A5006528562- Intracranial Aneurysms: Treatment and Complications
- Cerebrovascular and Carotid Artery Diseases
- Acute Ischemic Stroke Management
- Vascular Malformations Diagnosis and Treatment
- Traumatic Brain Injury and Neurovascular Disturbances
- Moyamoya disease diagnosis and treatment
- Stroke Rehabilitation and Recovery
- Peripheral Artery Disease Management
- Venous Thromboembolism Diagnosis and Management
- Cardiovascular Health and Disease Prevention
- Meningioma and schwannoma management
- Coronary Interventions and Diagnostics
- Neurosurgical Procedures and Complications
- Aortic aneurysm repair treatments
- Intracerebral and Subarachnoid Hemorrhage Research
- Spinal Fractures and Fixation Techniques
- Long-Term Effects of COVID-19
- Pituitary Gland Disorders and Treatments
- Cerebral Venous Sinus Thrombosis
- Aortic Disease and Treatment Approaches
- Cerebrospinal fluid and hydrocephalus
- Cardiovascular and Diving-Related Complications
- Neurological Disorders and Treatments
- Vascular Procedures and Complications
- Cardiac, Anesthesia and Surgical Outcomes
Advocate Health Care
2018-2025
Advocate Illinois Masonic Medical Center
2025
Rush University Medical Center
2014-2024
Advocate Lutheran General Hospital
2023-2024
Universidade do Porto
2024
Google (United States)
2024
Health and Education Research Management and Epidemiologic Services (United States)
2021-2023
Neurogen Brain & Spine Institute
2021-2022
Neurological Surgery
2011-2021
University of Southern California
2021
Among patients with acute ischemic stroke due to occlusions in the proximal anterior intracranial circulation, less than 40% regain functional independence when treated intravenous tissue plasminogen activator (t-PA) alone. Thrombectomy use of a stent retriever, addition t-PA, increases reperfusion rates and may improve long-term outcome.
The effect of endovascular thrombectomy that is performed more than 6 hours after the onset ischemic stroke uncertain. Patients with a clinical deficit disproportionately severe relative to infarct volume may benefit from late thrombectomy.
To evaluate the safety and effectiveness of Pipeline Embolization Device (PED; ev3/Covidien, Irvine, Calif) in treatment complex intracranial aneurysms.The for Uncoilable or Failed Aneurysms is a multicenter, prospective, interventional, single-arm trial PED uncoilable failed aneurysms internal carotid artery. Institutional review board approval HIPAA-compliant study protocol was obtained from each center. After providing informed consent, 108 patients with recently unruptured large giant...
<h3>BACKGROUND AND PURPOSE:</h3> Flow diverters are increasingly used in the endovascular treatment of intracranial aneurysms. Our aim was to determine neurologic complication rates following Pipeline Embolization Device placement for aneurysm a real-world setting. <h3>MATERIALS METHODS:</h3> We retrospectively evaluated all patients with aneurysms treated between July 2008 and February 2013 17 centers worldwide. defined 4 subgroups: internal carotid artery ≥10 mm, ICA <10 other anterior...
Abstract BACKGROUND: Early and mid-term safety efficacy of aneurysm treatment with the Pipeline Embolization Device (PED) has been well demonstrated in prior studies. OBJECTIVE: To present 5-yr follow-up for patients treated Uncoilable or Failed Aneurysms clinical trial. METHODS: In our prospective, multicenter trial, 109 complex internal carotid artery (ICA) aneurysms 107 subjects were PED. Patients followed per a standardized protocol at 180 d 1, 3, 5 yr. Aneurysm occlusion, in-stent...
Thrombectomy, primarily with stent retrievers or without adjunctive aspiration, provided clinical benefit across multiple prospective randomized trials. Whether this is exclusive to unclear.THERAPY (The Randomized, Concurrent Controlled Trial Assess the Penumbra System's Safety and Effectiveness in Treatment of Acute Stroke; NCT01429350) was an international, multicenter, prospective, (1:1), open label, blinded end point evaluation, concurrent controlled trial aspiration thrombectomy after...
Rationale Early reperfusion in patients experiencing acute ischemic stroke is critical, especially for with large vessel occlusion who have poor prognosis without revascularization. Solitaire™ stent retriever devices been shown to immediately restore vascular perfusion safely, rapidly, and effectively occlusions. Aim The aim of the study was demonstrate that, among vessel, anterior circulation received intravenous tissue plasminogen activator, treatment Solitaire revascularization reduces...
Background Preliminary clinical studies on the safety and efficacy of pipeline embolization device (PED) for treatment small/medium aneurysms have demonstrated high occlusion rates with low complications. Objective To evaluate effectiveness PED wide necked small medium intracranial aneurysms. Methods PREMIER is a prospective, multicenter, single arm trial. Patients were treated unruptured aneurysms, measuring ≤12 mm along internal carotid artery or vertebral artery, between July 2014...
OBJECTIVE The authors performed a pooled analysis of 3 studies-IntrePED (International Retrospective Study the Pipeline Embolization Device), PUFS (Pipeline for Uncoilable or Failed Aneurysms Study), and ASPIRe (Aneurysm in an Observational Registry)-in order to assess angiographic outcomes clinical safety embolization device (PED). METHODS IntrePED was retrospective study, while were prospective studies. For each patient included these studies, collected baseline demographic data, aneurysm...
