Neuroendovascular Devices for Treating Stroke and Vascular Malformation
Tuesday, April 10, 10:30-12:00, Ski-U-Mah, McNamara Alumni Center

Organizer: Afshin A. Divani, PhD, FAHA, Assistant Professor, Departments of Neurology, Neurosurgery and Radiology Director of Stroke Research, University of Minnesota

"Bench-to-bedside translational research in stroke: The era of endovascular and minimally invasive approach"
Afshin A. Divani, PhD, FAHA, Assistant Professor, Departments of Neurology, Neurosurgery and Radiology, Director of Stroke Research, University of Minnesota

"Large animal models for stroke device development and testing"
Andrew W. Grande, MD, Assistant Professor, Department of Neurosurgery, University of Minnesota

"Flow diversion for treatment of cerebrovascular aneurysms: A paradigm shift" 
Bharathidasan Jagadeesan, MD, University of Minnesota

"Endovascular treatment of brain AVMs"
Gustavo J. Rodriguez, MD, Assistant professor, Neurology and Neurosurgery Departments, University of Minnesota

"Hemodynamics and Medical Device Treatment of Cranial Aneurysms"
Ricky Chow, MS, Lake Region Medical

"Novel Methods for Treating Stroke with New Endovascular Devices"
Ramu Tummala, Neurosurgery, Neurology, and Radiology, University of Minnesota

Session Abstract:

Preclinical models of stroke are one of the integral parts in combating devistaing deseases like stroke.  In the past century, a closer collabroation between different discplinces such as enginering and medicine have revolutionized  the field of minimaly invasive surgeries and translumenal catheter based approch for treatment of stroke. In this presentation, the applications of preclinical models of stroke for different minimaly invasive surgical approch for treatment of cerebrovascular diseases are discussed.  

Session Organizer Bio:

Afshin A. Divani, PhD, FAHA, Assistant Professor, Departments of Neurology, Neurosurgery and Radiology Director of Stroke Research, University of Minnesota
Dr. Afshin Divani received his bachelor degree from Youngstown State University, Youngstown, Ohio, and his master and doctorate degree from the State University of New York at Buffalo (SUNY at Buffalo). He has completed a research fellowship in sleep disorder at the Pulmonary and Critical Care Division of Department of Medicine, SUNY at Buffalo. He has also completed a stroke research fellowship at the Department of Neurology and Neurosciences, New Jersey Medical School. Dr. Divani is currently an Assistant Professor in Department of Neurology at University of Minnesota. He also serves as the Director of Stroke Research at the same institution. Dr. Divani has been a primary or co-investigator on different funded projects by the National Institute of Health (NIH), American Heart Association (AHA), and private industry. His research interests include hemodynamics, cerebrovascular diseases, medical and endovascular devices, and medical imaging. Dr. Divani has been a Fellow of American Heart Association (FAHA) and member of various academic and professional organizations including New Jersey Stroke Medical Committee of American Stroke Association. Dr. Divani has contributed to over 60 scientific publications in peer- reviewed journals. In addition, he has contributed to over 200 presentations in various national and international meetings and 4 book chapters. He has mentored over 50 undergraduate and graduate students as well as MDs and residents. Dr. Divani has been served as an Ad Hoc reviewer and an associate editor for various journals and grant agencies including the US Army Medical Research and Materiel Command (USAMRMC) and Henry M. Jackson Foundation for the Advancement of Military Science.

Speaker Bios:

Andrew W. Grande, MD, Assistant Professor, Department of Neurosurgery, University of Minnesota
Andrew Grande is a vascular/endovascular neurosurgeon at the University of Minnesota. Clinically he is involved in the treatment of aneurysms, vascular malformations, trigeminal neuralgia and stroke. He is also the co-director of the Earl Grande Stroke and Stem Cell Laboratory at the University of Minnesota. His research is primarily focused on developing stem cell therapies for the treatment of stroke. Using large animal models of stroke the laboratory has recently begun varifying small rodent studies done in the lab, in which a novel cord blood stem cell line has shown to be beneficial in ameliorating the effects of stroke.

