Travis M Dumont
- Professor, Neurosurgery
- Assistant Professor, Medical Imaging
- Member of the Graduate Faculty
- (520) 626-6147
- Arizona Health Sciences Center, Rm. 4303B
- Tucson, AZ 85724
- travisdumont@arizona.edu
Biography
I am a board-certified neurological surgeon specializing in treatment of cerebrovascular disease, brain tumor, and complex spinal disorders. I am the Neurosurgery Residency Program Director at University of Arizona and an Associate Professor of Neurosurgery and Medical Imaging. I am the director and founder of the endovascular neurosurgery program at the University of Arizona which is now part of a Comprehensive Stroke Center at Banner-University of Arizona Medical Center. I serve as faculty for Stroke Neurology and Spine Fellowship programs. I completed medical school at Tufts University in 2005, residency at the University of Vermont in 2011 and fellowship at SUNY Buffalo in 2013. My clinical and research interests are multifaceted but remain patient-centered and focused on vascular and spinal disease. I have published many peer reviewed manuscripts and book contributions. I am a proud husband to my wife Kate since 2005 and father to three children Allie, Dax, and Boden.
Degrees
- M.D. Medicine
- Tufts University, Boston, Massachusetts, United States
- N/A
- B.A. Biology-Chemistry
- Claremont McKenna College, Claremont, California, United States
- B.A. Mathematics
- Claremont McKenna College, Claremont, California, United States
- N/A
Work Experience
- University of Arizona, Tucson, Arizona (2013 - Ongoing)
- State University of New York at Buffalo, Buffalo, New York (2012 - 2013)
- University of Vermont, Burlington, Vermont (2005 - 2011)
Awards
- Charles W. Needham Award for Neurosurgery Educator of the Year
- University of Arizona Medical Center, Summer 2021
- Neurosurgery Faculty Humanism Award
- University of Arizona Medical Center, Summer 2019
- John Green Award (Best abstract by resident awarded to Leonardo Brasiliense)
- Arizona Neurosurgery Society, Winter 2018
- Galbraith Award
- CNS, Fall 2015
- Neurosurgery Educator of the Year
- Division of Neurosurgery, Spring 2015
- Division of Neurosurgery, Spring 2014
- "Rookie of the year"
- The University of Arizona Health Network, Winter 2014
Licensure & Certification
- USMLE (2007)
- Fellow of the American Association of Neurological Surgeons, American Board of Neurological Surgeons (2015)
- Montana Medical License (2016)
- Arizona Medical License (2013)
Interests
Research
Clinical trials with focus on - Ischemic stroke - Subdural hematoma - Spinal Cord Injury
Teaching
Clinical neurosurgery with focus on - Neurovascular disease - Neurosurgical trauma - Spinal disorders
Courses
2023-24 Courses
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Neurosurgery
SURG 848C (Spring 2024)
2022-23 Courses
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Neurosurgery
SURG 848C (Spring 2023)
2021-22 Courses
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Neurosurgery
SURG 848C (Spring 2022) -
Neurosurgery
SURG 848C (Fall 2021)
2020-21 Courses
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Neurosurgery
SURG 848C (Spring 2021) -
Neurosurgery
SURG 848C (Fall 2020)
2019-20 Courses
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Neurosurgery
SURG 848C (Fall 2019)
2018-19 Courses
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Neurosurgery
SURG 848C (Spring 2019) -
Neurosurgery (Surgery Subspec)
SURG 837C (Fall 2018)
2016-17 Courses
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Neurosurgery
SURG 848C (Fall 2016) -
Neurosurgery (Surgery Subspec)
SURG 837C (Fall 2016)
Scholarly Contributions
Chapters
- Dumont, T. M., Levy, E. I., & Hopkins, L. N. (2015). Endovascular treatment of arteriovenous malformations of the infratentorial compartment (chapter 18). In Comprehensive Management of Arteriovenous Malformations of the Brain & Spine(pp 218-233). New York, NY: Thieme Medical Publishers.
- Dumont, T. M., Snyder, K. V., Siddiqui, A. H., Hopkins, L. N., & Levy, E. I. (2015). Endovascular Treatment of Carotid Stenosis (chapter 21). In Neurovascular Surgery, 2nd edition. Thieme Medical Publishers.
- Eller, J. L., Dumont, T. M., & Levy, E. I. (2015). Endovascular treatment of middle cerebral artery aneurysms.. In Neurovascular Surgery, 2nd edition. Thieme Medical Publishers.
- Mokin, M., Dumont, T. M., & Siddiqui, A. H. (2015). Self-Expandable Stents (Intracranial Atherosclerotic Disease) (chapter 59). In Neurointerventional Techniques: Tricks of the Trade(pp 274-278). New York, NY: Thieme.
- Mokin, M., Dumont, T. M., Jahshan, S., & Siddiqui, A. H. (2015). Balloon Angioplasty for Intracranial Atherosclerotic Disease (chapter 58). In Neurointerventional Techniques: Tricks of the Trade(pp 268-273). New York, NY: Thieme.
- Dumont, T. M., Jahshan, S., & Siddiqui, A. H. (2014). Intracranial Aneurysm Treatment (chapter 5). In Endovascular Interventions: A Case-based Approach to Methods and Procedures(pp 61-88). New York, NY: Springer.
- Dumont, T. M., Mokin, M., Kan, P., & Levy, E. I. (2014). Intracranial Stenting for Symptomatic Intracranial Stenosis. (chapter 3). In Endovascular Interventions: A Case-based Approach to Methods and Procedures(pp 23-38). New York, NY: Springer.
- Mokin, M., Dumont, T. M., Eller, J. L., Snyder, K. V., Hopkins, L. N., Siddiqui, A. H., & Levy, E. I. (2014). A New Tool in the Arsenal of the Neurointerventionist: The Checklist (chapter 1). In Neurointerventional Techniques: Tricks of the Trade(pp 2-7). New York, NY: Thieme.
- Mokin, M., Jahshan, S., Dumont, T. M., & Levy, E. I. (2014). Intracranial Strokes, Embolic – the Use of Catheter-directed Thrombolysis (chapter 2). In Endovascular Interventions: A Case-based Approach to Methods and Procedures(pp 9-22). New York, NY: Springer.
Journals/Publications
- Gaub, M., Kromenacker, B., Avila, M. J., Gonzales-Portillo, G. S., Aguilar-Salinas, P., & Dumont, T. M. (2023). Evolution of open surgery for unruptured intracranial aneurysms over a fifteen year period-increased difficulty and morbidity. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 107, 178-183.More infoThe approach to intervention for unruptured intracranial aneurysms (UIAs) remains controversial. Utilization of endovascular techniques for aneurysm repair increased dramatically during the last decade. We sought to analyze recent national trends for electively treated (open and endovascular) UIAs focusing on pre-existing patient disease burden and intervention modality selection.
- Shaban, A., Al Kasab, S., Chalhoub, R. M., Bass, E., Maier, I., Psychogios, M. N., Alawieh, A., Wolfe, S. Q., Arthur, A. S., Dumont, T. M., Kan, P., Kim, J. T., De Leacy, R., Osbun, J. W., Rai, A. T., Jabbour, P., Park, M. S., Crosa, R. J., Mascitelli, J. R., , Levitt, M. R., et al. (2023). Mechanical thrombectomy for large vessel occlusion strokes beyond 24 hours. Journal of neurointerventional surgery.More infoRecent clinical trials have shown that mechanical thrombectomy is superior to medical management for large vessel occlusion for up to 24 hours from onset. Our objective is to examine the safety and efficacy of thrombectomy beyond the standard of care window.
- Alawieh, A. M., Chalhoub, R. M., Al Kasab, S., Jabbour, P., Psychogios, M. N., Starke, R. M., Arthur, A. S., Fargen, K. M., De Leacy, R., Kan, P., Dumont, T. M., Rai, A., Crosa, R. J., Maier, I., Goyal, N., Wolfe, S. Q., Cawley, C. M., Mocco, J., Tjoumakaris, S. I., , Howard, B. M., et al. (2022). Multicenter investigation of technical and clinical outcomes after thrombectomy for distal vessel occlusion by frontline technique. Journal of neurointerventional surgery.More infoEndovascular thrombectomy (EVT) is the standard-of-care for proximal large vessel occlusion (LVO) stroke. Data on technical and clinical outcomes in distal vessel occlusions (DVOs) remain limited.
- Gravbrot, N., McDougall, R., Aguilar-Salinas, P., Avila, M. J., Burket, A. R., & Dumont, T. M. (2022). National trends in endovascular thrombectomy and decompressive craniectomy for acute ischemic stroke: A study using National Inpatient Sample data from 2006 to 2016. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 101, 234-238.More infoIschemic stroke is a frequently encountered neurologic process with wide-spanning impact. A dreaded complication is "malignant" cerebral edema, necessitating decompression to reduce herniation risk. Following the publication of several landmark trials in 2015, endovascular thrombectomy (EVT) with novel clot-removal devices has emerged as an effective treatment for proximal large vessel disease. Herein, we examine recent national trends in EVT and decompressive craniectomy (DC) rates for acute stroke.
