Steven J. Barrer, MD, FACS
Director, Neurosciences Institute
Pursuit of Neurovascular Excellence
6th Annual Conference
October 10, 2014
1
Christiaan Barnard
Andreas Gruentzig
Sean Mullen
Galen 129-217 CE
John Hunter
Victor Horsley
Antonio Moniz – Cerebral Angiography
Harvey Cushing – Father of Modern Neurosurgery
Selverstone Clamp
Suture Ligature
Walter Dandy, M.D.
Spring Loaded Aneurysm Clip
Operating Microscope
Gazi Yasargil, M.D.
Detachable Balloon Embolization
Detachable Platinum Coil
Neurovascular Associates of Abington
Dan Gzesh, M.D.
Debi Murphy, C.R.N.P.
B. Franklin Diamond, M.D.
ACTIVE CLINICAL TRIALS
ACE: An Aneurysm Coiling Efficiency Study of the Penumbra Coil 400 System. A prospective multi-center study of patients with
intracranial aneurysms, peripheral aneurysms or other malformations who are treated by the PC 400 system.
Sponsor: Penumbra, Inc.
Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH)-II: A Phase III Randomized Multicenter Clinical Trial of Blood
Pressure Reduction for Hypertension in Acute Intracerebral Hemorrhage.
Sponsor: NIH/NINDS
CLEAR III: Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage Phase III: The objective of this study is to
determine the long-term effects of lysing ventricular blood clots with rT-PA on functional outcomes of cerebral hemorrhage
patients.
Sponsor: NIH/NINDS
ESCAPE: Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke: The purpose of the study is to
understand whether a new treatment of stroke - endovascular clot removal - can be added to the current standard of care to
improve patient outcomes.
Sponsor: University of Calgary
GAMES-RP: Glyburide Advantage in Malignant Edema and Stroke - Remedy Pharmaceuticals: The purpose of the study is to
demonstrate the efficacy of RP-1127 compared to placebo in subjects with a severe anterior circulation ischemic stroke who are
likely to develop malignant edema.
Sponsor: Remedy Pharmaceuticals, Inc.
Intravascular Cooling in the Treatment of Stroke 2/3 Trial (ICTus 2/3). A Phase 2/3 Study of Intravenous Thrombolysis and
Hypothermia for Acute Treatment of Ischemic Stroke. The purpose of this study is to determine whether the combination of
thrombolysis and hypothermia is superior to thrombolysis alone for the treatment of ischemic stroke.
Sponsor: NIH/NINDS
MISTIE III Minimally Invasive Surgery Plus Rt-PA for ICH Evacuation Phase III: A phase III, randomized, case-controlled, open-label,
500-subject clinical trial of minimally invasive surgery plus rt-PA in the treatment of intracerebral hemorrhage (ICH).
Sponsor: NIH/NINDS and Dr. Daniel Hanley
Moyamoya Disease Treatment Evaluation: A descriptive pilot study that aims to evaluate the changes in the patient’s neurologic
and cognitive function following surgical treatment for Moyamoya disease. Pre-treatment and post-treatment evaluations of the
patients’ neurologic function and status, cognitive and psychological functioning and imaging studies will be performed. The aim
is to gain a better understanding of the cognitive and functional impact of Moyamoya disease after surgical intervention.
Sponsor: Innovators’ Circle Grant/Abington Memorial Hospital
Carotoid Artery Surgery
Carotoid Endarterectomy
Frederick Simeone at
the Simeone Museum
NASCET
ACAS
AMH Series- Results
Major Complications
• Death• Ipsilateral stroke
• MI
5
3
7
(1.5%)
(0.9%)
(2.1%)
• TIA
• Post-op occlusion
9
6
(2.7%)
(1.8%)
STA-MCA Bipass
Moya Moya Disease
EDAS Procedure
Post EDAS
ORTHOPEDIC
&
SPINE INSTITUTE WITH
NEUROSURGERY
37
Myelogram
Pedicle Screw
Pneumoencephalogram Chair
First
Generation CT
Scan
Sir Godfrey Hounsfield
Nobel prize 1979 shared
with Allan Cormack
First
Generation CT
Scan
Interoperative Neuro Navigation
Thank You