3 randomized trials. 3 positive results. Paradigm shift in the treatment of subdurals. More data coming and much science to learn but this is an encouraging start.
3 randomized trials. 3 positive results. Paradigm shift in the treatment of subdurals. More data coming and much science to learn but this is an encouraging start.
EMBOLISE showed significantly reduction in re-operation amongst patients undergoing adjunctive MMAe in addition to surgery compared to surgery alone. NNT ~12.
@_AdnanSiddiqui
@UB_Neurosurgery
@Medtronic_NV
Today was a five stroke day. Thrombectomy is definitely not the most convenient thing we do, but no doubt it is one of the most rewarding.
@UB_Neurosurgery
Mma embo is especially attractive for older patients in whom more invasive means more risky. Going transradial and awake helps minimize risk for our patients and gets them up and out of the hospital.
4x4 I kept in loupe box chief year. Every day b4 every case make use of time while anesthesia and nursing getting going to grab a mayo stand, microscope, and develop that dexterity. Simulation doesn’t have to be hi-fi to be invaluable
@NeurosurgUCSF
@UB_Neurosurgery
@mtlawton
Great to discuss our latest data on radial stroke. Thanks to
@SNISinfo
@PeterKa80460001
for the invitation (and to
@MikeTso1
for the pic). Punchline - improved techniques and technologies are eliminating the outcomes gap with TFA.
Busy Christmas Day at the hospital - ruptured aneurysm, cav mal, subdural, cervical abscess. Meanwhile, back at the farm, my dog's stuffed tiger apparently had an aneurysm, too.
What an honor to be invited as Visiting Professor
@uk_neurosurgery
. Beautiful part of the country, and what a great program they’ve built. Discussed building an academic career by leveraging the strengths of all the (smarter) people around you.
@DornbosIII_MD
@Doctorjfred
Dedication of the new helipad at Mount st Mary’s hospital - proud to be part of elevating stroke care for the people of Niagara county. Views from mercy flight joy ride over Niagara Falls also not too shabby.
@UB_Neurosurgery
@JacobsInstitute
@CHSBuffalo
Important to continue our educational mission. Thanks to
@JacobsInstitute
and
@microvention
for putting on the webinar. We've made a lot of progress with
#RadialFirst
, but more technique and device development necessary and more docs to convince.
Inspiring grand rounds
@NeurosurgUCSF
by alumni
@JMDaviesMDPhD
, now at SUNY Buffalo, discussing how to use flow/anatomic data to inform
#aneurysm
mgmt and the latest in
#transradial
access. Great example of how to use data to guide mgmt to achieve best outcome for each patient.
Congratulations to graduating chief neurosurgery resident
@kunalraygor
who will be starting an Endovascular Fellowship at
@AANSBuffaloNSIG
under the guidance of Elad Levy, MD MBA, Adnan Siddiqui, MD PhD, and Jason Davies, MD PhD 🎉🎓
#UCSFGrads
Aneurysm treatment has come a long way. Important to understand how better techniques and technologies truly impact patients for the better.
@JacobsInstitute
@UB_Neurosurgery
Disaster averted - middle son officially got his driver’s license today, so won’t have to revert to carpool duty when my oldest flies the coop next month for
@WUSTL
Life is full of transitions. Today a happy one at the 100th Commencement
@parkschoolbflo
->
#stanford26
. “life is a canvas, watch me paint it” -edrys wajed
Next week on our podcast Dr. Jason Davies, MD, PhD, Research Director at the Jacobs Institute and an Assistant Professor of Neurosurgery and Biomedical Informatics at
@UBCommunity
will chat with us about forecasting disease with big data & AI.
@UB_Neurosurgery
@KaleidaHealth
A new CNS Journal Club podcast, Radial Artery Access for Treatment of Posterior Circulation Aneurysms Using the Pipeline Embolization Device: Case Series, with Drs. Erez Nossek and
@JMDaviesMDPhD
, is available now! Access new and past podcasts here:
Join us live or online tomorrow
#AANAM
on the big stage during the Clinical Trials Plenary session for presentation of the EMBOLISE trial of middle meningeal artery embo for subdurals.
@_AdnanSiddiqui
#JaredKnopman
Big data seminar going on now at
#CNS2019
. Learn how AI is changing neurosurgery. Presenting on machine leaning in endovascular treatment of aneurysms.
@CNS_Update
@UB_Neurosurgery
Had a great conversation with the folks at
@NSGYPodcast
about the results of EMBOLISE and the other trials that have shown benefit for mma embolization for non acute subdurals.
Update - quickly and reliably delivers 072 to the clot face. First case wirh
@PenNeuro
Red 072, ulnar walrus access to left carotid with 360 cervical loop. Handled it like a boss.
Join us for big data symposium this afternoon- will be talking about starting your data science research effort. Lots of great examples (ie potential mentors) will be sharing their advice and experience.
