A5002699755- Cerebrovascular and Carotid Artery Diseases
- Acute Ischemic Stroke Management
- Cardiac Imaging and Diagnostics
- Traumatic Brain Injury and Neurovascular Disturbances
- MRI in cancer diagnosis
- Peripheral Artery Disease Management
- Neonatal and fetal brain pathology
- Intracranial Aneurysms: Treatment and Complications
- Gallbladder and Bile Duct Disorders
- Liver Disease and Transplantation
- Epilepsy research and treatment
- Oral and Maxillofacial Pathology
- Pediatric Hepatobiliary Diseases and Treatments
- Liver Diseases and Immunity
- Neurological Disease Mechanisms and Treatments
- Advanced MRI Techniques and Applications
- Cardiovascular Disease and Adiposity
- Atomic and Subatomic Physics Research
- Stroke Rehabilitation and Recovery
- Bone Tumor Diagnosis and Treatments
- Liver physiology and pathology
- Renal and Vascular Pathologies
- Sarcoma Diagnosis and Treatment
- Medical Image Segmentation Techniques
- Cardiovascular Health and Disease Prevention
Yale University
2023-2025
University of California, Los Angeles
2016-2019
Cedars-Sinai Medical Center
1993-1994
Objective To test the safety and efficacy of a bioartificial liver support system in patients with severe acute failure. Summary Background Data authors developed using porcine hepatocytes. The was tested vitro shown to have differentiated functions (cytochrome P450 activity, synthesis liver-specific proteins, bilirubin synthesis, conjugation). When vivo experimental animals failure, it gave substantial metabolic hemodynamic support. Methods Seven failure received double lumen catheter...
Collaterals 2016 (third International Symposium on to the Brain) was a multidisciplinary scientific conference focused collateral circulation in acute ischemic stroke. Decisive challenges include generalizability of optimal triage and selection paradigms based status for definitive treatment stroke, rapid dissemination expert methods, urgent need leverage networking opportunities stroke science related hemodynamics collaterals. The collaterome, or individual capacity offset ischemia brain,...
Background: Imaging of stroke due to vertebrobasilar dolichoectasia may not reveal either luminal stenosis or atherosclerotic plaque, leading misdiagnosis mechanism etiology. We leveraged the advanced imaging capabilities computational fluid dynamics (CFD) disclose hemodynamic abnormalities within these complex neurovascular lesions. Methods: CT angiography from a series patients with was selected prospective registry posterior circulation ischemia. A 3D geometric mesh generated CTA source...
ABSTRACT BACKGROUND AND PURPOSE Endovascular therapy (ET) has become the standard of care for selected patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). However, many LVO or medium (MVO) are ineligible ET, including some who harbor salvageable tissues. To develop complementary therapies these patients, it is important delineate their prevalence, clinical features, and outcomes. METHODS In a prospectively maintained database, we reviewed consecutive AIS between...
Background: Noninvasive fractional flow measures with CT angiography (CTA) have revolutionized cardiology, yet the complex anatomy of cerebral circulation and boundary conditions challenge study intracranial atherosclerosis. We developed a framework for systematic computational fluid dynamics (CFD) middle artery (MCA) stenosis CTA in SAMMPRIS. Methods: A 3D geometric mesh was generated from source images, followed by CFD processing Ansys (ICEM, CFX) on Cray supercomputer. Reference were...
<h3>BACKGROUND AND PURPOSE:</h3> The frequency and utility of gadolinium in evaluation acute pediatric seizure presentation is not well known. purpose this study was to assess the gadolinium-based contrast agents MR imaging performed for presentation. <h3>MATERIALS METHODS:</h3> We identified consecutive patients with new-onset seizures from October 1, 2016, September 30, 2021, who presented emergency department and/or were admitted inpatient unit had an brain seizures. clinical data...
Background: Systemic hemodynamic factors may affect blood flow to the brain, yet influence of volume status and use fluid administration improve perfusion in acute ischemic stroke remains unproven. We correlated presence dehydration defined by initial lab values with MRI collaterals at angiography middle cerebral artery (MCA) patients. Methods: Retrospective analysis a consecutive series isolated M1 MCA occlusions was conducted an expert core quantify Tmax volumes, hypoperfusion severity...
Background: Fractional flow across an atherosclerotic lesion measured with TOF-MRA signal intensity ratio (SIR) may be used to gauge hemodynamic severity and predict subsequent stroke. The degree of impairment also ascertained by quantitative MRA (QMRA). We analyzed performance these noninvasive imaging parameters estimate risk posterior circulation events in VERiTAS. Methods: data QMRA were simultaneously acquired SIR derived from TOF source images normalized for analysis volume ratios...