- Grossberg, J. A., Chalhoub, R. M., Al Kasab, S., Pullmann, D., Jabbour, P., Psychogios, M., Starke, R. M., Arthur, A. S., Fargen, K. M., De Leacy, R., Kan, P., Dumont, T., Rai, A., Crosa, R. J., Naamani, K. E., Maier, I., Goyal, N., Wolfe, S. Q., Michael Cawley, C., , Mocco, J., et al. (2022). Multicenter investigation of technical and clinical outcomes after thrombectomy for Proximal Medium Vessel Occlusion (pMeVO) by frontline technique. Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 15910199221138139.More infoEndovascular thrombectomy(EVT) is the standard of care for large vessel occlusion(LVO) stroke. Data on technical and clinical outcome in proximal medium vessel occlusions(pMeVOs) comparing frontline techniques remain limited.
- Hafeez, M. U., Essibayi, M. A., Raper, D., Tanweer, O., Sattur, M., Al-Kasab, S., Burks, J., Townsend, R., Alsbrook, D., Dumont, T., Park, M. S., Goyal, N., Arthur, A. S., Maier, I., Mascitelli, J., Starke, R., Wolfe, S., Fargen, K., Spiotta, A., , Kan, P. T., et al. (2022). Predictors and outcomes of first pass efficacy in posterior circulation strokes: Insights from STAR collaboration. Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 15910199221149080.More infoFirst-pass efficacy (FPE) has been established as an important predictor of favorable functional outcomes after endovascular thrombectomy (ET) in anterior circulation strokes. In this retrospective cohort study, we investigate predictors and clinical outcomes of FPE in posterior circulation strokes (pcAIS). The Stroke Thrombectomy and Aneurysm Registry database was used to identify pcAIS patients who achieved FPE. Their baseline characteristics and outcomes were compared with the non-FPE group. The primary outcome was a 90-day modified Rankin Scale (mRS) of 0-3. Univariate (UVA) and multivariate (MVA) analyses were done to evaluate predictors of FPE. Safety outcomes included distal emboli, vessel rupture, symptomatic intracranial hemorrhage, and mortality. Of 359 patients, 179 (50%) achieved FPE. Clot burden, occlusion site, and ET technique-related variables were similar between the two groups except for shorter procedure time with FPE. The primary outcome was significantly better with FPE (56.4% vs. 32.8%,
- Lu, V. M., Luther, E. M., Silva, M. A., Elarjani, T., Abdelsalam, A., Maier, I., Al Kasab, S., Jabbour, P. M., Kim, J. T., Wolfe, S. Q., Rai, A. T., Psychogios, M. N., Samaniego, E. A., Arthur, A. S., Yoshimura, S., Grossberg, J. A., Alawieh, A., Fragata, I., Polifka, A., , Mascitelli, J., et al. (2022). Prognostic significance of age within the adolescent and young adult acute ischemic stroke population after mechanical thrombectomy: insights from STAR. Journal of neurosurgery. Pediatrics, 1-7.More infoAlthough younger adults have been shown to have better functional outcomes after mechanical thrombectomy (MT) for acute ischemic stroke (AIS), the significance of this relationship in the adolescent and young adult (AYA) population is not well defined given its undefined rarity. Correspondingly, the goal of this study was to determine the prognostic significance of age in this specific demographic following MT for large-vessel occlusions.
- Mamaril-Davis, J. C., Aguilar-Salinas, P., Avila, M. J., Villatoro-Villar, M., & Dumont, T. M. (2022). Perioperative management of disease-modifying antirheumatic drugs for patients undergoing elective spine surgery: a systematic review. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 31(4), 815-829.More infoIn preparation for surgery, patients being treated with disease-modifying antirheumatic drugs (DMARDs) are recommended to either continue or withhold therapy perioperatively. Some of these drugs have known effects against bone healing, hence the importance of adequately managing them before and after surgery.
- Saad, H., Eshraghi, S., Alawieh, A. M., Akbik, F., Cawley, C. M., Howard, B. M., Ash, M., Hsu, A., Pabaney, A., Maier, I., Al Kasab, S., El Naamani, K., Jabbour, P., Kim, J. T., Wolfe, S. Q., Rai, A., Starke, R. M., Psychogios, M. N., Shaban, A., , Arthur, A. S., et al. (2022). Technical and clinical outcomes in concurrent multivessel occlusions treated with mechanical thrombectomy: insights from the STAR collaboration. Journal of neurointerventional surgery.More infoEndovascular thrombectomy (EVT) has become the mainstay treatment for large vessel occlusion, with favorable safety and efficacy profile. However, the safety and efficacy of EVT in concurrent multi-territory occlusions (MTVOs) remains unclear.
- Akbik, F., Alawieh, A., Dimisko, L., Howard, B. M., Cawley, C. M., Tong, F. C., Nahab, F., Samuels, O. B., Maier, I., Feng, W., Goyal, N., Starke, R. M., Rai, A., Fargen, K. M., Psychogios, M. N., Jabbour, P., De Leacy, R., Keyrouz, S. G., Dumont, T. M., , Kan, P., et al. (2021). Bridging thrombolysis in atrial fibrillation stroke is associated with increased hemorrhagic complications without improved outcomes. Journal of neurointerventional surgery.More infoAtrial fibrillation (AF) associated ischemic stroke is associated with worse functional outcomes, less effective recanalization, and increased rates of hemorrhagic complications after intravenous thrombolysis (IVT). Conversely, AF is not associated with hemorrhagic complications or functional outcomes in patients undergoing mechanical thrombectomy (MT). This differential effect of MT and IVT in AF associated stroke raises the question of whether bridging thrombolysis increases hemorrhagic complications in AF patients undergoing MT.
- Al Kasab, S., Almallouhi, E., Alawieh, A., Wolfe, S., Fargen, K. M., Arthur, A. S., Goyal, N., Dumont, T., Kan, P., Kim, J. T., De Leacy, R., Maier, I., Osbun, J., Rai, A., Jabbour, P., Grossberg, J. A., Park, M. S., Starke, R. M., Crosa, R., , Spiotta, A. M., et al. (2021). Outcomes of Rescue Endovascular Treatment of Emergent Large Vessel Occlusion in Patients With Underlying Intracranial Atherosclerosis: Insights From STAR. Journal of the American Heart Association, 10(12), e020195.More infoBackground Some emergent large vessel occlusions (ELVOs) are refractory to reperfusion because of underlying intracranial atherosclerosis (ICAS), often requiring rescue therapy (RT) with balloon angioplasty, stenting, or both. In this study, we investigate the safety, efficacy, and long-term outcomes of RT in the setting of mechanical thrombectomy for ICAS-related ELVO. Methods and Results We queried the databases of 10 thrombectomy-capable centers in North America and Europe included in STAR (Stroke Thrombectomy and Aneurysm Registry). Patients with ELVO who underwent ICAS-related RT were included. A matched sample was produced for variables of age, admission National Institute of Health Stroke Scale, Alberta Stroke Program Early CT Score, onset to groin puncture time, occlusion site, and final recanalization. Out of 3025 patients with MT, 182 (6%) patients required RT because of underlying ICAS. Balloon angioplasty was performed on 122 patients, and 117 patients had intracranial stenting. In the matched analysis, 141 patients who received RT matched to a similar number of controls. The number of thrombectomy passes was higher (3 versus 1,
- Almallouhi, E., Al Kasab, S., Hubbard, Z., Bass, E. C., Porto, G., Alawieh, A., Chalhoub, R., Jabbour, P. M., Starke, R. M., Wolfe, S. Q., Arthur, A. S., Samaniego, E., Maier, I., Howard, B. M., Rai, A., Park, M. S., Mascitelli, J., Psychogios, M., De Leacy, R., , Dumont, T., et al. (2021). Outcomes of Mechanical Thrombectomy for Patients With Stroke Presenting With Low Alberta Stroke Program Early Computed Tomography Score in the Early and Extended Window. JAMA network open, 4(12), e2137708.More infoLimited data are available about the outcomes of mechanical thrombectomy (MT) for real-world patients with stroke presenting with a large core infarct.
- Anadani, M., Alawieh, A., Chalhoub, R., Jabbour, P., Starke, R. M., Arthur, A., Goyal, N., Wolfe, S., Fargen, K. M., Grossberg, J. A., Howard, B. M., De Leacy, R., Kellner, C., Kan, P., Dumont, T., Rai, A., Osbun, J., Crosa, R., Maier, I., , Nascimento, F. A., et al. (2021). Mechanical Thrombectomy for Distal Occlusions: Efficacy, Functional and Safety Outcomes: Insight from the STAR Collaboration. World neurosurgery, 151, e871-e879.More infoMechanical thrombectomy (MT) is the standard of care for the treatment of proximal anterior circulation large vessel occlusions. However, little is known about its efficacy and safety in the treatment of distal intracranial occlusions.
- Avila, M. J., Aguilar-Salinas, P., Burket, A. R., & Dumont, T. M. (2021). Parkinson Disease, Dysphagia, and Cervical Spine Surgery. Clinical spine surgery.More infoAn analysis of a National Database.
- Blohm, J. E., Salinas, P. A., Avila, M. J., Barber, S. R., Weinand, M. E., & Dumont, T. M. (2021). 3D Printing in Neurosurgery Residency Training: A Systematic Review of the Literature. World neurosurgery.More infoThe use of 3-dimensional (3D) printing in neurosurgery has become more prominent in recent years for surgical training, preoperative planning and patient-education. Several smaller studies are available using 3D printing however there is a lack of a concise review. This article provides a systematic review of current 3D models in use by neurosurgical residents with emphasis on training, learning, and simulation.