Gustavo J. Rodriguez, MD, Assistant professor, Neurology and Neurosurgery Departments, University of Minnesota
Dr. Rodriguez was the first interventional neurologist to graduate from an ACGME accredited fellowship in Endovascular Surgical Neuroradiology (ESN). Dr. Rodriguez graduated from the University of Santiago de Compostela Medical School in Santiago De Compostela, Spain in 1996. After completing his residency training in neurology at the Xeral-Cies Hospital in Spain, he moved to the United States for additional training, completing neurology training at the University of Medicine and Dentistry in New Jersey, followed by vascular neurology and endovascular surgical neuroradiology fellowships at the University of Minnesota. He is board
certified in neurology and vascular neurology. His interests include interventional neuroradiology and endovascular treatment of acute ischemic stroke, intracranial aneurysms and treatment of arteriovenous malformations with liquid embolic agents. Dr. Rodriguez is the Medical Director of the Hennepin Stroke Center, a Joint Commission certified treatment center for ischemic and hemorrhagic strokes.

Ricky Chow, MS, Lake Region Medical
Ricky Chow earned his BS in Engineering Science at the University of Toronto, his MS in Biomedical Engineering at the University of Minnesota, and is currently a PhD candidate in the Mechanical Engineering department. Ricky Chow is also currently a Research and Development Engineer at Lake Region Medical. Past experience and current interests include CFD simulations of
medical devices, developing animal models, and investigating tissue engineered implants.

Ramu Tummala, Neurosurgery, Neurology, and Radiology at the University of Minnesota
Dr. Tummala is Assistant Professor of Neurosurgery, Neurology, and Radiology at the University of Minnesota. He attended medical school at the University of Alabama at Birmingham and completed neurosurgery residency at the University of Minnesota. He then completed fellowship training in vascular and skull base neurosurgery at the University of Miami and endovascular surgery at the University of Buffalo. Dr. Tummala’s clinical practice is focused on endovascular (catheter based treatments), open cerebrovascular, and skull base surgery. He is a member of the stroke center at the University of Minnesota Medical Center, Fairview and at Hennepin County Medical Center.

Presentation Abstracts:

"Bench-to-bedside translational reserch in stroke: The era of endovascular and minimaly invasive approch"
Preclinical models of stroke are one of the integral parts in combating devistaing deseases like stroke. In the past century, a closer collabroation between different discplinces such as enginering and medicine have revolutionized the field of minimaly invasive surgeries and translumenal catheter based approch for treatment of stroke. In this presentation, the applications of preclinical models of stroke for different minimaly invasive surgical approch for treatment of cerebrovascular diseases are discussed.

"Large animal models for stroke device development and testing"
Rodent models of stroke have been in existance for many years. Despite many promising discoveries for the treatment of stroke in these models, only one has ever proven beneficial in human clinical studies. Phylogenetically, these models don’t accurately reflect human stroke. These is even more meaningful as we contemplate endovascular treatments of stroke in which animal models allowing for catheter delivery of drugs and devices must be tested. Several large animal models of stroke have been developed in canine, swine, rabbit and non-human primate. The pros and cons, in addition to exciting future applications of these models will be discussed.

"Flow diversion for treatment of cerebrovascular aneurysms: A paradigm shift"
Currently available techniques for stroke imaging are suboptimal in their ability to triage patients with acute ischemic stroke for endovascular management. Further evolutions in neuroimaging in the form of combined real time MR PET scanning and MR scanning with F19 labeled tracers may help to better triage patients. Likewise, MR imaging of vascular malformations is also undergoing rapid evolution with the development of phase contrast and Susceptibility weighted techniques that will be discussed.

"Endovascular treatment of brain AVMs"
The overall treatment of arteriovenous malformations is a challenge. Not all cases have clear treatment indications and when treatment is required a multidisciplinary approach is often required. Complete cure is rarely achieved in those cases that are not operable. Therefore, endovascular approach is of great importance is such cases. The methods and techniques have tremendously evolved in the last few years. The contemporary endovascular treatment of brain AVMs will be here discussed.

"Hemodynamics and Medical Device Treatment of Cranial Aneurysms"
Rapid advances in imaging techniques are making high resolution characterization of aneurysms a more routine process. Readily accessible computational simulation tools are allowing for an understanding of the underlying hemodynamics that make some aneurysms more prone to rupture than others. This knowledge is highly useful in the development of a new class of devices, namely flow diverters, which may one day replace coiling as the standard endovascular treatment for intracranial aneurysms.

"Novel Methods for Treating Stroke with New Endovascular Devices"  
It is unknown who is the ideal candidate for acute stroke therapy. While intravenous thrombolysis remains the clinical standard, many patients present outside the window for this treatment. There has been growing interest in intra-arterial methods for stroke therapy. However, selection of candidates for catheter based treatment is variable with institutional and operator practice patterns. We present our experience with various methods in patient selection and outcomes for acute stroke intervention.