Michael T. Froehler
A5078197329- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Stroke Rehabilitation and Recovery
- Intracranial Aneurysms: Treatment and Complications
- Venous Thromboembolism Diagnosis and Management
- Traumatic Brain Injury and Neurovascular Disturbances
- Peripheral Artery Disease Management
- Vascular Malformations Diagnosis and Treatment
- Ocular Oncology and Treatments
- Neurosurgical Procedures and Complications
- Intracerebral and Subarachnoid Hemorrhage Research
- Advanced X-ray and CT Imaging
- Blood Coagulation and Thrombosis Mechanisms
- Brain Metastases and Treatment
- Cerebral Venous Sinus Thrombosis
- Retinal Diseases and Treatments
- Clinical practice guidelines implementation
- MRI in cancer diagnosis
- Moyamoya disease diagnosis and treatment
- Cardiac, Anesthesia and Surgical Outcomes
- Renal and Vascular Pathologies
- Cardiac Arrest and Resuscitation
- Glaucoma and retinal disorders
- Trauma and Emergency Care Studies
- Retinal Development and Disorders
Vanderbilt University Medical Center
2016-2025
Neurological Surgery
2014-2024
Vanderbilt University
2014-2024
Centre Hospitalier Universitaire de Reims
2024
Swedish Medical Center
2024
Jackson Memorial Hospital
2017-2024
Rhode Island Hospital
2024
Swedish Medical Center
2024
Stony Brook Medicine
2024
Université de Reims Champagne-Ardenne
2024
Background and Purpose— In acute ischemic stroke, fast complete recanalization of the occluded vessel is associated with improved outcomes. We describe a novel measure for newer generation devices: first pass effect (FPE). FPE defined as achieving single thrombectomy device pass. Methods— The North American Solitaire Acute Stroke Registry database was used to identify subgroup. Their baseline features clinical outcomes were compared non-FPE patients. Clinical outcome measures included...
Background: Endovascular treatment with mechanical thrombectomy (MT) is beneficial for patients acute stroke suffering a large-vessel occlusion, although efficacy highly time-dependent. We hypothesized that interhospital transfer to endovascular-capable centers would result in delays and worse clinical outcomes compared direct presentation. Methods: STRATIS (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices Acute Ischemic Stroke) was prospective, multicenter,...
Efficient and timely recanalization is an important goal in acute stroke endovascular therapy. Several studies demonstrated improved clinical outcomes with the stent retriever devices compared Merci device. The of this study was to evaluate role balloon guide catheter (BGC) success a substudy North American Solitaire Acute Stroke (NASA) registry.The investigator-initiated NASA registry recruited 24 sites within America submit demographic, clinical, site-adjudicated angiographic, outcome data...
Mechanical thrombectomy with stent retrievers has become standard of care for treatment acute ischemic stroke patients because large vessel occlusion. The STRATIS registry (Systematic Evaluation Patients Treated With Neurothrombectomy Devices Acute Ischemic Stroke) aimed to assess whether similar process timelines, technical, and functional outcomes could be achieved in a real world cohort as the randomized trials.STRATIS was designed prospectively enroll treated United States Solitaire...
Thrombolytic agents, including tenecteplase, are generally used within 4.5 hours after the onset of stroke symptoms. Information on whether tenecteplase confers benefit beyond is limited. We conducted a multicenter, double-blind, randomized, placebo-controlled trial involving patients with ischemic to compare (0.25 mg per kilogram body weight, up 25 mg) placebo administered 24 time that patient was last known be well. Patients had have evidence occlusion middle cerebral artery or internal...
Importance The effects of moderate systolic blood pressure (SBP) lowering after successful recanalization with endovascular therapy for acute ischemic stroke are uncertain. Objective To determine the futility lower SBP targets (<140 mm Hg or 160 Hg) compared a higher target (≤180 Hg). Design, Setting, and Participants Randomized, open-label, blinded end point, phase 2, clinical trial that enrolled 120 patients who had undergone at 3 US comprehensive centers from January 2020 to...
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...
Background Limited post-marketing data exist on the use of Solitaire FR device in clinical practice. The North American Stent Retriever Acute Stroke (NASA) registry aimed to assess real world performance contrast with results from SWIFT (Solitaire Intention for Thrombectomy) and TREVO 2 (Trevo versus Merci retrievers thrombectomy revascularization large vessel occlusions acute ischemic stroke) trials. Methods investigator initiated NASA recruited sites submit retrospective angiographic...
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...
Current guidelines suggest treating blood pressure above 180/105 mm Hg during the first 24 hours in patients with acute ischemic stroke undergoing any form of recanalization therapy. Currently, no studies exist to guide management treated specifically mechanical thrombectomy. We aimed determine association between parameters within after thrombectomy and patient outcomes.We retrospectively studied a consecutive sample adult who underwent for anterior cerebral circulation at 3 institutions...