Background: FLAIR lesion burden is an established biomarker in small vessel disease. To examine its role intracranial atherosclerosis, we studied ischemic throughout the brain at baseline or enrollment SAMMPRIS trial and also on serial MRIs medical arm, investigating relationship with recurrent stroke. Methods: We performed blinded measurement of followup DWI images. Baseline volume vascular hyperintensities (FVH) were analyzed respect to variables including prior history, co-morbidities...
Background: Most endovascular stroke therapy studies and subsequent guidelines restrict intervention based on ASPECTS. A wide range of ASPECTS scores may be encountered in practice individual patient benefit realized even at low We examined large-scale data outcomes after therapy, stratified by baseline the Trevo Retriever Registry. Methods: The independent Imaging Core Lab Registry prospectively determines imaging acquired immediately prior to thrombectomy. regional involvement were...
Background: Endovascular thrombectomy trials established efficacy in acute ischemic stroke, yet real-world data on device effectiveness is warranted. Core lab adjudication of angiography required to validate reperfusion, providing evidence and detailed beyond randomized, controlled trials. We report the largest endovascular therapy registry linking independent core reperfusion with clinical outcomes. Methods: The Trevo Retriever Registry a prospective, open-label, consecutive enrollment,...
Background: Collateral status has been shown to be a potent determinant of long-term clinical outcomes in subjects with intracranial atherosclerosis, yet the grading collaterals can challenging. We developed simple collateral metric spatial and temporal hemodynamic changes at anterior borderzone MCA stenoses. Methods: Conventional angiography acquired baseline SAMMPRIS was analyzed subset Two readers independently measured watershed angle (AWSA) or shift on AP views. The relative timing...
Background: The pathophysiology and optimal management of blood pressure changes in acute ischemic stroke remain unknown. Blood guidelines do not consider patient-specific or serial data on dynamic readings. We investigated continuous during endovascular therapy for to discern associated with collaterals, recanalization reperfusion. Methods: Continuous monitoring was collected consecutive cases due ICA proximal MCA occlusion. Angiography details were independently analyzed document site...
Background: Clot characteristics and porosity at the proximal portion of an arterial occlusion may influence potential recanalization. Thrombus permeability be a factor in intravenous thrombolysis, whereas such features clots prior to endovascular thrombectomy remains largely unexplored. We developed technique image clot yield quantitative measures that predict mechanical Methods: Consecutive cases large artery (ICA or M1 MCA) with single-phase CT angiography (CTA) acquired immediately were...
Background: Serial ASPECTS of ischemic stroke lesion evolution from baseline to 24-hours has been established as an effective surrogate endpoint in endovascular therapy. The use this imaging shift not implemented beyond thrombectomy trials estimate impact therapy large-scale registry data. Methods: STRATIS Imaging Core Lab, blind all clinical data, independently determined scores on and 24-hour studies. regional involvement resulting total were analyzed anterior circulation occlusions...
Background: CT angiography (CTA) is routinely acquired in acute ischemic stroke, providing data on extent of collaterals yet current techniques compromise either spatial or temporal resolution. We developed and validated a novel imaging technique from standard single-phase CTA to discriminate both the blood flow features leptomeningeal collaterals. Methods: Consecutive stroke patient data, including (sCTA) followed immediately by digital subtraction (DSA), setting ICA proximal MCA occlusions...
Introduction: Ischemic infarct core grows at variable rates despite early reperfusion. The purpose of this study was to determine the predictors growth full recanalization a large vessel occlusion in acute ischemic stroke. Method: Patients with stroke due ICA or MCA who received endovascular therapy Thrombolysis Cerebral Infarction scale (TICI) scores 2b greater were subsequently selected between July 2012 and May 2016. Alberta Stroke Program Early CT Score (ASPECT) measured on initial MRI...
Background: ASPECTS is routinely used to estimate ischemic lesion burden in acute stroke, yet the topography and influence of collaterals has been unexplored. Imaging selection for endovascular therapy various time epochs may also be simplified with ASPECTS. We leveraged large-scale registry data STRATIS discern role collaterals, other factors at baseline. Methods: The Core Lab, blind all clinical data, independently determined scores regional involvement anterior circulation occlusions....
Background and Purpose: Intracranial atherosclerotic stenosis (ICAS) is a common cause of stroke especially in Asia, but little known about its prevalence ischemic patients North America. We studied the ICAS single comprehensive center leveraging routine acquisition MRI MR angiography (MRA). Methods: retrospectively reviewed with transient attack who were admitted within seven days onset from Jan 2014 to July 2016. Patients we excluded: 1) Age <18 years; 2) without intracranial...