A5049315425- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Intracranial Aneurysms: Treatment and Complications
- Traumatic Brain Injury and Neurovascular Disturbances
- Stroke Rehabilitation and Recovery
- Intracerebral and Subarachnoid Hemorrhage Research
- Vascular Malformations Diagnosis and Treatment
- Venous Thromboembolism Diagnosis and Management
- Cerebral Venous Sinus Thrombosis
- Cerebrospinal fluid and hydrocephalus
- COVID-19 and healthcare impacts
- Aortic aneurysm repair treatments
- Moyamoya disease diagnosis and treatment
- Neurological Complications and Syndromes
- Advanced X-ray and CT Imaging
- Advanced Technologies and Applied Computing
- Climate Change and Health Impacts
- Bone Tumor Diagnosis and Treatments
- Long-Term Effects of COVID-19
- Cardiovascular Health and Disease Prevention
- Sarcoma Diagnosis and Treatment
- Renal and Vascular Pathologies
- Congenital Heart Disease Studies
- Cardiovascular Issues in Pregnancy
- Oral and Maxillofacial Pathology
Bon Secours Mercy Health
2024
University of Virginia
2024
New Hanover Regional Medical Center
2022-2023
Novant Health
2023
Boston Medical Center
2021
Universidade Federal do Rio Grande do Sul
2021
Hospital de Clínicas de Porto Alegre
2021
Boston University
2021
Grady Memorial Hospital
2021
University of North Carolina Wilmington
2021
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...
Symptomatic intracranial hemorrhage (sICH) is a serious complication of stroke thrombolytic therapy. Many centers have adopted 0.25-mg/kg tenecteplase instead alteplase for thrombolysis based on evidence from randomized comparisons to as well its practical advantages. There been no significant differences in symptomatic reported clinical trials or published case series the 0.25-mg/Kg dose.
The natural history of acute ischemic stroke (AIS) due to basilar artery occlusion (BAO) is poor. Endovascular reperfusion therapy (EVT) improves recanalization rates in patients with emergent large vessel intracranial occlusion.To examine the hypothesis that good collateral patterns identified by pretreatment CT angiography (CTA) might be associated favorable outcomes after EVT.We conducted a retrospective chart review presenting AIS BAO tertiary care center during 4-year period. was...
High admission blood pressure (BP) levels have been associated with lower recanalization rates after endovascular treatment (EVT) for patients acute ischemic stroke (AIS) emergent large vessel occlusion (ELVO). We sought to evaluate the association of BP early outcomes in ELVO treated EVT.Consecutive AIS presenting a tertiary center during 4-year period were prospectively evaluated. Admission systolic (SBP) and diastolic (DBP) measured using automated cuff recordings. A blinded...
Stent-assisted coil embolization using the new generation Neuroform Atlas Stent System has shown promising safety and efficacy. The primary study results of anterior circulation aneurysm cohort treatment wide-neck, saccular, intracranial, aneurysms with (ATLAS trial [Safety Effectiveness Treatment Wide Neck, Saccular Intracranial Aneurysms With System]) are presented.ATLAS IDE (Investigational Device Exemption) is a prospective, multicenter, single-arm, open-label wide-neck (neck ≥4 mm or...
Endovascular therapy of cerebral venous thrombosis using modern approaches to intracranial recanalization, such as stent retrievers and aspiration thrombectomy, is not well described. We performed a retrospective review data for consecutive patients with sinus who underwent endovascular treatment between 1 January 2010 31 December 2013 at participating institutions. identified total 13 diagnosis thrombosis. The most frequently utilized type intervention was the Penumbra system (Penumbra...
A patient with a giant symptomatic vertebrobasilar aneurysm was treated by endoscopic third ventriculostomy for obstructive hydrocephalus followed treatment of the flow diversion using Pipeline Embolization Device. After an uneventful procedure and initial periprocedural period, experienced unexpected fatal subarachnoid hemorrhage 1 week later. Autopsy demonstrated extensive rupture (linear whole wall rupture). The patent Device in its intended location, as persistent coil occlusion distal...
Background Recent guidelines for endovascular management of emergent large vessel occlusion (ELVO) award top tier evidence to the same selective criteria in recent trials. We aimed understand how guideline adherence would have impacted treatment numbers and outcomes a cohort patients from comprehensive stroke center. Methods A retrospective observational study was conducted using consecutive patients. Mechanical thrombectomy (MT) performed with stent retrievers or bore clot aspiration...
Aneurysmal bone cysts (ABCs) are destructive cystic lesions of the and common in children. They expansile nature and, therefore, may become symptomatic. These have traditionally been treated surgically; but recently, endovascular embolization has shown promise as a stand-alone therapy. The authors describe case an ABC highlighting effectiveness efficiency treatment. A 16-year-old boy was referred for 4-month history radiating back pain urinary hesitancy. Findings from his neurological...
Residual aneurysm after microsurgical clipping carries a risk of growth and rupture. Digital subtraction angiography (DSA) remains the standard to determine adequacy clipping. Intraoperative indocyanine green (ICG) is increasingly utilized confirm optimal clip positioning across neck evaluate adjacent vasculature.We evaluated correlation between ICG DSA in clipped intracranial aneurysms.A retrospective study patients who underwent craniotomy aneurysms with for 2 years. Patient...