Agonism of protease-activated receptor (PAR) 1 by activated protein C (APC) provides neuro- and vasculoprotection in experimental neuroinjury models. The pleiotropic PAR1 agonist, 3K3A-APC, reduces neurological injury promotes vascular integrity; 3K3A-APC proved safe human volunteers. We performed a randomized, controlled, blinded trial to determine the maximally tolerated dose (MTD) ischemic stroke patients.
Recent randomized clinical trials (RCTs) demonstrated the efficacy of mechanical thrombectomy using stent-retrievers in patients with acute ischemic stroke (AIS) large vessel occlusions; however, it remains unclear if these results translate to a real-world setting. The TREVO Stent-Retriever Acute Stroke (TRACK) multicenter Registry aimed evaluate use Trevo device everyday practice.Twenty-three centers enrolled consecutive AIS treated from March 2013 through August 2015 device. primary...
Background and Purpose— Mechanical thrombectomy has been shown to improve clinical outcomes in patients with acute ischemic stroke. However, the impact of balloon guide catheter (BGC) use is not well established. Methods— STRATIS (Systematic Evaluation Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) was a prospective, multicenter study large vessel occlusion treated Solitaire stent retriever as first-line therapy. In this study, an independent core laboratory,...
Intracranial aneurysms (IAs) remain a challenging neurological diagnosis associated with significant morbidity and mortality. There is plethora of microsurgical endovascular techniques for the treatment both ruptured unruptured aneurysms. no definitive consensus as to best option this cerebrovascular pathology. The Aneurysm, Arteriovenous Malformation, Chronic Subdural Hematoma Roundtable Discussion With Industry Stroke Experts discussed practices most promising approaches improve management brain
Background The success of mechanical clot retrieval for acute ischemic stroke may be influenced by the characteristics occlusive thrombus. thrombus can partly characterized CT, as hyperdense vessel sign (HVS) suggests erythrocyte-rich whereas fibrin-rich isodense. We hypothesized that physical determine CT density also likelihood with Merci device. Methods reviewed all cases initially imaged non-contrast before attempted at a single center between 2004 and 2010. Each was blindly assessed...
Background and Purpose— The Solitaire With the Intention for Thrombectomy (SWIFT) thrombectomy revascularization of large vessel occlusions in acute ischemic stroke (TREVO 2) trial results demonstrated improved recanalization rates with mechanical thrombectomy; however, outcomes elderly population remain poorly understood. Here, we report effect age on clinical angiographic outcome within North American Solitaire-FR Stent-Retriever Acute Stroke (NASA) Registry. Methods— NASA Registry...
Background and Purpose- The safety efficacy of mechanical thrombectomy in patients with acute ischemic stroke has been demonstrated. However, the impact stent retriever size on clinical angiographic outcomes is not well established. Methods- This was a retrospective ad hoc analysis data from STRATIS (Systematic Evaluation Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) registry-a prospective, multicenter study large vessel occlusion treated Solitaire retriever. An...
Background and Purpose- Mechanical thrombectomy (MT) devices have led to improved reperfusion clinical outcomes in acute ischemic stroke patients with emergent large vessel occlusions; however, less than one-third of achieve complete reperfusion. Use intraarterial thrombolysis the context MT may provide an opportunity enhance these results. Here, we evaluate use rtPA (recombinant tissue-type plasminogen activator) as rescue therapy (RT) after failed North American Solitaire Stent-Retriever...
In this multicenter study, we sought to evaluate comparative safety and efficacy of combined IV thrombolysis (IVT) mechanical thrombectomy (MT) vs direct MT in emergent large vessel occlusion (ELVO) patients.Consecutive ELVO patients treated with at 6 high-volume endovascular centers were evaluated. Standard outcomes (successful reperfusion [modified Thrombolysis Cerebral Infarction IIb/III], functional independence [FI] Rankin Scale (mRS) score 0-2 3 months], favorable outcome [mRS 0-1...
Background and Purpose— We aimed to compare functional procedural outcomes of patients with acute ischemic stroke none-to-minimal (modified Rankin Scale [mRS] score, 0–1) moderate (mRS 2–3) prestroke disability treated mechanical thrombectomy. Methods— Consecutive adult undergoing thrombectomy for an anterior circulation were prospectively identified at 2 comprehensive centers from 2012 2018. Procedural 90-day compared among mRS scores 0 1 3 using χ , logistic, linear regression tests....
The Solitaire stent retriever registry showed improved reperfusion, faster procedure times, and better outcome in acute stroke patients with large vessel occlusion treated a balloon guide catheter (BGC) compared conventional catheter. goal of this study was to evaluate whether use BGC the Trevo improves outcomes catheter.The TRACK recruited 23 sites submit demographic, clinical, site adjudicated angiographic data on consecutive retriever. at discretion physician.536 anterior circulation (of...
This study investigates clinical outcomes after mechanical thrombectomy in adult patients with baseline Alberta Stroke Program Early CT Score (ASPECTS) of 0 to 5.We included data from the STRATIS Registry (Systematic Evaluation Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) who underwent within 8 hours symptom onset and had available ASPECTS adjudicated by an independent core laboratory. Angiographic were collected, including successful reperfusion (modified...