechanical thrombectomy (MT).Consecutive AIS due ELVO MT three tertiary centers were evaluated. The following documented using standard definitions: symptomatic intracranial hemorrhage (sICH), complete reperfusion, mortality, functional independence (modified Rankin...
Introduction Effective triage of patients with emergent large vessel occlusion (ELVO) to endovascular therapy capable centers may decrease time treatment and improve outcome for these patients. Here we performed a derivation study evaluate the accuracy portable, non-invasive, easy use severe stroke detector. Methods The volumetric impedance phase shift spectroscopy (VIPS) device was used assign bioimpedance asymmetry score 248 subjects across three cohorts, including 41 presenting as acute...