- Eaton, R. G., Shah, V. S., Dornbos, D., Zaninovich, O. A., Wenger, N., Dumont, T. M., & Powers, C. J. (2021). Demographic age-related variation in Circle of Willis completeness assessed by digital subtraction angiography. Brain circulation, 6(1), 31-37.More infoIncomplete circle of Willis (CoW) configuration is an important risk factor for cerebrovascular pathology, namely aneurysm formation and ischemic stroke. This study was performed to characterize CoW variation using digital subtraction angiography and to identify demographic and physiologic features that may influence the risk of having an incomplete CoW configuration.
- Fehlings, M. G., Chen, Y., Aarabi, B., Ahmad, F., Anderson, K. D., Dumont, T., Fourney, D. R., Harrop, J. S., Kim, K. D., Kwon, B. K., Lingam, H. K., Rizzo, M., Shih, L. C., Tsai, E. C., Vaccaro, A., & McKerracher, L. (2021). A Randomized Controlled Trial of Local Delivery of a Rho Inhibitor (VX-210) in Patients with Acute Traumatic Cervical Spinal Cord Injury. Journal of neurotrauma, 38(15), 2065-2072.More infoAcute traumatic spinal cord injury (SCI) can result in severe, lifelong neurological deficits. After SCI, Rho activation contributes to collapse of axonal growth cones, failure of axonal regeneration, and neuronal loss. This randomized, double-blind, placebo-controlled phase 2b/3 study evaluated the efficacy and safety of Rho inhibitor VX-210 (9 mg) in patients after acute traumatic cervical SCI. The study enrolled patients 14-75 years of age with acute traumatic cervical SCIs, C4-C7 (motor level) on each side, and American Spinal Injury Association Impairment Scale (AIS) Grade A or B who had spinal decompression/stabilization surgery commencing within 72 h after injury. Patients were randomized 1:1 with stratification by age (
- Gonzales-Portillo, G. S., Rizvi, O., Avila, M. J., & Dumont, T. M. (2021). The prevalence of 11 ribs and its potential implications in spine surgery. Clinical neurology and neurosurgery, 203, 106544.More infoWrong level surgery is a preventable event in spine surgery. The thoracic spine given its length and anatomical landmarks remains the most challenging spine section for accurate localization during surgery. Traditionally, counting the ribs with intraoperative fluoroscopy is the preferred method. The incidence of 11 ribs instead of the conventional 12 ribs is not examined in current scientific literature, even though the incidence of 11 ribs may have a substantial impact on spinal procedures and the outcomes. This is especially relevant if patients have a potential surgical pathology of their thoracic spine. In this case series we sought to investigate the prevalence of 11 ribs in a trauma population.
- Li, Y., Chen, S. H., Spiotta, A. M., Jabbour, P., Levitt, M. R., Kan, P., Griessenauer, C. J., Arthur, A. S., Osbun, J. W., Park, M. S., Chalouhi, N., Sweid, A., Wolfe, S. Q., Fargen, K. M., Dumont, A. S., Dumont, T. M., Brunet, M. C., Sur, S., Luther, E., , Strickland, A., et al. (2021). Lower complication rates associated with transradial versus transfemoral flow diverting stent placement. Journal of neurointerventional surgery, 13(1), 91-95.More infoCurrently, there are no large-scale studies in the neurointerventional literature comparing safety between transradial (TRA) and transfemoral (TFA) approaches for flow diversion procedures. This study aims to assess complication rates in a large multicenter registry for TRA versus TFA flow diversion.
- Ramey, W. L., Reyes, A. A., Avila, M. J., Hurlbert, R. J., Chapman, J. R., & Dumont, T. M. (2021). The Central Cord Score: A Novel Classification and Scoring System Specific to Acute Traumatic Central Cord Syndrome. World neurosurgery, 156, e235-e242.More infoAcute traumatic central cord syndrome (ATCCS) is the most common form of spinal cord injury in the United States. Treatment remains controversial, which is a consequence of ATCCS having an inherently different natural history from conventional spinal cord injury, thus requiring a separate classification system. We devised a novel Central Cord Score (CCscore), which both guides treatment and tracks improvement over time with symptoms specific to ATCCS.
- Reyes, A. A., Hurlbert, R. J., Dumont, T. M., & Ramey, W. L. (2021). The Number of Organ System Injuries Is a Predictor of Intrahospital Mortality in Complete Cervical Spinal Cord Injury. World neurosurgery.More infoWe sought to determine the extent to which polytrauma significantly impacts intrahospital mortality among patients with complete cervical spinal cord injury (cSCI) and to assess whether an organ system-based approach would be appropriate as a mortality predictor as compared with conventional standards to help guide prognosis and management.
- Spiotta, A. M., Park, M. S., Bellon, R. J., Bohnstedt, B. N., Schirmer, C. M., De Leacy, R. A., Fiorella, D. J., Yoo, A. J., Dumont, T. M., & Starke, R. M. (2021). Technical Success and Early Efficacy in 851 Patients with Saccular Intracranial Aneurysms: A Subset Analysis of SMART, a Prospective, Multicenter Registry Assessing the Embolization of Neurovascular Lesions using the Penumbra SMART COIL System. World neurosurgery, 155, e323-e334.More infoThe Prospective, Multicenter Registry Assessing the Embolization of Neurovascular Lesions Using the Penumbra SMART COIL® System (SMART) is the largest prospective, multicenter, postmarket registry established to gather real-world experience on Penumbra (Alameda, USA) SMART COIL System, PC400, and POD embolization coils. The goal of this study is to report the technical success and efficacy of SMART COIL System coils in treating saccular intracranial aneurysms.
- Spiotta, A. M., Park, M. S., Bellon, R. J., Bohnstedt, B. N., Yoo, A. J., Schirmer, C. M., DeLeacy, R. A., Fiorella, D. J., Woodward, B. K., Hawk, H. E., Nanda, A., Zaidat, O. O., Sunenshine, P. J., Liu, K. C., Kabbani, M. R., Snyder, K. V., Sivapatham, T., Dumont, T. M., Reeves, A. R., , Starke, R. M., et al. (2021). The SMART Registry: Long-Term Results on the Utility of the Penumbra SMART COIL System for Treatment of Intracranial Aneurysms and Other Malformations. Frontiers in neurology, 12, 637551.More infoPenumbra SMART COIL® (SMART) System is a novel generation embolic coil with varying stiffness. The study purpose was to report real-world usage of the SMART System in patients with intracranial aneurysms (ICA) and non-aneurysm vascular lesions. The SMART Registry is a post-market, prospective, multicenter registry requiring ≥75% Penumbra Coils, including SMART, PC400, and/or POD coils. The primary efficacy endpoint was retreatment rate at 1-year and the primary safety endpoint was the procedural device-related serious adverse event rate. Between June 2016 and August 2018, 995 patients (mean age 59.6 years, 72.1% female) were enrolled at 68 sites in the U.S. and Canada. Target lesions were intracranial aneurysms in 91.0% of patients; 63.5% were wide-neck and 31.8% were ruptured. Adjunctive devices were used in 55.2% of patients. Mean packing density was 32.3%. Procedural device-related serious adverse events occurred in 2.6% of patients. The rate of immediate post-procedure adequate occlusion was 97.1% in aneurysms and the rate of complete occlusion was 85.2% in non-aneurysms. At 1-year, the retreatment rate was 6.8%, Raymond Roy Occlusion Classification (RROC) I or II was 90.0% for aneurysms, and Modified Rankin Scale (mRS) 0-2 was achieved in 83.1% of all patients. Predictors of 1-year for RROC III or retreatment (incomplete occlusion) were rupture status ( < 0.0001), balloon-assisted coiling ( = 0.0354), aneurysm size ( = 0.0071), and RROC III immediate post-procedure ( = 0.0086) in a model that also included bifurcation aneurysm ( = 0.7788). Predictors of aneurysm retreatment at 1-year was rupture status ( < 0.0001). Lesions treated with SMART System coils achieved low long-term retreatment rates. https://www.clinicaltrials.gov/, identifier NCT02729740.
- Sumdani, H., Aguilar-Salinas, P., Avila, M. J., Barber, S. R., & Dumont, T. M. (2021). Utility of Augmented Reality and Virtual Reality in Spine Surgery: A Systematic Review of the Literature. World neurosurgery.More infoAugmented reality, virtual reality, and mixed reality (AR, VR, MR) are emerging technologies that are starting to be translated into clinical practice. There is limited data available about these tools being used in live surgery of the spine. The objective of this paper was to systematically collect, analyze, and interpret the existing data regarding AR, VR, and MR use in spine surgery on live people.
- Sumdani, H., Aguilar-Salinas, P., Avila, M. J., El-Ghanem, M., & Dumont, T. M. (2021). Carotid Cavernous Fistula Treatment via Flow Diversion: A Systematic Review of the Literature. World neurosurgery, 149, e369-e377.More infoCarotid cavernous fistulas (CCFs) are pathologic connections between the carotid arteries and the cavernous sinus and have been classically treated with endovascular coil embolization, although flow diverters have been used for treatment successfully multiple times. The aim of this study is to systematically review the literature for efficacy of flow diverters in treating CCFs.
- Akbik, F., Alawieh, A., Cawley, C. M., Howard, B. M., Tong, F. C., Nahab, F., Saad, H., Dimisko, L., Mustroph, C., Samuels, O. B., Pradilla, G., Maier, I., Goyal, N., Starke, R. M., Rai, A., Fargen, K. M., Psychogios, M. N., Jabbour, P., De Leacy, R., , Giles, J., et al. (2020). Differential effect of mechanical thrombectomy and intravenous thrombolysis in atrial fibrillation associated stroke. Journal of neurointerventional surgery.More infoAtrial fibrillation (AF) associated ischemic stroke has worse functional outcomes, less effective recanalization, and increased rates of hemorrhagic complications after intravenous thrombolysis (IVT). Limited data exist about the effect of AF on procedural and clinical outcomes after mechanical thrombectomy (MT).
