15 results on '"Woodward, Keith"'
Search Results
2. The Dotter method revisited: early experience with a novel method of rapid internal carotid artery revascularization in the setting of acute ischemic stroke
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Woodward, Keith, Wegryn, Scott, Staruk, Carla, and Nyberg, Eric M
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- 2016
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3. Intravenous alteplase has different effects on the efficacy of aspiration and stent retriever thrombectomy: analysis of the COMPASS trial.
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Mokin, Maxim, Waqas, Muhammad, Fifi, Johanna T., de De Leacy, Rea, Fiorella, David, Levy, Elad I., Snyder, Kenneth, Hanel, Ricardo A., Woodward, Keith, Chaudry, Imran, Rai, Ansaar T., Frei, Donald, Delgado Almandoz, Josser E., Kelly, Michael, Arthur, Adam S., Baxter, Blaise W., English, Joey, Linfante, Italo, Fargen, Kyle M., and Turk, Aquilla
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ARTERIAL occlusions ,STATISTICS ,INTRAVENOUS therapy ,RESPIRATORY aspiration ,MULTIVARIATE analysis ,CEREBRAL infarction ,SURGICAL stents ,DECISION support systems ,TREATMENT effectiveness ,THROMBECTOMY ,DESCRIPTIVE statistics ,DATA analysis ,DATA analysis software ,TISSUE plasminogen activator - Abstract
Background There is conflicting evidence on the utility of intravenous (IV) alteplase in patients with emergent large vessel occlusion (ELVO) treated with mechanical thrombectomy (MT). Methods This was a post hoc analysis of the COMPASS: a trial of aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion. We compared clinical, procedural and angiographic outcomes of patients with and without prior IV alteplase administration. Results In the COMPASS trial, 235 patients had presented to the hospital within the first 4 hours of stroke symptom onset and were eligible for analysis. On univariate analysis, administration of IV alteplase prior to MT was found to be significantly associated with favorable outcomes (modified Rankin scale (mRS) 0--2 at 3 months; 55.6% vs 40.0% in the MT-only group, P=0.037). However, on multivariate analysis, only baseline (pre-stroke) mRS, admission National Institutes of Health Stroke Scale (NIHSS) score and age were identified as independent predictors of favorable outcomes at 3 months. We found higher final thrombolysis in cerebral infarction (TICI) 2b/3 rates in patients without the use of alteplase prior to the aspiration first approach (100.0% vs 87.9% in IV altepase +aspiration first MT, P=0.03). In the stent retriever first group, final TICI 2b/3 rates were identical in patients with and without IV alteplase administration (87.5% and 87.5%, P=1.0). Conclusions Prior administration of IV alteplase may adversely affect the efficacy of aspiration, but does not seem to influence the stent retriever first approach to MT in patients with anterior circulation ELVO. [ABSTRACT FROM AUTHOR]
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- 2022
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4. Primary results of the Vesalio NeVa VS for the Treatment of Symptomatic Cerebral Vasospasm following Aneurysm Subarachnoid Hemorrhage (VITAL) Study
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Gupta, Rishi, primary, Woodward, Keith, additional, Fiorella, David, additional, Woo, Henry H, additional, Liebeskind, David, additional, Frei, Donald, additional, Siddiqui, Adnan, additional, De Leacy, Reade, additional, Hanel, Ricardo, additional, Elijovich, Lucas, additional, and Maud, Alberto, additional
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- 2021
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5. Primary results of the Vesalio NeVa VS for the Treatment of Symptomatic Cerebral Vasospasm following Aneurysm Subarachnoid Hemorrhage (VITAL) Study.
