A5052821294- Intracranial Aneurysms: Treatment and Complications
- Acute Ischemic Stroke Management
- Cerebrovascular and Carotid Artery Diseases
- Intracerebral and Subarachnoid Hemorrhage Research
- Vascular Malformations Diagnosis and Treatment
- Venous Thromboembolism Diagnosis and Management
- Traumatic Brain Injury and Neurovascular Disturbances
- Neurosurgical Procedures and Complications
- Stroke Rehabilitation and Recovery
- Peripheral Artery Disease Management
- Antiplatelet Therapy and Cardiovascular Diseases
- Moyamoya disease diagnosis and treatment
- Neurological Complications and Syndromes
- Aortic Disease and Treatment Approaches
- Spinal Fractures and Fixation Techniques
- Aortic aneurysm repair treatments
- Cardiac Valve Diseases and Treatments
- Neurological Disorders and Treatments
- HIV Research and Treatment
- Spinal Hematomas and Complications
- Cerebrospinal fluid and hydrocephalus
- Meningioma and schwannoma management
- Central Venous Catheters and Hemodialysis
- HIV-related health complications and treatments
- Cerebral Venous Sinus Thrombosis
Abbott Northwestern Hospital
2015-2024
Abbott (United States)
2020
Jose Matias Delgado University
2012-2020
Oxford University Press (United Kingdom)
2020
Associated Radiologists
2013-2020
University of Iowa
2017-2019
Carolinas Medical Center
2017
Mallinckrodt (United States)
2010-2017
Washington University in St. Louis
2010-2017
Brigham and Women's Hospital
2017
<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...
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,...
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...
<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....
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...
The presence of active contrast extravasation (the spot sign) on computed tomography (CT) angiography has been recognized as a predictor hematoma expansion in patients with intracerebral hemorrhage. We aim to systematically characterize the sign identify features that are most predictive and construct scoring system.
The spot sign score is a potent predictor of hematoma expansion in patients with primary intracerebral hemorrhage (ICH). We aim to determine the accuracy this scoring system for prediction in-hospital mortality and poor outcome among survivors ICH.
To compare rates of symptomatic intracranial hemorrhage (SICH) and good clinical outcome at 90 days in patients with ischemic strokes from anterior circulation emergent large vessel occlusions (ELVO) treated mechanical thrombectomy using either Solumbra or A Direct Aspiration first-Pass Thrombectomy (ADAPT) techniques.We compared characteristics, procedural variables, outcomes ELVOs a ADAPT technique our institution over 38-month period. SICH was defined the SITS-MOST criteria. as modified...
Background There is wide variability in the reported incidence of perioperative thromboembolic (0–14%) and hemorrhagic (0–11%) complications after Pipeline Embolization Device (PED) procedures for cerebral aneurysm treatment, which could be partly due to differences patient response P2Y12 receptor antagonist administered while PED endothelializes. This study aims identify an optimal pre-procedure reaction units (PRU) value range determine independent predictors procedures. Methods We...
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...
A recent study identified a preprocedural P2Y12 reaction units value of <60 or >240 as strong independent predictor perioperative thromboembolic and hemorrhagic complications after treatment cerebral aneurysms with the Pipeline Embolization Device. This aimed to determine whether last-recorded predicts up 6 months Device in same patient cohort.We recorded aneurysm characteristics, receptor antagonist administered, VerifyNow, procedural variables, procedures at our institution during an...
We retrospectively evaluated the composition of retrieved clots from ischemic stroke patients to study association between histological and etiology METHODS: Consecutive enrolled in Stroke Thromboembolism Registry Imaging Pathology (STRIP) were included this study. All underwent mechanical thrombectomy sent a central core lab for processing. Histological analysis was performed using martius scarlet blue (MSB) staining, quantification red blood cells (RBCs), white (WBCs), fibrin platelets...
The US Woven EndoBridge Intra-saccular Therapy (WEB-IT) study is a pivotal, prospective, single arm, investigational device exemption to evaluate the safety and effectiveness of WEB for treatment wide neck bifurcation aneurysms (WNBAs). We present complete 5 year data cohort 150 patients.150 patients with WNBAs were enrolled at 21 six international centers. Imaging from index procedure, 6 month, 1 year, 3 follow-up reviewed by core laboratory. Adverse events adjudicated clinical...