- Alawieh, A. M., Eid, M., Anadani, M., Sattur, M., Maier, I. L., Feng, W., Goyal, N., Starke, R. M., Rai, A., Fargen, K. M., Psychogios, M. N., De Leacy, R., Grossberg, J. A., Keyrouz, S. G., Dumont, T. M., Kan, P., Lena, J., Liman, J., Arthur, A. S., , Elijovich, L., et al. (2020). Thrombectomy Technique Predicts Outcome in Posterior Circulation Stroke-Insights from the STAR Collaboration. Neurosurgery, 87(5), 982-991.More infoRandomized controlled trials evaluating mechanical thrombectomy (MT) for acute ischemic stroke predominantly studied anterior circulation patients. Both procedural and clinical predictors of outcome in posterior circulation patients have not been evaluated in large cohort studies.
- Avila, M. J., Martirosyan, N. L., Hurlbert, R. J., & Dumont, T. M. (2020). Penetrating Spinal Cord Injury in civilians: analysis of a national database. World neurosurgery.More infoSpinal trauma is common in polytrauma; spinal cord injury (SCI) is present in a subset of these patients. Penetrating SCI has been studied in the military; however, civilian SCI is less studied. Civilian injury pathophysiology varies given the generally lower velocity of the projectiles. We sought to investigate civilian penetrating SCI in the United States.
- Gravbrot, N., Aguilar-Salinas, P., Walter, C. M., & Dumont, T. M. (2020). Laparoscopically Assisted Ventriculoperitoneal Shunt Placement Is not Cost-Effective nor Preventive for Distal Shunt Malfunction. World neurosurgery, 137, e308-e314.More infoLaparoscopy for ventriculoperitoneal shunt creation might offer smaller incisions and more reliable placement. We assessed the reliability and cost-effectiveness of this technique compared with mini-laparotomy shunt placement.
- Tschoe, C., Kittel, C., Brown, P., Hafeez, M., Kan, P., Alawieh, A., Spiotta, A. M., Almallouhi, E., Dumont, T. M., McCarthy, D. J., Starke, R. M., De Leacy, R., Wolfe, S. Q., & Fargen, K. M. (2020). Impact of off-hour endovascular therapy on outcomes for acute ischemic stroke: insights from STAR. Journal of neurointerventional surgery.More infoThe off-hour effect has been observed in the medical care of acute ischemic stroke. However, it remains unclear if time of arrival affects revascularization rates and outcomes after endovascular therapy (EVT) for emergent large vessel occlusion (ELVO). We aimed to investigate the clinical outcomes of EVT between on-hour and off-hour admissions.
- Aghaebrahim, A., Agnoletto, G. J., Aguilar-Salinas, P., Granja, M. F., Monteiro, A., Siddiqui, A. H., Levy, E. I., Shallwani, H., Kim, S. J., Haussen, D. C., Nogueira, R. G., Lopes, D., Saied, A., Jovin, T. G., Jadhav, A. P., Limaye, K., Turk, A. S., Spiotta, A. M., Chaudry, M. I., , Turner, R. D., et al. (2019). Endovascular Recanalization of Symptomatic Intracranial Arterial Stenosis Despite Aggressive Medical Management. World neurosurgery, 123, e693-e699.More infoThe optimal management of intracranial arterial stenosis is unclear, particularly in patients who have failed medical management. We report a multicenter real-world experience of endovascular recanalization of intracranial atherosclerotic stenosis refractory to aggressive medical therapy.
- Alawieh, A., Vargas, J., Fargen, K. M., Langley, E. F., Starke, R. M., De Leacy, R., Chatterjee, R., Rai, A., Dumont, T., Kan, P., McCarthy, D., Nascimento, F. A., Singh, J., Vilella, L., Turk, A., & Spiotta, A. M. (2019). Impact of Procedure Time on Outcomes of Thrombectomy for Stroke. Journal of the American College of Cardiology, 73(8), 879-890.More infoEndovascular thrombectomy (ET) for acute ischemic stroke is the current standard of care. Although successful ET has high efficacy in improving functional outcomes, the decision to abort a long procedure remains a challenge. Longer procedure time (PT) has been associated with lower rates of functional independence.
- Cherian, J., Srinivasan, V., Froehler, M. T., Grossberg, J. A., Cawley, C. M., Hanel, R. A., Puri, A., Dumont, T., Ducruet, A. F., Albuquerque, F., Arthur, A., Cheema, A., Spiotta, A., Anadani, M., Lopes, D., Saied, A., Kim, L., Kelly, C. M., Chen, P. R., , Mocco, J., et al. (2019). Flow Diversion for Treatment of Intracranial Aneurysms in Pediatric Patients: Multicenter Case Series. Neurosurgery.More infoThough the Pipeline Embolization Device (Medtronic) is approved for use in adults 22 yr and older, the high efficacy and long-term durability of the device is attractive for treatment of intracranial aneurysms in younger patients who often have aneurysms less amenable to traditional endovascular treatments.
- Nisson, P. L., Fard, S. A., Walter, C. M., Johnstone, C. M., Mooney, M. A., Tayebi Meybodi, A., Lang, M., Kim, H., Jahnke, H., Roe, D. J., Dumont, T. M., Lemole, G. M., Spetzler, R. F., & Lawton, M. T. (2019). A novel proposed grading system for cerebellar arteriovenous malformations. Journal of neurosurgery, 1-11.More infoOBJECTIVEThe objective of this study was to evaluate the existing Spetzler-Martin (SM), Spetzler-Ponce (SP), and Lawton-Young (LY) grading systems for cerebellar arteriovenous malformations (AVMs) and to propose a new grading system to estimate the risks associated with these lesions.METHODSData for patients with cerebellar AVMs treated microsurgically in two tertiary medical centers were retrospectively reviewed. Data from patients at institution 1 were collected from September 1999 to February 2013, and at institution 2 from October 2008 to October 2015. Patient outcomes were classified as favorable (modified Rankin Scale [mRS] score 0-2) or poor (mRS score 3-6) at the time of discharge. Using chi-square and logistic regression analysis, variables associated with poor outcomes were assigned risk points to design the proposed grading system. The proposed system included neurological status prior to treatment (poor, +2 points), emergency surgery (+1 point), age > 60 years (+1 point), and deep venous drainage (deep, +1 point). Risk point totals of 0-1 comprised grade 1, 2-3 grade 2, and 4-5 grade 3.RESULTSA total of 125 cerebellar AVMs of 1328 brain AVMs were reviewed in 125 patients, 120 of which were treated microsurgically and included in the study. With our proposed grading system, we found poor outcomes differed significantly between each grade (p < 0.001), while with the SM, SP, and LY grading systems they did not (p = 0.22, p = 0.25, and p = 1, respectively). Logistic regression revealed grade 2 had 3.3 times the risk of experiencing a poor outcome (p = 0.008), while grade 3 had 9.9 times the risk (p < 0.001). The proposed grading system demonstrated a superior level of predictive accuracy (area under the receiver operating characteristic curve [AUROC] of 0.72) compared with the SM, SP, and LY grading systems (AUROC of 0.61, 0.57, and 0.51, respectively).CONCLUSIONSThe authors propose a novel grading system for cerebellar AVMs based on emergency surgery, venous drainage, preoperative neurological status, and age that provides a superior prognostication power than the formerly proposed SM, SP, and LY grading systems. This grading system is clinically predictive of patient outcomes and can be used to better guide vascular neurosurgeons in clinical decision-making.
- Ramey, W. L., Walter, C. M., Zeller, J., Dumont, T. M., Lemole, G. M., & Hurlbert, R. J. (2019). In Reply: Neurotrauma From Border Wall Jumping: 6 Years at the Mexican-American Border Wall. Neurosurgery, 85(4), E792.
- Ramey, W. L., Walter, C. M., Zeller, J., Dumont, T. M., Lemole, G. M., & Hurlbert, R. J. (2019). Neurotrauma From Border Wall Jumping: 6 Years at the Mexican-American Border Wall. Neurosurgery, 85(3), E502-E508.More infoThe border between the United States (US) and Mexico is an international boundary spanning 3000 km, where unauthorized crossings occur regularly. We examine patterns of neurotrauma, health care utilization, and financial costs at our level 1 trauma center incurred by patients from wall-jumping into the US.
- Williams, M. M., Leslie-Mazwi, T., Hirsch, J. A., Kittel, C., Spiotta, A., De Leacy, R., Mocco, J., Albuquerque, F. C., Ducruet, A. F., Goyal, N., Arthur, A. S., Kan, P., Mokin, M., Dumont, T. M., Reeves, A., Wolfe, S. Q., & Fargen, K. (2019). Real-world effects of late window neurothrombectomy: procedure rates increase without night-time bias. Journal of neurointerventional surgery.More infoWith the expansion of the interventional time window for stroke from emergent large vessel occlusion (ELVO), the rate of mechanical thrombectomy (MT) is expected to rise, potentially causing higher burnout rates and requiring hospitals to develop strategies for adequate coverage of these procedures.