@CNS_Update
@UB_Neurosurgery
@JacobsInstitute
#BigDataBuffalo
The key for biaxial
#radialfirst
is to get your benchmark around the horizontal petrous to lock it in and give good support. Usually that’s all you need, avoids big guide in small vessel, and 6fr fits is just about everyone.
@UB_Neurosurgery
Grateful to the
#linncamericas
team for the invite to share results from EMBOLISE, alongside
@AdamArthurMD
sharing STEM. MMA embolization for subdurals works! Tune in Fri morning
@LINNConline
Trying to write a "lay summary" for a grant proposal, and I've got to say that even after taking out all the commas, complex sentence structures, and jargon, still have a ways to go... or maybe we just need a better education system.
Today: 2/7 cases ended up going ulnar. Ultrasound is key. Every case, every time. Can quickly assess options, poke once, and go. The more you use it, the more you see.
In Nice, France for ESMINT - European Society for Minimally Invasive Neurological Therapy. An impressive display of technology and the latest endovascular devices. But here the pendulum has swung away from open surgery . Has the baby been thrown out with the bath water?
We are delighted to invite you to register for a Zoom Webinar on:
New Tool in Neuro-Intervention:
Tips & Tricks using
#Comaneci
as an Adjunct Device in Wide-Neck Aneurysm Coil Embolization led by:
Dr.
@_AdnanSiddiqui
and Dr.
@JMDaviesMDPhD
TRA is my go to for everything, including stroke, but just because we can do it as well as TFA doesn’t mean we’re there quite yet. Still need better devices made appropriate for caliber and angularity coming from radial/ulnar.
Basic embryology of ophthalmic artery (OA): eye is composed of ophthalmic and orbital structures, i.e., retinal and muscular/lacrimal structures. Retina is a part of brain and is supplied by primitive OA composed of "intradural" ventral and dorsal OAs. Primitive OA runs through..
We are thrilled to announce the appointment of Edward Chang, MD as the new Chair of the Department of Neurological Surgery at UCSF! 👏👏 Learn more about him here:
We've got some great ideas for how use AI to revolutionize hemorrhagic and ischemic stroke care. If you're interested in joining the team, reach out.
@UB_Neurosurgery
@JacobsInstitute
Physicians like Dr. Davies,
@JMDaviesMDPhD
, are exploring artificial intelligence as one of the driving forces toward the future. Listen to Dr. Davies' take on AI in our most recent podcast episode. Tune in here or wherever you listen to podcasts.
Early start to a busy weekend. Father-son
#3
date night for our favorite NPR show WWDTM. Son
#2
stuck on a tarmac somewhere on his way back to home base for admit weekend. Son
#1
suffering through finals studying. Off at 5am for flight to
@AANSNeuro
in Philly
Looking for lunch plans
@CNS_Update
? Join us for lunch seminar talking about AI in cerebrovascular imaging. Discussing stroke prediction, aneurysm treatment support, and new horizons.
@UB_Neurosurgery
@JacobsInstitute
Great turnout for the Guangzhou Neuro Thrombectomy Club webinar with over 2000 participating. Transradial BGC works, but for populations with smaller radial arteries, is it viable? More work needed.
@timbo_phillips
Couldn’t agree more. This captures an early snapshot of our experience that no longer reflect our practice. Now routinely using 8fr balloon guide and large bore aspiration through TRA. More to come...
@UB_Neurosurgery
This should be good. Med students - Get to know
@UB_Neurosurgery
and see if we're a good fit for your career goals. You might be pleasantly surprised by what you find.
Excited to announce the
@UB_Neurosurgery
Virtual Sub-Internship. Advance your neurosurgical knowledge, learn surgical skills, and engage with faculty and residents. Apply today on VSAS, check the website to learn more
As has been pointed out many times before - CTP at early timeframes is more about focusing attention on WHERE the clot is rather than ruling out intervention. M3s can be tough
Agree completely with
@VivienHLee
and
@ShahidNimjee
. CTP within 6 hrs is as reckless waste of time, neurons and resources. I’m less and less of a fan of CTP >6 hours out too. If you have an LVO at 15h, unfavorable CTP, high NIHSS and an ASPECTS of 9, then
#GTFVO
Pleased to share the Buffalo experience evolving transradial thrombectomy with our friends across the pond. Join Mon 0800
@UB_Neurosurgery
@JacobsInstitute
We've had a run of CRAO recently
@UB_Neurosurgery
. The key to the case is geometry - anticipate how your wire is going to react to the patient's anatomy (ie pancake siphon, early OphA, tortuous anatomy) and shape accordingly.
@calebcuts
is one of the hardest working residents I have had the pleasure to work with
@NeurosurgUCSF
. Wish we could have gotten him
@UB_Neurosurgery
but he’ll no doubt do great things in Phoenix