OBJECTIVE The long-term effectiveness of endovascular treatment large and giant wide-neck aneurysms using traditional techniques has been disappointing, with high recanalization re-treatment rates. Flow diversion the Pipeline Embolization Device (PED) recently used as a stand-alone therapy for complex aneurysms, showing significant improvement in while demonstrating similar safety profile to stent-supported coil treatment. However, relatively little is known about its effectiveness. Here...
Rationale Efficacy of mechanical thrombectomy for acute stroke due to large vessel occlusion initiated beyond 6 h time last seen well has not been demonstrated in randomized trials. Aim To establish whether subjects considered have substantial areas salvageable brain based on age-adjusted clinical core mismatch who can undergo endovascular treatment within 6–24 from (TLSW) better outcomes at three months compared treated with standard medical therapy alone. Age-adjusted is defined by age...
<b><i>Background and Objective:</i></b> Few prospective studies exist evaluating the safety efficacy of Pipeline Embolization Device (PED) in treatment intracranial aneurysms. The Aneurysm Study In an observational Registry (ASPIRe) study prospectively analyzed rates complete aneurysm occlusion neurologic adverse events following PED <b><i>Materials Methods:</i></b> We performed a multicenter patients with unruptured aneurysms treated PED....
Hemodynamic instability can occur acutely after carotid angioplasty and stent placement (CAS). We performed this study to determine the frequency of hemodynamic in a series patients who underwent CAS analyze factors associated with development postprocedural events.We reviewed medical records angiograms 51 (mean age 68.3+/-8.9 years) for symptomatic (n=29) or asymptomatic (n=22) artery stenosis. Any episodes hypotension (systolic blood pressure <90 mm Hg), hypertension >160 bradycardia...
Abstract OBJECTIVE We prospectively evaluated the safety and effectiveness of aggressive mechanical disruption clot in conjunction with intra-arterial administration a low-dose third-generation thrombolytic agent (reteplase) to treat ischemic stroke patients who were considered poor candidates for intravenous alteplase therapy or failed improve after thrombolysis. Mechanical was used if pharmacological thrombolysis ineffective. This strategy adopted increase recanalization rate without...
Objective Within the context of a prospective randomized trial (SWIFT PRIME), we assessed whether early imaging stroke patients, primarily with computed tomography (CT) perfusion, can estimate size irreversibly injured ischemic core and volume critically hypoperfused tissue. We also evaluated accuracy hypoperfusion volumes for predicting infarct in patients target mismatch profile. Methods Baseline were prior to treatment intravenous (IV) tissue plasminogen activator (tPA) alone versus IV...
The development of comprehensive stroke centers within hub-and-spoke networks offers the opportunity to increase proportion acute ischemic patients treated with intra-arterial therapies (IAT). Interhospital transfer delays will be critical in evaluating success this strategy.We collected data on consecutive who were transferred our institution for possible IAT. We defined time as elapsed from initial call arrival at hospital and assessed whether was a predictor emergent angiography using...
Background Thromboembolic events after Pipeline Embolization Device (PED) placement remain a feared complication among neuroendovascular surgeons. This study aimed to investigate potential risk factors for thromboembolic in patients undergoing PED placement. Methods Medical records of who underwent from April 2011 August 2013 were reviewed. Variables including pre-procedure P2Y12 reaction unit (PRU) value, procedure time, number PEDs deployed and perioperative neurovascular complications...
<h3>BACKGROUND AND PURPOSE:</h3> Stent-assisted coiling may result in less aneurysm recanalization but more complications than alone. We evaluated outcomes of with and without stents the multicenter Matrix Platinum Science Trial. <h3>MATERIALS METHODS:</h3> All patients Trial unruptured intracranial aneurysms treated per protocol were included. Baseline patient characteristics, procedural details, neurologic outcomes, angiographic safety data analyzed. <h3>RESULTS:</h3> Overall, 137 361...
Background and Purpose— Clinical trials have demonstrated improved 90-day outcomes for patients with acute ischemic stroke treated stent retriever thrombectomy plus tissue-type plasminogen activator (SST+tPA) compared tPA. Previous studies suggested that this strategy may be cost-effective, but models were derived from pooled data older assumptions. Methods— In prospective economic substudy conducted alongside the SWIFT-PRIME trial (Solitaire With Intention Thrombectomy as Primary...
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 Follow-up infarct volume (FIV) has been recommended as an early indicator of treatment efficacy in patients with acute ischemic stroke. Questions remain about the optimal imaging approach for FIV measurement. Objective To examine association 90-day modified Rankin Scale (mRS) score and investigate its dependency on acquisition time modality. Methods Data seven trials were pooled. was assessed follow-up (12 hours to 2 weeks) CT or MRI. Infarct location defined laterality...
<h3>BACKGROUND AND PURPOSE:</h3> Risk factors for acute ischemic stroke following flow-diverter treatment of intracranial aneurysms are poorly understood. Using the International Retrospective Study Pipeline Embolization Device (IntrePED) registry, we studied demographic, aneurysm, and procedural characteristics associated with postoperative (PED) treatment. <h3>MATERIALS METHODS:</h3> We identified patients in IntrePED registry post-PED-treatment stroke. The rate was determined by...
The treatment effects of individual mechanical thrombectomy devices in large-vessel acute ischemic stroke (AIS) remain unclear.To determine whether the novel 3-dimensional (3-D) stent retriever used conjunction with an aspiration-based device (Penumbra System; Penumbra) is noninferior to alone AIS.This randomized, noninferiority clinical trial enrolled patients at 25 North American centers from May 19, 2012, through November 2015, follow-up for 90 days. Adjudicators primary end points were...
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....