<b>BACKGROUND AND PURPOSE:</b> Multidetector CT angiography (MDCTA) is emerging as the favored initial diagnostic examination in evaluation of patients presenting with spontaneous intraparenchymal hemorrhage (IPH). This study aims to evaluate accuracy and yield MDCTA for detection vascular etiologies adult emergency department IPH. <b>MATERIALS METHODS:</b> We conducted a retrospective 623 consecutive IPH, who were evaluated during 9-year period. angiograms reviewed by 2 neuroradiologists...
To determine the prevalence of trauma-related dural venous sinus thrombosis (DVST) in high-risk patients with blunt head trauma who are examined multidetector computed tomographic (CT) venography.With institutional review board approval, HIPAA compliance, and waived informed consent, authors retrospectively studied findings 195 consecutive presented to emergency department acute were CT venography because they considered be at high risk for DVST owing presence a fracture near or jugular bulb...
Variability in response to clopidogrel therapy is increasingly being recognized as an important factor thromboembolic and hemorrhagic complications encountered after neurointerventional procedures. This study aims determine the variability associated patients undergoing endovascular treatment of unruptured cerebral aneurysms.We recorded baseline patient characteristics, co-administered medications, P2Y12 reaction units (PRU) values with VerifyNow, dosing, aneurysms at our institution during...
Background and Purpose- Nearly 30% of large vessel occlusion acute ischemic stroke clots are from an unknown source. We assessed histological clot composition in a series patients with investigated correlations between pathogenesis. Methods- As part the multi-institutional STRIP registry (Stroke Thromboembolism Registry Imaging Pathology), consecutive emboli retrieved during mechanical thrombectomy were stained using Martius Scarlett Blue analyzed machine learning software. proportions red...
To report the efficacy of A Direct Aspiration first-Pass Thrombectomy (ADAPT) technique with larger-bore ACE aspiration catheters as first-line treatment for anterior circulation emergent large vessel occlusions (ELVOs), and assess presence a first-pass effect ADAPT.We retrospectively reviewed 152 consecutive patients ELVOs treated ADAPT using ACE60, 64, or 68 at our institution. Baseline characteristics, procedural variables, modified Rankin Scale (mRS) 90 days were recorded.Fifty-seven...
Stroke is the leading cause of adult disability in North America and fifth most common death.1 ,2 The natural history patients with acute ischemic stroke occlusion a major intracranial vessel such as internal carotid artery (ICA), middle cerebral (MCA), or basilar dismal, high rates mortality low disability-free survival.3 ,4 We introduce term ‘Emergent Large Vessel Occlusion (ELVO)’ to describe this clinical scenario. Among stroke, ELVO accounts for greatest proportion long-term...
Ischemic stroke is a leading cause of death and disability worldwide. Much the long-term occurs in patients with Emergent Large Vessel Occlusion (ELVO). In fact, these patients, occlusion major intracerebral artery results large area brain injury often resulting
Recent randomized clinical trials1–5 established the superiority of endovascular recanalization techniques, specifically mechanical embolectomy, compared with best medical therapy alone for treatment patients emergent large vessel occlusion (ELVO) stroke. ELVO stroke is defined as a secondary to anterior circulation (LVO) internal carotid, middle cerebral (M1 segments) arteries documented by imaging, without completed infarct and presenting within 6 hours symptom onset.6 Given overwhelming...
Background Current studies on clot characterization in acute ischemic stroke focus fibrin and red blood cell composition. Few have examined platelet composition clots. We characterize using the Martius Scarlet Blue stain assess associations between density CT density. Materials method Histopathological analysis of clots collected as part multi-institutional STRIP registry was performed quantified Orbit Image Analysis (www.orbit.bio) machine learning software. Prior to endovascular treatment,...
CT angiography (CTA) is receiving increased attention in intracerebral hemorrhage (ICH) for its role ruling out vascular abnormalities and potentially predicting ongoing bleeding. Its use limited by the concern contrast induced nephropathy (CIN); however, magnitude of this risk not known.We performed a retrospective analysis prospectively collected cohort consecutive patients with ICH presenting to single tertiary care hospital from 2002 2007. Demographic, clinical, radiographic data were...
Background and Purpose— To determine the accuracy of susceptibility-weighted MRI (SWI) for detection arteriovenous shunting (AVS) in vascular malformations brain (BVM). Methods— We retrospectively identified 60 patients who had been evaluated known or suspected BVM by both SWI digital subtraction angiography, without intervening treatment, during a 3-year period. images were assessed 2 independent reviewers presence AVS as determined signal hyperintensity within venous structure vicinity...