Ep. 360 Stroke Thrombectomy in Special Populations with Dr. Fawaz Al-Mufti

Ep. 360 Stroke Thrombectomy in Special Populations with Dr. Fawaz Al-Mufti

In this episode, guest host and neurointerventional surgeon Dr. Krishna Amuluru interviews triple-boarded neurointerventional surgeon, neurointensivist, and neurologist Dr. Fawaz Al-Mufti about stroke thrombectomy in special populations. --- CHECK OUT OUR SPONSOR MicroVention FRED X https://www.fred-x.com/ --- SHOW NOTES Fawaz serves as an Associate Professor, Director of Neuroendovascular Surgery Fellowship & Neurocritical-Care Unit, Assistant Dean of GME research, and Vice-Chair of Neurology research at New York Medical College, Westchester Medical Center. First, we define the special populations that have been excluded from stroke thrombectomy randomized controlled trials (RCTs). These populations include octogenarian, nonagenarian, pediatric, and pregnant patients. Fawaz then recaps the landmark trials that have shaped the field of neuroendovascular surgery, beginning with the handful that were published in 2015/2016. Approaching mechanical stroke thrombectomy in patients in their 80s and 90s and the lack of existing RCT literature is also discussed. Switching gears, Fawaz then speaks on caring for pediatric patients with large-vessel occlusion (LVO). Krishna and Fawaz cover the relative rarity of pediatric LVOs, significant differences in adult vs. pediatric stroke, and what literature exists to help guide decision-making in this patient population. Krishna then asks Fawaz about mechanical stroke thrombectomy in pregnant patients. They also cover existing literature, etiologies, and their approaches to intervention. To conclude the episode, Fawaz and Krishna speak on the purposes, applications, extrapolations, and limitations of randomized-controlled trials. --- RESOURCES SVIN 2023 Annual Meeting: https://www.svin.org/i4a/pages/index.cfm?pageid=3625 IMS-III Trial 2013: https://www.nejm.org/doi/full/10.1056/nejmoa1214300 Mr. Clean Study: https://www.nejm.org/doi/full/10.1056/nejmoa1411587 REVASCAT Study: https://www.nejm.org/doi/full/10.1056/nejmoa1503780 EXTEND-IA Study: https://www.nejm.org/doi/full/10.1056/nejmoa1414792 ESCAPE Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1414905 SWIFT PRIME Trial: https://www.nejm.org/doi/full/10.1056/nejmoa1415061 HERMES Registry: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00351-2/fulltext?rss%3Dyes Thrombolysis in Pediatric Stroke Study (TIPS): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342311/ Delay to Diagnosis in Acute Pediatric Arterial Ischemic Stroke Study: https://www.ahajournals.org/doi/10.1161/strokeaha.108.519066#:~:text=Analysis%20of%20Delay%20in%20Arterial,and%2020%25%20within%206%20hours. Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke Study: https://www.ahajournals.org/doi/10.1161/STROKEAHA.121.036361 Recanalization Treatments for Pediatric Acute Ischemic Stroke in France (Kids-Clot): https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796278 Feasibility, Safety, and Outcome of Endovascular Recanalization in Childhood Stroke: The Save ChildS Study: https://pubmed.ncbi.nlm.nih.gov/31609380/ Thrombectomy in special populations: report of the Society of NeuroInterventional Surgery Standards and Guidelines Committee: https://jnis.bmj.com/content/14/10/1033 O-039 diameters of large vessels in children and compatibility with adult interventional stroke devices: children are not little adults: https://jnis.bmj.com/content/7/Suppl_1/A21.1 Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke: A Multi-Institutional Experience of Technical and Clinical Outcomes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8660626/#bib28 WEB Device from Microvention TERUMO: https://www.microvention.com/products/web-family

Episoder(616)

Ep. 56 Transitioning from a Hospital to OBL practice (Part II) with Dr. Yates and Dr. Patel

Ep. 56 Transitioning from a Hospital to OBL practice (Part II) with Dr. Yates and Dr. Patel

In Part 2 of this 2-part series, Dr. Tim yates and Dr. Lincoln Patel provide insight on marketing strategies, as well as the importance of experience and partners in an outpatient based endovascular practice. --- CHECK OUT OUR SPONSORS RADPAD® Radiation Protection https://www.radpad.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/5UxgxL

23 Feb 202043min

Ep. 55 Transitioning from a Hospital to OBL practice (Part I) with Dr. Yates and Dr.  Patel

Ep. 55 Transitioning from a Hospital to OBL practice (Part I) with Dr. Yates and Dr. Patel

In Part 1 of this 2-part series, Dr. Tim yates and Dr. Lincoln Patel provide insight on how they made their career change decisions, as well as the advantages and disadvantages of a hospital-based vs. outpatient-based endovascular practice. --- CHECK OUT OUR SPONSORS RADPAD® Radiation Protection https://www.radpad.com/ Accountable Physician Advisors http://www.accountablephysicianadvisors.com/ Accountable Revenue Cycle Solutions https://www.accountablerevcycle.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/vog6G0

11 Feb 202051min

Ep. 54 Inclusivity in IR with Dr. Barbara Hamilton and Dr. Mary Costantino

Ep. 54 Inclusivity in IR with Dr. Barbara Hamilton and Dr. Mary Costantino

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/o6ecMR Dr. Barbara Hamilton and Dr. Mary Costantino, MD discuss inclusivity in IR, including the importance of mentorship and diversity in medicine.

16 Jan 202023min

Ep. 53 International Volunteer Work with Dr. Stephen Hunt

Ep. 53 International Volunteer Work with Dr. Stephen Hunt

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/Fh5LxS Dr. Stephen Hunt shares his international volunteer experiences traveling with IR4Nigeria and RAD-AID International. Get involved at www.rad-aid.org.

1 Jan 202026min

Ep. 52 IVUS for Iliac Vein Compression with Dr. Mark Lessne and Dr. Mike Cumming

Ep. 52 IVUS for Iliac Vein Compression with Dr. Mark Lessne and Dr. Mike Cumming

Dr. Michael Cumming and Dr. Mark Lessne discuss the utility of Intravascular Ultrasound (IVUS) in the diagnosis and treatment of Deep Venous Disease, including patient selection, appropriate assessment of stenoses and assistance with stent placement. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/ySM6hy

11 Nov 201944min

Ep. 51 Cone Beam CT Technique with Dr. Austin Bourgeois

Ep. 51 Cone Beam CT Technique with Dr. Austin Bourgeois

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/zGhYib Austin Bourgeois and Dr. Christopher Beck discuss ways you can improve your Cone Beam imaging for liver directed therapy, prostate artery embolization and how it can be used to improve safety of other procedures, such as G-tube placement.

30 Okt 201944min

Ep. 50 Practicing IR in India with Dr. Deepa Shree

Ep. 50 Practicing IR in India with Dr. Deepa Shree

Dr. Deepa Shree tells us about the challenges she faced building her IR practice in Chennai, and how she is spreading awareness of the specialty and training new IRs to help serve the need throughout India.

13 Okt 201948min

Ep. 49 Collaboration in the Hybrid OR with Dr. Racadio and Dr. von Allmen

Ep. 49 Collaboration in the Hybrid OR with Dr. Racadio and Dr. von Allmen

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/Ucy8jI Director of IR Innovation Dr. John Racadio and Pediatric Surgeon-in-Chief Dr. Daniel von Allmen of Cincinnati Children’s Hospital discuss their experiences in the Hybrid OR, how they built it, and how cross-specialty collaboration with pulmonary, urology, and orthopedic surgeons has greatly improved patient care.

30 Sep 201929min

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