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Gupta, Rishi, Woodward, Keith, Fiorella, David, Woo, Henry H., Liebeskind, David, Frei, Donald, Siddiqui, Adnan, de De Leacy, Rea, Hanel, Ricardo, Elijovich, Lucas, and Maud, Alberto
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RESEARCH ,CLINICAL trials ,CEREBRAL angiography ,SURGICAL equipment ,CEREBRAL vasospasm ,SUBARACHNOID hemorrhage ,TREATMENT effectiveness ,DESCRIPTIVE statistics ,INTRACRANIAL aneurysms ,PATIENT safety ,LONGITUDINAL method ,DISEASE complications - Abstract
Background Cerebral vasospasm (CV) after aneurysmal subarachnoid hemorrhage (aSAH) is linked to worse neurological outcomes. The NeVa VS is a novel cerebral dilation device based on predicate stent retrievers. We report the results of the Vesalio NeVa VS for the Treatment of Symptomatic Cerebral Vasospasm following aSAH (VITAL) Study. Methods This was a single-arm prospective multicenter trial to assess the safety and probable benefit of the NeVa VS device to treat CV. Patients were screened and treated if they had CV >50% on non-invasive imaging confirmed by cerebral angiography. The vessel diameters were measured before and after treatment by an independent core laboratory. The primary endpoint was ≥50% vessel diameter immediately after treatment with the NeVa VS device. Results Thirty patients with a mean age of 52±11 years and mean Hunt-Hess grade of 3.1±0.9 were enrolled. A total of 74 vessels were treated with an average of 1.3 deployments per vessel (95 deployments total). The mean pre-treatment narrowing of the target vessel (n=74) was 65.6% with reduction of the narrowing to 29.4% after treatment. The primary endpoint was achieved in 64 of 74 vessels (86.5%). In three of 95 total deployments (3.2%), thrombus at the site of deployment was observed during the procedure without apparent neurological sequelae. Conclusions The NeVa VS device appears to be a safe treatment to regain vessel diameter in severely narrowed intracranial arteries secondary to CV associated with aSAH. This treatment offers a new tool that allows for controlled vessel expansion to treat CV. [ABSTRACT FROM AUTHOR]
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- 2022
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6. POSITIVE: Perfusion imaging selection of ischemic stroke patients for endovascular therapy
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Mocco, J, primary, Siddiqui, Adnan H, additional, Fiorella, David, additional, Alexander, Michael J, additional, Arthur, Adam S, additional, Baxter, Blaise W, additional, Budzik, Ronald F, additional, Froehler, Michael T, additional, Hanel, Ricardo A, additional, Lena, Jonathan, additional, Persaud, Steven, additional, Puri, Ajit S, additional, Rai, Ansaar T, additional, Wintermark, Max, additional, Woodward, Keith, additional, Zhang, Xiangnan, additional, and Turk, Aquilla, additional
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- 2021
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7. AngioSuite: an accurate method to calculate aneurysm volumes and packing densities
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Woodward, Keith and Forsberg, David A
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- 2013
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8. POSITIVE: Perfusion imaging selection of ischemic stroke patients for endovascular therapy.
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Mocco, J., Siddiqui, Adnan H., Fiorella, David, Alexander, Michael J., Arthur, Adam S., Baxter, Blaise W., Budzik, Ronald F., Froehler, Michael T., Hanel, Ricardo A., Lena, Jonathan, Persaud, Steven, Puri, Ajit S., Rai, Ansaar T., Wintermark, Max, Woodward, Keith, Zhang, Xiangnan, and Turk, Aquilla
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RESEARCH ,CONFIDENCE intervals ,ISCHEMIC stroke ,PATIENT selection ,MEDICAL cooperation ,MAGNETIC resonance imaging ,FISHER exact test ,RADIONUCLIDE imaging ,RANDOMIZED controlled trials ,T-test (Statistics) ,STROKE patients ,DESCRIPTIVE statistics ,ENDOVASCULAR surgery ,DATA analysis software ,ODDS ratio ,PERFUSION ,LONGITUDINAL method ,CEREBRAL ischemia - Abstract
Background The PerfusiOn imaging Selection of Ischemic sTroke patIents for endoVascular thErapy (POSITIVE) trial was designed to evaluate functional outcome in patients with emergent large vessel occlusion (ELVO) presenting within 0--12 hours with pre- specified bifurcated arms of early and late window presentation, who were selected for endovascular thrombectomy with non- vendor specific commercially available perfusion imaging software. Recent trials demonstrating the benefit of thrombectomy up to 16-- 24 hours following ELVO removed equipoise to randomize late window ELVO patients and therefore the trial was halted. Methods Up to 200 patients were to be enrolled in this FDA- cleared, prospective, randomized, multicenter international trial to compare thrombectomy and best medical management in patients with ELVO ineligible for or refractory to treatment with IV tissue plasminogen activator (IV- tPA) selected with perfusion imaging and presenting within 0--12 hours of last seen normal. The primary outcome was 90- day clinical outcome as measured by the raw modified Rankin Scale (mRS) with scores 5 and 6 collapsed (mRS shift analysis). Results The POSITIVE trial suspended enrollment with the release of results from the DAWN trial and was stopped after the release of the DEFUSE 3 trial results. Thirty- three patients were enrolled (21 for medical management and 12 for thrombectomy). Twelve of the 33 patients were enrolled in the 6--12 hour cohort. Despite the early cessation, the primary outcome demonstrated statistically significant superior clinical outcomes for patients treated with thrombectomy (P=0.0060). The overall proportion of patients achieving an mRS score of 0--2 was 75% in the thrombectomy cohort and 43% in the medical management cohort (OR 4.00, 95% CI 0.84 to 19.2). Conclusion POSITIVE supports the already established practice of delayed thrombectomy for appropriately selected patients presenting within 0--12 hours selected by perfusion imaging from any vendor. The results of the POSITIVE trial are consistent with other thrombectomy trials. The statistically significant effect on functional improvement, despite the small number of patients, reinforces the robust benefits of thrombectomy. [ABSTRACT FROM AUTHOR]
