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Steven J. Barrer, MD, FACS Director, Neurosciences Institute

Pursuit of Neurovascular Excellence 6th Annual Conference

October 10, 2014

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

• Death- 5 (1.5%) • Ipsilateral stroke 3 (0.9%) • MI 7 (2.1%)

• TIA 9 (2.7%) • Post-op occlusion 6 (1.8%)

AMH Series- Results Major Complications

STA-MCA Bipass

Moya Moya Disease

EDAS Procedure

Post EDAS

ORTHOPEDIC & SPINE INSTITUTE WITH

NEUROSURGERY

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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