A patient with a giant symptomatic vertebrobasilar aneurysm was treated by endoscopic third ventriculostomy for obstructive hydrocephalus followed treatment of the flow diversion using Pipeline Embolization Device. After an uneventful procedure and initial periprocedural period, experienced unexpected fatal subarachnoid hemorrhage 1 week later. Autopsy demonstrated extensive rupture (linear whole wall rupture). The patent Device in its intended location, as persistent coil occlusion distal...
Background Mechanical thrombectomy has become the standard of care for treatment acute ischemic stroke secondary to large‐vessel occlusion up 24 hours from last known normal time. Multiple different techniques mechanical have been described, including a direct aspiration first‐pass technique and stent retriever thrombectomy. With technique, classically, large‐bore catheter is delivered over microcatheter microwire clot. Recently, novel macrowire introduced as potential alternative use...
Hashimoto encephalopathy (HE)—also known as steroid-responsive associated with autoimmune thyroiditis—is a rare syndrome loosely thyroiditis. HE mostly affects middle-aged women; is characterized by delirium, seizures, and myoclonus; thought to be an immune-mediated disorder. The pathophysiology of not entirely understood. Most cases appear due vasculitis or immune complex deposition that disrupts the cerebral microvasculature. This immunologic phenomenon has been observed on brain biopsy...
Following complicated endovascular or microsurgical treatments, assessment of radiographic outcome can be challenging due to device resolution and metallic artifact. Two-dimensional three-dimensional angiography reveal information about flow aneurysm obliteration, but may limited by beam hardening, overlapping vessels, image degradation in the region implants. In this study, we investigated combination a collimated volumetric imaging (volume interest, VOI) protocol followed metal artifact...
Background and Purpose Mechanical thrombectomy (MT) has become the standard of care for treatment acute ischemic stroke secondary to large vessel occlusion up 24 h from last known normal time. With ADAPT SOLUMBRA techniques, classically, a bore aspiration catheter is delivered over microcatheter microwire crossing clot perform thrombectomy. Recently, novel macrowire (Colossus 035 in.) been introduced as potential alternative use microwire-microcatheter allow delivery (ID = 0.070 in. 0.088...
Parenchymal blood volume (PBV) mapping with flat panel detectors may provide real-time estimates of tissue perfusion during endovascular ischemic stroke procedures. We present two cases acute middle cerebral artery (MCA) occlusion to demonstrate how PBV may: (1) be used in stroke; (2) influence intraprocedural decision-making; and (3) potentially serve as a predicator clinical outcome. Both were successfully recanalized embolectomy. Intraprocedural maps obtained immediately before after...
Carotid endarterectomy (CEA) is the established standard to treat occlusive extracranial atherosclerotic carotid disease. Complications of CEA must be recognized and dealt with efficiently due potentially catastrophic neurologic sequelae. A 67-year-old African American man was transferred from an outside hospital for acute stroke. He had initially presented a small right frontal subcortical infarct undergone 2 days prior transfer. fluctuating examination left-sided hemiplegia slight...
Parenchymal blood volume (PBV) mapping with flat panel detectors may provide real-time estimates of tissue perfusion during endovascular ischemic stroke procedures. We present two cases acute middle cerebral artery (MCA) occlusion to demonstrate how PBV may: (1) be used in stroke; (2) influence intraprocedural decision-making; and (3) potentially serve as a predicator clinical outcome. Both were successfully recanalized embolectomy. Intraprocedural maps obtained immediately before after...
Introduction: Despite pharmacological and practical advantages for tenecteplase (TNK) over alteplase (ALT), no differences were observed in percent of symptomatic intracranial hemorrhage (sICH) randomized trials (fewer than 900 total patients either treatment). We compared rates sICH treated with drug, using a large, multicenter, international registry. Methods: The CERTAIN collaboration is an ongoing registry deidentified patient-level data thrombolytic ischemic stroke from various...
Background & Purpose: The outcomes of patients with acute ischemic stroke (AIS) due to basilar artery occlusion (BAO) are poor. Endovascular therapy (EVT) improves rates recanalization. We hypothesized that good collateral patterns by pre-treatment CT Angiography (CTA) would predict favorable outcome after EVT. Methods: conducted a retrospective chart review presenting AIS BAO in tertiary care center during four-year period. was diagnosed CTA all cases, who received EVT as standard care....
<h3>Introduction</h3> Following complex endovascular or microsurgical treatment of aneurysms, volumetric assessment the surgical outcome in angiography suite can be challenging due to device resolution and metallic artefact. We investigated a collimated imaging protocol followed by metal artefact suppression post processing evaluate correct positioning stents, flow diverting devices, coils, clips. <h3>Methods</h3> Under an IRB approved study protocol, ten patients who underwent cerebral...
Carotid endarterectomy (CEA) is the established standard to treat occlusive extracranial atherosclerotic carotid disease. Complications of CEA must be recognized and dealt with efficiently due potentially catastrophic neurologic sequelae. A 67-year-old African American man was transferred from an outside hospital for acute stroke. He had initially presented a small right frontal subcortical infarct undergone 2 days prior transfer. fluctuating examination left-sided hemiplegia slight...