- Zaidat, O. O., Mueller-Kronast, N. H., Hassan, A. E., Haussen, D. C., Jadhav, A. P., Froehler, M. T., Jahan, R., Ali Aziz-Sultan, M., Klucznik, R. P., Saver, J. L., Hellinger, F. R., Yavagal, D. R., Yao, T. L., Gupta, R., Martin, C. O., Bozorgchami, H., Kaushal, R., Nogueira, R. G., Gandhi, R. H., , Peterson, E. C., et al. (2019). Impact of Balloon Guide Catheter Use on Clinical and Angiographic Outcomes in the STRATIS Stroke Thrombectomy Registry. Stroke, 50(3), 697-704.More infoBackground and Purpose- Mechanical thrombectomy has been shown to improve clinical outcomes in patients with acute ischemic stroke. However, the impact of balloon guide catheter (BGC) use is not well established. Methods- STRATIS (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) was a prospective, multicenter study of patients with large vessel occlusion treated with the Solitaire stent retriever as first-line therapy. In this study, an independent core laboratory, blinded to the clinical outcomes, reviewed all procedures and angiographic data to classify procedural technique, target clot location, recanalization after each pass, and determine the number of stent retriever passes. The primary clinical end point was functional independence (modified Rankin Scale, 0-2) at 3 months as determined on-site, and the angiographic end point was first-pass effect (FPE) success rate from a single device attempt (modified Thrombolysis in Cerebral Infarction, ≥2c) as determined by a core laboratory. Achieving modified FPE (modified Thrombolysis in Cerebral Infarction, ≥2b) was also assessed. Comparisons of clinical outcomes were made between groups and adjusted for baseline and procedural characteristics. All participating centers received institutional review board approval from their respective institutions. Results- Adjunctive technique groups included BGC (n=445), distal access catheter (n=238), and conventional guide catheter (n=62). The BGC group had a higher rate of FPE following first pass (212/443 [48%]) versus conventional guide catheter (16/62 [26%]; P=0.001) and distal access catheter (83/235 [35%]; P=0.002). Similarly, the BGC group had a higher rate of modified FPE (294/443 [66%]) versus conventional guide catheter (26/62 [42%]; P
- Aguilar-Salinas, P., Brasiliense, L. B., Walter, C. M., Hanel, R. A., & Dumont, T. M. (2018). Current Status of the PulseRider in the Treatment of Bifurcation Aneurysms: A Systematic Review. World neurosurgery, 115, 288-294.More infoThe PulseRider is an innovative stent-like device designed for the treatment of intracranial bifurcation aneurysms. The aim of this study was to assess the current evidence on safety and effectiveness of the PulseRider.
- Alawieh, A., Starke, R. M., Chatterjee, A. R., Turk, A., De Leacy, R., Rai, A. T., Fargen, K., Kan, P., Singh, J., Vilella, L., Nascimento, F., Dumont, T. M., McCarthy, D., & Spiotta, A. M. (2018). Outcomes of endovascular thrombectomy in the elderly: a 'real-world' multicenter study. Journal of neurointerventional surgery.More infoThe efficacy of endovascular thrombectomy (ET) for acute ischemic stroke (AIS) in octogenarians is still controversial.
- Dumont, T. M., & Bina, R. W. (2018). Difficult Vascular Access Anatomy Associated with Decreased Success of Revascularization in Emergent Thrombectomy. Journal of vascular and interventional neurology, 10(2), 11-14.More infoThrombectomy has become established as a successful treatment strategy for ischemic stroke, and consequently, more patients are undergoing this procedure. Due to comorbid conditions, chronic disease states, and advanced age, many patients have anatomy which complicates revascularization, specifically difficult aortic arch anatomy, or tortuous common and internal artery anatomy, or both.
- Nisson, P. L., Fard, S. A., Meybodi, A. T., Mooney, M. A., Kim, H., Jahnke, H., Walter, C. M., Dumont, T. M., Lemole, G. M., Lawton, M. T., & Spetzler, R. F. (2018). The Unique Features and Outcomes of Microsurgically Resected Cerebellar Arteriovenous Malformations. World neurosurgery, 120, e940-e949.More infoCerebellar arteriovenous malformations (CAVMs) are challenging to treat given their close proximity to the brain stem, greater propensity for rupture, and greater rates of morbidity and mortality than other brain arteriovenous malformations. The present investigation sought to describe and characterize the features of these rare and unique lesions.
- Williams, M. M., Wilson, T. A., Leslie-Mazwi, T., Hirsch, J. A., Kellogg, R. T., Spiotta, A. M., De Leacy, R., Mocco, J., Albuquerque, F. C., Ducruet, A. F., Arthur, A., Srinivasan, V. M., Kan, P., Mokin, M., Dumont, T. M., Reeves, A., Singh, J., Wolfe, S. Q., & Fargen, K. M. (2018). The burden of neurothrombectomy call: a multicenter prospective study. Journal of neurointerventional surgery, 10(12), 1143-1148.More infoNeurothrombectomy frequency is increasing, and a better understanding of the neurothrombectomy call burden is needed.
- Brasiliense, L. B., & Dumont, T. M. (2017). Alarming Internal Carotid Artery Aneurysm Eroding the Sphenoid Sinus. World neurosurgery, 108, 985.e13-985.e14.More infoIn rare instances, extradural internal carotid artery aneurysms can present with massive epistaxis, which is often a fatal event. We present the case of a young female with an aneurysm eroding through the sphenoid sinus and whose timely diagnosis resulted in treatment of the aneurysm with coil embolization and satisfactory outcome.
- Brasiliense, L. B., Walter, C. M., Avila, M. J., & Dumont, T. M. (2017). Letter: Rerupture of a Blister Aneurysm After Treatment With a Single Flow-Diverting Stent. Neurosurgery, 81(3), E40.
- Dumont, T. M. (2017). Use of a tubular retractor for transoral odontoidectomy of upper cervical epidural phlegmon extraction and abscess drainage. Interdisciplinary Neurosurgery.
- Fennell, V. S., Martirosyan, N. L., Atwal, G. S., Kalani, M. Y., Ponce, F. A., Lemole, G. M., Dumont, T. M., & Spetzler, R. F. (2017). Hemodynamics Associated With Intracerebral Arteriovenous Malformations: The Effects of Treatment Modalities. Neurosurgery.More infoThe understanding of the physiology of cerebral arteriovenous malformations (AVMs) continues to expand. Knowledge of the hemodynamics of blood flow associated with AVMs is also progressing as imaging and treatment modalities advance. The authors present a comprehensive literature review that reveals the physical hemodynamics of AVMs, and the effect that various treatment modalities have on AVM hemodynamics and the surrounding cortex and vasculature. The authors discuss feeding arteries, flow through the nidus, venous outflow, and the relative effects of radiosurgical monotherapy, endovascular embolization alone, and combined microsurgical treatments. The hemodynamics associated with intracranial AVMs is complex and likely changes over time with changes in the physical morphology and angioarchitecture of the lesions. Hemodynamic change may be even more of a factor as it pertains to the vast array of single and multimodal treatment options available. An understanding of AVM hemodynamics associated with differing treatment modalities can affect treatment strategies and should be considered for optimal clinical outcomes.
- Fennell, V. S., Martirosyan, N. L., Atwal, G. S., Kalani, M. Y., Spetzler, R. F., Lemole, G. M., & Dumont, T. (2017). Effective Surgical Management of Competitive Venous Outflow Restriction After Radiosurgery for Cerebral AVMs: Report of 2 Cases. World neurosurgery, 98, 882.e1-882.e7.More infoIntracranial arteriovenous malformations (AVMs) are complex pathologies. For patients who do not present with hemorrhage, treatment strategies are often predicated on reducing the risk of hemorrhage and minimizing morbidity. Outcomes vary according to the efficacy of treatment selected. Radiosurgical treatment of certain AVMs can result in incomplete obliteration and may also have only a minimal effect on the presenting nonhemorrhagic symptoms.
- Froehler, M. T., Saver, J. L., Zaidat, O. O., Jahan, R., Aziz-Sultan, M. A., Klucznik, R. P., Haussen, D. C., Hellinger, F. R., Yavagal, D. R., Yao, T. L., Liebeskind, D. S., Jadhav, A. P., Gupta, R., Hassan, A. E., Martin, C. O., Bozorgchami, H., Kaushal, R., Nogueira, R. G., Gandhi, R. H., , Peterson, E. C., et al. (2017). Interhospital Transfer Before Thrombectomy Is Associated With Delayed Treatment and Worse Outcome in the STRATIS Registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke). Circulation, 136(24), 2311-2321.More infoEndovascular treatment with mechanical thrombectomy (MT) is beneficial for patients with acute stroke suffering a large-vessel occlusion, although treatment efficacy is highly time-dependent. We hypothesized that interhospital transfer to endovascular-capable centers would result in treatment delays and worse clinical outcomes compared with direct presentation.
- Mokin, M., Fargen, K. M., Primiani, C. T., Ren, Z., Dumont, T. M., Brasiliense, L. B., Dabus, G., Linfante, I., Kan, P., Srinivasan, V. M., Binning, M. J., Gupta, R., Turk, A. S., Elijovich, L., Arthur, A., Shallwani, H., Levy, E. I., & Siddiqui, A. H. (2017). Vessel perforation during stent retriever thrombectomy for acute ischemic stroke: technical details and clinical outcomes. Journal of neurointerventional surgery, 9(10), 922-928.More infoVessel perforation during stent retriever thrombectomy is a rare complication; typically only single instances have been reported.