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- 2022
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9. Clot perviousness is associated with first pass success of aspiration thrombectomy in the COMPASS trial
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Mokin, Maxim, primary, Waqas, Muhammad, additional, Fifi, Johanna, additional, De Leacy, Reade, additional, Fiorella, David, additional, Levy, Elad I, additional, Snyder, Kenneth, additional, Hanel, Ricardo, additional, Woodward, Keith, additional, Chaudry, Imran, additional, Rai, Ansaar T, additional, Frei, Donald, additional, Delgado Almandoz, Josser E, additional, Kelly, Michael, additional, Arthur, Adam S, additional, Baxter, Blaise W, additional, English, Joey, additional, Linfante, Italo, additional, Fargen, Kyle M, additional, Turk, Aquilla, additional, Siddiqui, Adnan H, additional, and Mocco, J, additional
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- 2020
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10. Clot perviousness is associated with first pass success of aspiration thrombectomy in the COMPASS trial.
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Mokin, Maxim, Waqas, Muhammad, Fifi, Johanna, de De Leacy, Rea, Fiorella, David, Levy, Elad I., Snyder, Kenneth, Hanel, Ricardo, Woodward, Keith, Chaudry, Imran, Rai, Ansaar T., Frei, Donald, Delgado Almandoz, Josser E., Kelly, Michael, Arthur, Adam S., Baxter, Blaise W., English, Joey, Linfante, Italo, Fargen, Kyle M., and Turk, Aquilla
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THROMBOSIS risk factors ,STATISTICS ,CONFIDENCE intervals ,CEREBRAL infarction ,MULTIVARIATE analysis ,VEIN surgery ,TREATMENT effectiveness ,THROMBECTOMY ,DESCRIPTIVE statistics ,ANGIOGRAPHY ,DATA analysis ,ODDS ratio - Abstract
Background Clot density (Hounsfield units, HU) and perviousness (post- contrast increase in the HU of clot) are thought to be associated with clot composition. We evaluate whether these imaging characteristics were associated with angiographic outcomes of aspiration and stent retriever thrombectomy in COMPASS: a trial of aspiration thrombectomy versus stent retriever thrombectomy as first- line approach for large vessel occlusion. Methods Clot density and perviousness were measured by two independent operators who were blind to all the final angiographic and clinical outcomes. The association of clot density and perviousness with the Thrombolysis In Cerebral Infarction (TICI) scale after first pass was assessed using univariate and multivariate analysis. Results Among all patients enrolled in COMPASS, 165 were eligible for the post- hoc analysis (81 patients in the aspiration first and 84 in the stent retriever first groups). Overall mean perviousness of clot was significantly higher in patient with mTICI 2b-3 after first pass (28.6±22.9 vs 20.3±19.2, p=0.017). Mean perviousness among patients who achieved TICI 2c/3 versus TICI 2b versus TICI 0- 2a in the aspiration first group varied significantly (32.6±26.1, 35.3±24.4, and 17.7±13.1, p=0.013). The association of perviousness with first pass success was not significant in the stent retriever group. Using multivariate analysis, high perviousness (defined as cut- off >27.6) was an independent predictor of TICI 2b-3 (OR 3.82, 95% CI 1.10 to 13.19; p=0.034). Conclusions Clot perviousness is associated with first pass angiographic success in patients treated with the aspiration first approach for thrombectomy. [ABSTRACT FROM AUTHOR]
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- 2021
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11. An international multicenter retrospective study to survey the landscape of thrombectomy in the treatment of anterior circulation acute ischemic stroke: outcomes with respect to age
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Martini, Michael, primary, Mocco, J, additional, Turk, Aquilla, additional, Siddiqui, Adnan H, additional, Fiorella, David, additional, Hanel, Ricardo, additional, Woodward, Keith, additional, Rai, Ansaar, additional, Frei, Don, additional, Delgado Almandoz, Josser E, additional, Kelly, Michael E, additional, Peeling, Lissa, additional, Arthur, Adam S, additional, Baxter, Blaise, additional, English, Joey, additional, Linfante, Italo, additional, and De Leacy, Reade, additional
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- 2019
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12. ‘Real-world’ comparison of first-line direct aspiration and stent retriever mechanical thrombectomy for the treatment of acute ischemic stroke in the anterior circulation: a multicenter international retrospective study
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Martini, Michael, primary, Mocco, J, additional, Turk, Aquilla, additional, Siddiqui, Adnan H, additional, Fiorella, David, additional, Hanel, Ricardo A, additional, Woodward, Keith, additional, Rai, Ansaar, additional, Frei, Don, additional, Delgado Almandoz, Josser E, additional, Kelly, Michael E, additional, Peeling, Lissa, additional, Arthur, Adam S, additional, Baxter, Blaise, additional, English, Joey, additional, Linfante, Italo, additional, and De Leacy, Reade, additional
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- 2019
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13. An international multicenter retrospective study to survey the landscape of thrombectomy in the treatment of anterior circulation acute ischemic stroke: outcomes with respect to age.
