Third Stage: After

Improve quality-of-life for our patients after they leave the hospital through addressing the medical and mental health burden following stroke and other neurological conditions.

Research Projects

Memories Retrieved by the Solitaire Stentriever: Acute Stroke from the First-Person Perspective

This qualitative narrative medicine study, done in conjunction with Mount Sinai Department of Neurosurgery, is attempting to show the benefits of thrombectomy devices while also giving a voice to both stroke patients and their caregivers of what going through a stroke is like, firsthand. The stroke patient, or their caregiver, will be interviewed multiple times throughout the initial treatment and at post-op check-ups. Their answers will help give them a voice and space to be heard within the medical community and will in turn help the medical community gain invaluable insight into the needs of their patients. Patients who have suffered a stroke and underwent stroke thrombectomy and their caregivers are the main focus of this study. 

STAR: Stroke Thrombectomy and Aneurysm Registry

The stroke thrombectomy and aneurysm registry (STAR), sponsored by Medical University of South Carolina, is a multicenter initiative including centers across the U.S. and the globe to track patient outcomes following a stroke thrombectomy or endovascular aneurysm treatment using data from real-world practice. The registry serves as a data source for answering questions relevant to patient selection, the effects of new interventions and techniques, and predictors of technical and clinical outcomes. All patients who are undergoing surgical interventions for central nervous system vascular legions will be included. 

Clinical Outcomes of Vasospasm

This retrospective study of the population of subarachnoid hemorrhage patients attempts to bridge the gap in knowledge between the different types of screening methods used to detect vasospasm and their respective patient’s clinical outcomes. Ultimately, we would like to discover the associations between screening method, frequency of testing, and clinical outcomes in relation to vasospasm occurrence.

Vasospasm Computational Fluid Dynamics

This retrospective study incorporates computational fluid dynamics (CFD), computed tomography angiograms (CTA), and Transcranial Doppler (TCD) wave forms obtained from patients presenting with subarachnoid hemorrhage (SAH) and vasospasm. CTA images taken prior to balloon angioplasty treatment of vasospasm are analyzed using computer simulations. Using this data, we hope to develop an effective model for predicting the likelihood of vasospasm and its location in SAH patients. 

Volcano: Doppler Flow Wires in Cerebral Angiography

This study aims to identify the hemodynamic factors associated with treatment success or failure after cerebral angiogram for patients with neurological diseases of the blood vessels using patient–specific blood flow measurements and computational fluid dynamics modeling. Our objective is to improve the treatment process by standardizing the deployment of coils and stents depending on the shape, location, and size of the aneurysm. The patient population is comprised of patients undergoing cerebral angiograms for neurological diseases of the blood vessels. 

Durability: Durability of Endovascular Treatment of Pericallosal Artery Aneurysms, Coiling vs. Flow Diversion

This study, sponsored by the Medical University of South Carolina, hopes to improve the care of patients with pericallosal aneurysms by comparing the outcomes of the two most common treatments: coil embolization and flow diversion embolization. To do this, delayed complications, need for retreatment, functional outcome, and mortality rates between the two methods will be analyzed and compared.  

Detection of Peripheral Arterial Emboli using Doppler Ultrasound

This project aims to uncover the relationship between blood clots outside the brain and the occurrence of emboli in the cerebral vasculature as well as their associated risk of stroke. The occurrence of emboli in the cerebral vasculature is thought to correspond with the risk of stroke. Therefore, by performing peripheral arterial Doppler ultrasound scans on patients at risk of stroke as well as standard-of-care cerebral transcranial Doppler (TCD) ultrasound scans in adult cardioembolic stroke patients we hope to determine that the detection of emboli in the peripheral vasculature corresponds to the risk of stroke. 

Depression: Preventative Treatment of Depression in Survivors of Aneurysmal Subarachnoid Hemorrhage

With the support of the Brain Aneurysm Foundation, this randomized drug trial aims to use control, intervention, and observational groups of aneurysmal subarachnoid hemorrhage (aSAH) stroke survivors to assess for depression and quality–of–life after treatment. Enrolled patients will be randomized into either a control group, which receives a placebo medication, or an intervention group, which will receive fluoxetine, a selective serotonin reuptake inhibitor (SSRI) antidepressant. Patients will be evaluated for depression and health care-related quality of life immediately after treatment of aSAH and three more times in the span of a year after discharge. 

Improving the computational modeling of coiled cerebral aneurysms through synchrotron microtomography

Our National Institute of Health (NIH) National Institute of Neurological Disorders and Stroke (NINDS) R01 funded project titled Improving the computational modeling of coiled cerebral aneurysms through synchrotron microtomography seeks to develop a clinically applicable coil modeling toolkit based on novel homogenization methods through looking at adult patients undergoing coil or stent-coil treatments of unruptured aneurysms. By creating this toolkit, we will be able to improve the accuracy of computational fluid dynamic (CFD) modeling of aneurysm coils without the use for microtomography to identify the factors associated with disease progression. Also, we wish to quantify the shortcomings of simplified porous medium approach to CFD.

AHA Platelets: Improving the computational modeling of cerebral aneurysms treated with flow-diverting stents utilizing platelet activation simulations

With support from the American Heart Association we use computer representations of actual patients’ brain blood vessels with cerebral aneurysms to simulate blood flow in and around the aneurysms before and after treatment with flow-diverting stents. We apply a special computer modeling technique that simulates thousands of individual platelets within the computer simulation of blood flow to understand how flow-diverting stents cause platelets to activate, leading to clotting within the aneurysm and eventual aneurysm healing. We also create precise 3D-printed physical models of the blood vessels and aneurysms of each patient, and pump a special blood-like fluid through these models to validate the accuracy of computer simulation. We use high-speed cameras and lasers to measure the speed of the blood flow within the aneurysm models, including measuring tiny microparticles in the fluid that act like platelets. The final result of this project will be a computer simulation technique that allows for accurate prediction of cerebral aneurysm treatment outcome. 

Support the SANS Center in discovering ways to understand, treat, and prevent stroke, cerebrovascular disease, and other neurological disorders​

Come Meet Us Up Close

Stroke

Memories Retrieved by the Solitaire Stentriever: Acute Stroke from the First-Person Perspective

Endovascular Aneurysm

Stroke Thrombectomy and Aneurysm Registry

Vasospasm

Clinical Outcomes of Vasospasm

Vasospasm and Subarachnoid Hemorrhage

Vasospasm Computational Fluid Dynamics

Neurological Diseases of the Blood Vessels

Doppler Flow Wires in Cerebral Angiography (Volcano)

Pericallosal Aneurysms

Durability: Durability of Endovascular Treatment of Pericallosal Artery Aneurysms, Coiling vs. Flow Diversion

Peripheral Arterial Emboli

Detection of Peripheral Arterial Emboli using Doppler Ultrasound

Depression

Preventative Treatment of Depression in Survivors of Aneurysmal Subarachnoid Hemorrhage

Cerebral Aneurysm

Improving the Computational Modeling of Coiled Cerebral Aneurysms through Synchotron Microtomography

Cerebral Aneurysms

Improving the Computational Modeling of Cerebral Aneurysms treated with flow-diverting stents utilizing platelet activation simulation