- Mokin, M., Primiani, C. T., Ren, Z., Kan, P., Duckworth, E., Turner, R. D., Turk, A. S., Fargen, K. M., Dabus, G., Linfante, I., Dumont, T. M., Brasiliense, L. B., Shallwani, H., Snyder, K. V., Siddiqui, A. H., & Levy, E. I. (2017). Endovascular Treatment of Middle Cerebral Artery M2 Occlusion Strokes: Clinical and Procedural Predictors of Outcomes. Neurosurgery, 81(5), 795-802.More infoPatients with strokes from M2 segment middle cerebral artery (MCA) occlusion have been underrepresented in recent randomized trials of endovascular therapy.
- Mueller-Kronast, N. H., Zaidat, O. O., Froehler, M. T., Jahan, R., Aziz-Sultan, M. A., Klucznik, R. P., Saver, J. L., Hellinger, F. R., Yavagal, D. R., Yao, T. L., Liebeskind, D. S., Jadhav, A. P., Gupta, R., Hassan, A. E., Martin, C. O., Bozorgchami, H., Kaushal, R., Nogueira, R. G., Gandhi, R. H., , Peterson, E. C., et al. (2017). Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke: Primary Results of the STRATIS Registry. Stroke, 48(10), 2760-2768.More infoMechanical thrombectomy with stent retrievers has become standard of care for treatment of acute ischemic stroke patients because of large vessel occlusion. The STRATIS registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) aimed to assess whether similar process timelines, technical, and functional outcomes could be achieved in a large real world cohort as in the randomized trials.
- Palejwala, S. K., Rughani, A. I., & Dumont, T. M. (2017). Increased Utilization of Cervical Disk Arthroplasty in University Hospitals with Regional Variation and Socioeconomic Discrepancies. World neurosurgery, 99, 433-438.More infoTreatment of cervical radiculopathy with disk arthroplasty has been approved by the U.S. Food and Drug Administration since 2007. Recently, a significant increase in clinical data including mid- and long-term follow-up has become available, demonstrating the superiority of disk arthroplasty compared with anterior discectomy and fusion. The aim of this project is to assess the nationwide use of cervical disk arthroplasty.
- Palejwala, S. K., Rughani, A. I., Lemole, G. M., & Dumont, T. M. (2017). Socioeconomic and regional differences in the treatment of cervical spondylotic myelopathy. Surgical neurology international, 8, 92.More infoCervical spondylotic myelopathy (CSM) is the leading cause of spinal cord dysfunction in the world. Surgical treatment is both medically and economically advantageous, and can be achieved through multiple approaches, with or without fusion. We used the Nationwide Inpatient Sample (NIS) database to better elucidate regional and socioeconomic variances in the treatment of CSM.
- Ramey, W. L., Basken, R. L., Walter, C. M., Khalpey, Z., Lemole, G. M., & Dumont, T. M. (2017). Intracranial Hemorrhage in Patients with Durable Mechanical Circulatory Support Devices: Institutional Review and Proposed Treatment Algorithm. World neurosurgery, 108, 826-835.More infoSpontaneous intracranial hemorrhage (ICH) is frequently managed in neurosurgery. Patients with durable mechanical circulatory support devices, including total artificial heart (TAH) and left ventricular assist device (LVAD), are often encountered in the setting of ICH. Although durable mechanical circulatory support devices have improved survival and quality of life for patients with advanced heart failure, ICH is one of the most feared complications following LVAD and TAH implantation. Owing to anticoagulation and clinically relevant acquired coagulopathies, ICH should be treated promptly by neurosurgeons and cardiac critical care providers. We provide an analysis of ICH in patients with mechanical circulatory support and propose a treatment algorithm.
- Srinivasan, V. M., Ghali, M. G., Reznik, O. E., Cherian, J., Mokin, M., Dumont, T. M., Gaughen, J. R., Grandhi, R., Puri, A. S., Chen, S. R., Johnson, J. N., & Kan, P. (2017). Flow diversion for the treatment of posterior inferior cerebellar artery aneurysms: a novel classification and strategies. Journal of neurointerventional surgery.More infoThe pipeline embolization device (PED) is frequently used in the treatment of anterior circulation aneurysms, especially around the carotid siphon, with generally excellent results. However, treatment of posterior inferior cerebellar artery (PICA) aneurysms with flow diversion (FD) has not been specifically described or discussed. While there are reports of treating PICA aneurysms using placement of FD stents in the vertebral artery, there are no reports of treating these lesions by placement of flow diverting stents in the PICA vessel itself. Due to the unique anatomy and morphology of these aneurysms, it requires special attention. We assessed our multi-institutional experience treating these lesions, including the first reported cases of the PED placed within the PICA.
- Wilson, T. A., Leslie-Mazwi, T., Hirsch, J. A., Frey, C., Kim, T. E., Spiotta, A. M., De Leacy, R., Mocco, J., Albuquerque, F. C., Ducruet, A. F., Cheema, A., Arthur, A., Srinivasan, V. M., Kan, P., Mokin, M., Dumont, T., Rai, A., Singh, J., Wolfe, S. Q., & Fargen, K. M. (2017). A multicenter study evaluating the frequency and time requirement of mechanical thrombectomy. Journal of neurointerventional surgery.More infoThere are few published data evaluating the incidence of mechanical thrombectomy among stroke centers or the times at which they occur.
- Zaninovich, O. A., Ramey, W. L., Walter, C. M., & Dumont, T. M. (2017). Completion of the Circle of Willis Varies by Gender, Age, and Indication for Computed Tomography Angiography. World neurosurgery, 106, 953-963.More infoThe circle of Willis (CoW) is the foremost anastomosis and blood distribution center of the brain. Its effectiveness depends on its completion and the size and patency of its vessels. Gender-related and age-related anatomic variations in the CoW may play an important role in the pathogenesis of cerebrovascular diseases. In this study, we analyzed computed tomography angiograms (CTAs) to assess for differences in CoW completion related to gender, age, and indication for CTA.
- Bina, R. W., Lemole, G. M., & Dumont, T. M. (2016). Measuring Quality of Neurosurgical Care: Readmission Is Affected by Patient Factors. World neurosurgery, 88, 21-4.More infoThe Hospital Readmission Reduction Program section of the Patient Protection and Affordable Care Act uses readmission rates as a proxy for measuring quality of care. Multiple studies have demonstrated that readmission rates are highly imprecise proxies for quality of care because readmission rates contain large amounts of statistical noise and are dependent on disease type, insurance type, severity, population, and a multitude of other factors. The current study was conducted to investigate characteristics associated with readmission and the quality of neurosurgical care.
- Bina, R., Bina, R., Lemole, G. M., Lemole, G. M., Dumont, T. M., & Dumont, T. M. (2016). Editorial Response: On resident duty hour restriction and neurosurgical training. Journal of Neurosurgery, 124(3), 841.
- Dumont, T. M. (2016). Lumbar corpectomy for correction of degenerative scoliosis from osteoradionecrosis reveals a delayed complication of lumbar myxopapillary ependymoma. Journal of Clinical Neuroscience, 160-162. doi:10.1016/j.jocn.2016.02.010
- Dumont, T. M. (2016). Measuring quality of neurosurgical care: Readmission is affected by patient factors. World Neurosurgery. doi:10.1016/j.wneu.2015.12.091
- Dumont, T. M. (2016). Prospective Assessment of a Symptomatic Cerebral Vasospasm Predictive Neural Network Model. World neurosurgery, 94, 126-130.More infoThe author introduced a symptomatic cerebral vasospasm (SCV) prediction model built with freeware based on a 91-patient dataset. In a prospective test group of 22 patients at the same hospital, this model outperformed logistic regression models in vasospasm prediction on the basis of the same datasets. One of the model's limitations was a question of reproducibility in other centers. In this report, the author describes his experience with the prospective use of the model at a different hospital with a different population setting.
- Dumont, T. M. (2016). Prospective assessment of a symptomatic cerebral vasospasm predictive neural network model. World Neurosurgery. doi:10.1016/j.wneu.2016.06.110
- Dumont, T. M., Fennell, V. S., & Lemole, G. M. (2016). Response. Journal of neurosurgery, 124(1), 11-2.
- Dumont, T. M., Fennell, V. S., & Lemole, G. M. (2016). Response. Journal of neurosurgery, 124(1), 8.
- Dumont, T. M., Fennell, V., & Lemole, G. M. (2016). Editorial Response: Discipline and training. Journal of Neurosurgery, 124(1).
- Dumont, T. M., Lemole, G. M., & Fennell, V. (2016). Editorial Response: Does physician specialty matter?. Journal of Neurosurgery, 124(1), 8.