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Martini, Michael, Mocco, J., Turk, Aquilla, Siddiqui, Adnan H., Fiorella, David, Hanel, Ricardo, Woodward, Keith, Rai, Ansaar, Frei, Don, Delgado Almandoz, Josser E., Kelly, Michael E., Peeling, Lissa, Arthur, Adam S., Baxter, Blaise, English, Joey, Linfante, Italo, and De Leacy, Reade
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AGE distribution ,MEDICAL cooperation ,RESEARCH ,STROKE ,THROMBOSIS ,VEIN surgery ,LOGISTIC regression analysis ,TREATMENT effectiveness ,RETROSPECTIVE studies ,ACUTE diseases ,REVASCULARIZATION (Surgery) ,DESCRIPTIVE statistics - Abstract
Background Thrombectomy is an efficacious treatment for acute ischemic stroke (AIS). However, relatively few studies to date have specifically examined the impact and clinical implications of age on outcomes for thrombectomy in anterior AIS. Objective To provide a snapshot of patient metrics and outcomes with respect to age following thrombectomy for anterior AIS to supplement the current body of data for predictors of clinical outcomes in a real-world setting. Methods Data were collected for 20 consecutive patients with AIS treated with thrombectomy at 15 highvolume stroke centers across North America between 2015 and 2016. Patients with anterior occlusions were dichotomized based on whether they were older or younger than 80 years. Ordinal logistic regression analyzed how clinical variables impacted disability using 90-day modified Rankin Scale (mRS) scores. results Adequate revascularization (TICI ≥2B) was achieved in 92.3% of patients aged <80 years with an average 1.7±0.1 passes taken with the primary technique and in 88.0% of patients aged ≥80 years with an average 1.7±0.2 passes. Despite similar baseline characteristics, mRS scores were significantly higher in older patients postoperatively and at 90 days after intervention. Age was a significant predictor of 90-day mRS across the study population. Conclusion This analysis affirms age is a significant determinant of 90-day mRS scores following thrombectomy for large vessel anterior AIS. Further investigation into risks faced by elderly patients during thrombectomy may provide actionable information to help refine patient selection and improve outcomes. [ABSTRACT FROM AUTHOR]
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- 2020
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14. The Dotter method revisited: early experience with a novel method of rapid internal carotid artery revascularization in the setting of acute ischemic stroke
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Woodward, Keith, primary, Wegryn, Scott, additional, Staruk, Carla, additional, and Nyberg, Eric M, additional
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- 2015
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15. Primary results from the CLEAR study of a novel stent retriever with drop zone technology.