- Dumont, T. M., Sonig, A., Mokin, M., Eller, J. L., Sorkin, G. C., Snyder, K. V., Nelson Hopkins, L., Levy, E. I., & Siddiqui, A. H. (2016). Submaximal angioplasty for symptomatic intracranial atherosclerosis: a prospective Phase I study. Journal of neurosurgery, 1-8.More infoOBJECTIVE Intracranial atherosclerotic disease (ICAD) accounts for approximately 10% of ischemic strokes. The recent Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study demonstrated a high incidence of perioperative complications (15%) for treatment of ICAD with stenting. Although the incidence of stroke was lower in the medical arm, recurrent stroke was found in 12% of patients despite aggressive medical management, suggesting that intervention may remain a viable option for ICAD if perioperative risk is minimized. Angioplasty without stenting represents an alternative and understudied revascularization treatment for ICAD. Submaximal angioplasty limits the risks of thromboembolism, vessel perforation, and reperfusion hemorrhage that were frequently reported with stenting in the SAMMPRIS trial. The authors conducted a prospective Phase I trial designed to assess the safety of submaximal angioplasty in patients with symptomatic ICAD. METHODS This study was approved by the local institutional review board. Demographic and clinical data were prospectively collected. Angioplasty was performed with a balloon undersized to approximately 50%-70% of the nondiseased vessel diameter in patients with symptomatic ICAD who had angiographically significant stenosis of ≥ 70%. The primary outcome measure was the incidence of periprocedural complications (combined rate of death, stroke, and hemorrhage occurring within 30 days and at 1 year). RESULTS Among the 65 patients with symptomatic ICAD who were screened, 24 had significant angiographic stenosis that met the inclusion criteria of this study. The mean age was 64.08 years (median 65 years; SD ± 11.24 years), most were men (62.5%), and most were white (66.67%). Many patients had concomitants of vascular disease, including hypertension (95.8%), hyperlipidemia (70.83%), smoking history (54.1%), and diabetes mellitus (50.0%). Coronary artery disease (41.66%) and previous stroke or transient ischemic attack (45.83%) were frequently present. Most patients (75%) had anterior circulation stenosis. The mean preprocedure stenosis was 80.16% (median 80%, range 70%-95%). Submaximal angioplasty was performed in patients who met the inclusion criteria, with a mean postangioplasty stenosis rate of 54.62% (median 55.5%, range 31%-78%). Rates of ischemic stroke in the territory of the treated artery were 0% within 30 days and 5.55% (in the only patient who presented with recurrent stroke) at 1 year. The mortality and hemorrhage rates in this series were 0%. CONCLUSIONS This study demonstrates the safety of the submaximal angioplasty technique, with no permanent periprocedural complications in 24 treated patients.
- Fanous, A. A., Natarajan, S. K., Jowdy, P. K., Dumont, T. M., Mokin, M., Yu, J., Goldstein, A., Wach, M. M., Budny, J. L., Hopkins, L. N., Snyder, K. V., Siddiqui, A. H., & Levy, E. I. (2016). In Reply: High-Risk Factors in Symptomatic Patients Undergoing Carotid Artery Stenting With Distal Protection: Buffalo Risk Assessment Scale (BRASS). Neurosurgery, 79(5), E640-E641.
- Fanous, A. A., Natarajan, S. K., Jowdy, P. K., Dumont, T. M., Mokin, M., Yu, J., Goldstein, A., Wach, M. M., Budny, J. L., Hopkins, L. N., Snyder, K. V., Siddiqui, A. H., & Levy, E. I. (2016). In Reply: High-Risk Factors in Symptomatic Patients Undergoing Carotid Artery Stenting With Distal Protection: Buffalo Risk Assessment Scale (BRASS).. Neurosurgery.
- Fennell, V. S., Martirosyan, N. L., Atwal, G. S., Kalani, M. Y., Spetzler, R. F., Lemole, G. M., & Dumont, T. M. (2016). The effective surgical management of competitive venous outflow restriction after radiosurgery for cerebral AVMs: Report of 2 cases. World Neurosurgery.
- Mokin, M., Fargen, K. M., Primiani, C. T., Ren, Z., Dumont, T. M., Brasiliense, L. B., Dabus, G., Linfante, I., Kan, P., Srinivasan, V. M., Binning, M. J., Gupta, R., Turk, A. S., Elijovich, L., Arthur, A., Shallwani, H., Levy, E. I., & Siddiqui, A. H. (2016). Vessel perforation during stent retriever thrombectomy for acute ischemic stroke: technical details and clinical outcomes. Neurointerventional Surgery.
- Palejwala, S. K., Lawson, K. A., Kent, S. L., Martirosyan, N. L., & Dumont, T. M. (2016). Lumbar corpectomy for correction of degenerative scoliosis from osteoradionecrosis reveals a delayed complication of lumbar myxopapillary ependymoma. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 30, 160-162.More infoOsteoradionecrosis is a known complication following radiation therapy, presenting most commonly in the cervical spine as a delayed consequence of radiation that is often necessary in the management of head and neck cancers. In contrast, osteoradionecrosis has rarely been described in the lumbar spine. Here we describe, to our knowledge, the first reported case of lumbar spine osteoradionecrosis, after adjuvant radiation for a primary spinal cord tumor, leading to progressive degenerative scoliosis which required subsequent operative management. Established guidelines recommend that mature bone can tolerate a dose of up to 6000 cGy without injury. However, once bone has been exposed to radiation over this level progressive soft tissue changes may lead to devascularization, leaving the bone vulnerable to osteonecrosis, specifically when manipulated. Radiation necrosis can be progressive and lead to eventual mechanical instability requiring debridement and surgical fixation. In the setting of the lumbar spine, osseous necrosis can lead to biomechanical instability, deformity, pain, and neurologic deficit.
- Palejwala, S. K., Rughani, A. I., & Dumont, T. M. (2016). Increased Utilization of Cervical Disk Arthroplasty in University Hospitals with Regional Variation and Socioeconomic Discrepancies. World Neurosurgery.
- Abla, A. A., Kan, P., Jahshan, S., Dumont, T. M., Levy, E. I., & Siddiqui, A. H. (2015). External carotid dissection and external carotid proatlantal intersegmental artery with subclavian steal prompting external carotid and subclavian artery stenting. Journal of neuroimaging : official journal of the American Society of Neuroimaging, 24(4), 399-403.More infoThe authors describe a case of a proatlantal intersegmental artery seen in the setting of external carotid artery dissection and subclavian steal due to proximal subclavian artery stenosis.
- Bina, R. W., Lemole, G. M., & Dumont, T. M. (2015). On resident duty hour restrictions and neurosurgical training: review of the literature. Journal of neurosurgery, 1-7.More infoWithin neurosurgery, the national mandate of the 2003 duty hour restrictions (DHR) by the Accreditation Council for Graduate Medical Education (ACGME) has been controversial. Ensuring the proper education and psychological well-being of residents while fulfilling the primary purpose of patient care has generated much debate. Most medical disciplines have developed strategies that address service needs while meeting educational goals. Additionally, there are numerous studies from those disciplines; however, they are not specifically relevant to the needs of a neurosurgical residency. The recent implementation of the 2011 DHR specifically aimed at limiting interns to 16-hourduty shifts has proven controversial and challenging across the nation for neurosurgical residencies-again bringing education and service needs into conflict. In this report the current literature on DHR is reviewed, with special attention paid to neurosurgical residencies, discussing resident fatigue, technical training, and patient safety. Where appropriate, other specialty studies have been included. The authors believe that a one-size-fits-all approach to residency training mandated by the ACGME is not appropriate for the training of neurosurgical residents. In the authors' opinion, an arbitrary timeline designed to limit resident fatigue limits patient care and technical training, and has not improved patient safety.
- Dumont, T. M., & Horgan, M. A. (2015). The surgical skills laboratory residency interview: an enjoyable alternative. Journal of surgical education, 69(3), 407-10.More infoThe authors aimed to trial an alternative interviewing strategy by inviting residency candidates to our surgical anatomy laboratory. Interviews were coincident with surgical dissection. The authors hypothesized that residency candidates hoping to match into a surgical subspecialty might enjoy this unconventional interviewing strategy, which would mimic an operating room experience.
- Dumont, T. M., Kan, P., Snyder, K. V., Hopkins, L. N., Siddiqui, A. H., & Levy, E. I. (2015). A proposed grading system for endovascular treatment of cerebral arteriovenous malformations: Buffalo score. Surgical neurology international, 6, 3.More infoThe Spetzler-Martin arteriovenous malformation (AVM) grading system has proven to be useful in guiding treatment of cerebral AVMs with craniotomy. It is based on anatomical characteristics each of which makes surgical resection of an AVM more difficult, namely, deep venous drainage, eloquence of surrounding tissue, and large nidus size. A higher score correlates with more complications after treatment. Although this grading system has proven reliable over time, it does not reflect the major determinants of risk associated with endovascular treatment. The authors developed a grading system unique to endovascular treatment of cerebral AVMs.
- Dumont, T. M., Levy, E. I., Siddiqui, A. H., Snyder, K. V., & Hopkins, L. N. (2015). Endovascular treatment of giant intracranial aneurysms: a work in progress. World neurosurgery, 81(5-6), 671-5.
- Dumont, T. M., Lin, C., Tranmer, B. I., & Horgan, M. A. (2015). Pseudarthrosis failures of anterior subaxial cervical spine fusion using a plate with a single screw per vertebral body: a case series. World neurosurgery, 82(1-2), 225-30.More infoThe UNIPLATE was developed to improve operative times and limit dissection at the lateral margins of the vertebral bodies. The distinguishing character of this plate is its thin design, which requires only one screw per vertebral level (monovertebral screw plate). Most cervical spine plates, in contrast, are designed for two screws per vertebral level (bivertebral screw plate). Limited reports of the biomechanical efficacy of the UNIPLATE are available, and to the authors' knowledge, this report represents the largest clinical study of its use.
- Dumont, T. M., Sorkin, G. C., Snyder, K. V., Siddiqui, A. H., Levy, E. I., & Hopkins, L. N. (2015). On waffle cones and in vitro analysis of endovascular aneurysm treatment. World neurosurgery, 80(1-2), 50-2.