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Yoo AJ, Geyik S, Froehler MT, Maurer CJ, Kass-Hout T, Zaidat OO, Nogueira RG, Hanel RA, Pierot L, Spelle L, Lopes D, Hassan A, Širvinskas A, Lin E, Ribo M, Blasco J, Taqi MA, Badruddin A, Siddiqui AH, Miller TR, Hussain SM, Haussen DC, Woodward K, Groden C, Consoli A, Chaudry MI, Ramsey C, Maud A, Bentley J, Bajrami A, Sahnoun M, Fiehler J, and Gupta R
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Background: Challenges to revascularization of large vessel occlusions (LVOs) persist. Current stent retrievers have limited effectiveness for removing organized thrombi. The NeVa device is a novel stent retriever designed to capture organized thrombi within the scaffold during retrieval., Objective: To evaluate the safety and effectiveness of revascularization of acute LVOs with the NeVa device., Methods: Prospective, international, multicenter, single-arm, Investigational Device Exemption study to evaluate the performance of the NeVa device in recanalizing LVOs including internal carotid artery, M1/M2 middle cerebral artery, and vertebrobasilar arteries, within 8 hours of onset. Primary endpoint was rate of expanded Treatment in Cerebral Ischemia (eTICI) score 2b-3 within 3 NeVa passes, tested for non-inferiority against a performance goal of 72% with a -10% margin. Additional endpoints included first pass success and 90-day modified Rankin Scale (mRS) score 0-2. Primary composite safety endpoint was 90-day mortality and/or 24-hour symptomatic intracranial hemorrhage (sICH)., Results: From April 2021 to April 2022, 139 subjects were enrolled at 25 centers. Median National Institutes of Health Stroke Scale (NIHSS) score was 16 (IQR 12-20). In the primary analysis population (n=107), eTICI 2b-3 within 3 NeVa passes occurred in 90.7% (97/107; non-inferiority P<0.0001; post hoc superiority P<0.0001). First pass eTICI 2b-3 was observed in 73.8% (79/107), with first pass eTICI 2b67-3 in 69.2% (74/107) and eTICI 2c-3 in 48.6% (52/107). Median number of passes was 1 (IQR 1-2). Final eTICI 2b-3 rate was 99.1% (106/107); final eTICI 2b67-3 rate was 91.6% (98/107); final eTICI 2c-3 rate was 72.9% (78/107). Good outcome (90-day mRS score 0-2) was seen in 65.1% (69/106). Mortality was 9.4% (13/138) with sICH in 5.0% (7/139)., Conclusions: The NeVa device is highly effective and safe for revascularization of LVO strokes and demonstrates superior first pass success compared with a predicate performance goal., Trial Registration Number: NCT04514562., Competing Interests: Competing interests: AJY: consultant: Penumbra, Cerenovus, Vesalio, Zoll Circulation, Philips Neurovascular; individual stocks/stock options: Nicolab; ownership interest: Insera Therapeutics, Galaxy Therapeutics; research funding (principal investigator (PI) or named investigator): Medtronic, Cerenovus, Penumbra, Stryker, Genentech. LS: consultant: Balt, Medtronic, Microvention, Stryker; research funding (PI or named investigator): Philips. AH: consultant: Medtronic, Microvention, Stryker, Penumbra, Cerenovus, Genentech, GE Healthcare, Scientia, Balt, Viz.ai, Insera therapeutics, Proximie, NeuroVasc, NovaSignal, Vesalio, Rapid Medical, Imperative Care. AS: consultant: Microvention, Stryker, Vesalio. AHS: consultant: Amnis Therapeutics, Apellis Pharmaceuticals, Inc., Boston Scientific, Canon Medical Systems USA, Inc., Cardinal Health 200, LLC, Cerebrotech Medical Systems, Inc., Cerenovus, Cerevatech Medical, Inc; inidividual stocks/stock options: Adona Medical, Inc., Amnis Therapeutics, Bend IT Technologies, Ltd., BlinkTBI, Inc, Borvo Medical, Inc., Cerebrotech Medical Systems, Inc., Cerevatech Medical, Inc., Cognition Medical, Collavidence, I; other; Cerenovus EXCELLENT and ARISE II Trial; Medtronic SWIFT PRIME, VANTAGE, EMBOLISE and SWIFT DIRECT Trials; MicroVention FRED Trial; CONFIDENCE Study; MUSC POSITIVE Trial; Penumbra 3D Separator Trial, Research Funding (PI or named investigator); co-investigator for NIH - 1R01EB030092-01, Project Title: High speed angiography at 1000 frames per second; Mentor for Brain Aneurysm Foundation Carol W. Harvey Chair of Research, Sharon Epperson Chai. SG: Consultant; Stryker, Microvention, Medtronic. TRM: Advisor; Carpl AI. MTF: advisor; Cerenovus; research funding (PI or named investigator): Medtronic Neurovascular; researcher: Stryker Neurovascular, Cerenovus, Rapid Medical. DCH: consultant; Stryker Neurovascular, Cerenovus, Chiesi USA, Brainomix, Poseydon Medical; individual stocks/stock options: VizAI and Motif; other: Jacobs Institute/Medtronic, Vesalio., Frontiers in Neurology. MIC: advisor: Celt/Vasorum; consultant: Microvention, Medtronic, Imperative Care, Q'Apel; individual stocks/stock options: Imperative Care, Celt/Vasorum, Synchron, Endostream, Cerebrotech, Q'Apel, RIST, Three Rivers Medical, Neuolutions, Radical Medical, Tulavi, viseon, VMT, Vastrax, Serenity Medical. MF: consultant: Cerenovus, Balt, Jacobs Institute, Kai Medical, Oculus; research funding (PI or named investigator): Vesalio, Genentech, Siemens. MS: consultant: Vesalio., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2023
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