- Fanous, A. A., Natarajan, S. K., Jowdy, P. K., Dumont, T. M., Mokin, M., Yu, J., Goldstein, A., Wach, M. M., Budny, J. L., Hopkins, L. N., Snyder, K. V., Siddiqui, A. H., & Levy, E. I. (2015). High-Risk Factors in Symptomatic Patients Undergoing Carotid Artery Stenting With Distal Protection: Buffalo Risk Assessment Scale (BRASS). Neurosurgery, 77(4), 531-43.More infoDemographics and vascular anatomy may play an important role in predicting periprocedural complications in symptomatic patients undergoing carotid artery stenting (CAS).
- Fennell, V. S., Martirosyan, N. L., Palejwala, S. K., Lemole, G. M., & Dumont, T. M. (2015). Morbidity and mortality of patients with endovascularly treated intracerebral aneurysms: does physician specialty matter?. Journal of neurosurgery, 1-5.More infoOBJECT Endovascular treatment of cerebrovascular pathology, particularly aneurysms, is becoming more prevalent. There is a wide variety in clinical background and training of physicians who treat cerebrovascular pathology through endovascular means. The impact of clinical training background on patient outcomes is not well documented. METHODS The authors conducted a retrospective analysis of a large national database, the University HealthSystem Consortium, that was queried in the years 2009-2013. Cases of both unruptured cerebral aneurysms and subarachnoid hemorrhage treated by endovascular obliteration were studied. Outcome measures of morbidity and mortality were evaluated according to the specialty of the treating physician. RESULTS Elective embolization of an unruptured aneurysm was the procedure code and primary diagnosis, respectively, for 12,400 cases. Patients with at least 1 complication were reported in 799 cases (6.4%). Deaths were reported in 193 cases (1.6%). Complications and deaths were varied by specialty; the highest incidence of complications (11.1%) and deaths (3.0%) were reported by neurologists. The fewest complications were reported by neurosurgeons (5.4%; 1.4% deaths), with a higher incidence of complications reported in cases performed by neurologists (p < 0.0001 for both complications and deaths) and to a lesser degree interventional radiologists (p = 0.0093 for complications). Subarachnoid hemorrhage was the primary diagnosis and procedure for 8197 cases. At least 1 complication was reported in 2385 cases (29%) and deaths in 983 cases (12%). The number of complications and deaths varied among specialties. The highest incidence of complications (34%) and deaths (13.5%) in subarachnoid hemorrhage was in cases performed by neurologists. The fewest complications were in cases by neurosurgeons (27%), with a higher incidence of complications in cases performed by neurologists (34%, p < 0.0001), and a trend of increased complications with interventional radiologists (30%, p < 0.0676). The lowest incidence of mortality was in cases performed by neurosurgeons (11.5%), with a significantly higher incidence of mortality in cases performed by neurologists (13.5%, p = 0.0372). Mortality rates did not reach statistical significance with respect to interventional radiologists (12.1%, p = 0.4884). CONCLUSIONS Physicians of varied training types and backgrounds use endovascular treatment of ruptured and unruptured intracerebral aneurysms. In this study there was a statistically significant finding that neurosurgically trained physicians may demonstrate improved outcomes with respect to endovascular treatment of unruptured aneurysms in this cohort. This finding warrants further investigation.
- Kan, P., Dumont, T. M., Levy, E. I., Siddiqui, A. H., & Hopkins, L. N. (2015). Acute stroke therapy: are we ready for primetime clinical trials?. World neurosurgery, 77(5-6), 596-7.
- Lin, N., Lanzino, G., Lopes, D. K., Arthur, A. S., Ogilvy, C. S., Ecker, R. D., Dumont, T. M., Turner, R. D., Gooch, M. R., Boulos, A. S., Kan, P., Snyder, K. V., Levy, E. I., & Siddiqui, A. H. (2015). Treatment of Distal Anterior Circulation Aneurysms With the Pipeline Embolization Device: A US Multicenter Experience. Neurosurgery.More infoUtilization of the Pipeline embolization device (PED) to treat distal carotid circulation aneurysms has not been well studied.
- Mokin, M., Dumont, T. M., Chi, J. M., Mangan, C. J., Kass-Hout, T., Sorkin, G. C., Snyder, K. V., Hopkins, L. N., Siddiqui, A. H., & Levy, E. I. (2013). Proximal versus distal protection during carotid artery stenting: analysis of the two treatment approaches and associated clinical outcomes. World neurosurgery, 81(3-4), 543-8.More infoCerebral protection device utilization during carotid artery stenting (CAS) has been shown to decrease risk of perioperative stroke. The two most commonly used devices are distal filters and proximal protection devices, which allow blood flow cessation or flow reversal. The goal of the present study was to examine anatomic and morphologic characteristics of the treated lesions using each type of cerebral protection device and compare clinical 30-day adverse event rates between the two cerebral protection groups.
- Natarajan, S. K., Sonig, A., Mocco, J., Dumont, T. M., Thind, H., Hartney, M. L., Snyder, K. V., Hopkins, L. N., Siddiqui, A. H., & Levy, E. I. (2015). Primary Stenting for Acute Ischemic Stroke Using the Enterprise Intracranial Stent: 2-Year Results of a Phase-I Trial. Journal of vascular and interventional neurology, 8(3), 62-7.More infoThe preliminary results of a prospective consecutive series of 20 patients who underwent Enterprise-assisted recanalization for acute ischemic stroke were recently reported. Recanalization to thrombolysis in myocardial infarction (TIMI) grade 2 (n = 6) or 3 (n = 12) flow was achieved in 18 patients (90% revascularization rate). Good outcome (modified Rankin Scale [mRS] score of ≤2) was obtained in 10 patients (50%) at 30 days. Here, we report the 2-year clinical follow-up data for patients enrolled in that prospective study.
- Rughani, A. I., Tranmer, B. I., & Dumont, T. M. (2015). In reply. World neurosurgery, 82(1-2), e378.
- Seward, C. J., Dumont, T. M., & Levy, E. I. (2015). Endovascular therapy of extracranial carotid artery pseudoaneurysms: case series and literature review. Journal of neurointerventional surgery, 7(9), 682-9.More infoExperience with endovascular therapy of extracranial carotid artery pseudoaneurysm (ECAP) has been growing, and various results suggest it as a suitable treatment option. We present a consecutive case series of patients with ECAPs treated with endovascular therapy, and a pertinent literature review.
- Shakir, H. J., Diletti, S. M., Hart, A. M., Meyers, J. E., Dumont, T. M., & Siddiqui, A. H. (2015). Carotid body tumor imitator: An interesting case of Castleman's disease. Surgical neurology international, 6, 181.More infoThere are very few reports in the literature of Castleman's disease affecting the carotid artery and a single previous report of a case of Castleman's disease of the neck originally mistaken as a carotid body tumor.
- Sorkin, G. C., Dumont, T. M., Mokin, M., Eller, J. L., Natarajan, S. K., Levy, E. I., & Siddiqui, A. H. (2015). Hyperacute Carotid Stent Thrombosis During Emergent Revascularization Treated with Intraarterial Eptifibatide After Systemic Administration of Recombinant Tissue Plasminogen Activator. Journal of vascular and interventional neurology, 8(3), 50-5.More infoA 57-year-old woman with National Institutes of Health Stroke Scale (NIHSS) score of 26 was found to have an acute left carotid occlusion with tandem left M1 thrombus within 1.5 hours of symptom onset. After no neurologic improvement following standard-dose intravenous (IV) recombinant tissue plasminogen activator (rtPA), emergent neuroendovascular revascularization with carotid stenting and intracranial thrombectomy were performed under conscious sedation. Thrombolysis in myocardial infarction (TIMI)-3 flow restoration and symptom resolution were achieved postprocedure; however, complete carotid stent thrombosis was noted on final angiographic runs (25 minutes later), correlating with neurologic decline. Rapid administration of an intraarterial (IA) bolus dose of eptifibatide resulted in TIMI-3 flow restoration, with neurologic improvement. The patient was discharged three days postrevascularization on dual antiplatelet therapy with an NIHSS score of 1. Intraarterial (IA) eptifibatide can be an effective option for acute stent occlusion during emergent neuroendovascular revascularization after IV rtPA administration.
- Wach, M. M., Dumont, T. M., Shakir, H. J., Snyder, K. V., Hopkins, L. N., Levy, E. I., & Siddiqui, A. H. (2015). Carotid artery stenting in nonagenarians: are there benefits in surgically treating this high risk population?. Journal of neurointerventional surgery, 7(3), 182-7.More infoCarotid angioplasty and stenting (CAS) is considered desirable treatment for patients at high risk for carotid endarterectomy. Despite a growing elderly population, scant data exist on CAS in nonagenarians. Nonagenarians represent a high risk population for open and endovascular interventions due to unique anatomic and physiologic characteristics presenting significant challenges to anesthesiologists and surgeons. Studies have quantified that symptomatic and asymptomatic patients should survive 2 and 5 years, respectively, to gain benefit from revascularization; thus doubt exists on the value of CAS in nonagenarian patients because of their extreme age and unique risk factors. We therefore evaluated CAS safety and efficacy in our hospital's nonagenarian population.
- Dumont, T. M., Eller, J. L., Mokin, M., Sorkin, G. C., & Levy, E. I. (2014). Advances in endovascular approaches to cerebral aneurysms. Neurosurgery, 74 Suppl 1, S17-31.More infoRecent advancements in all phases of endovascular aneurysm treatment, including medical therapy, diagnostics, devices, and implants, abound. Advancements in endovascular technologies and techniques have enabled treatment of a wide variety of intracranial aneurysms. In this article, technical advances in endovascular treatment of cerebral aneurysms are discussed, with an effort to incorporate a clinically relevant perspective. Advancements in diagnostic tools, medical therapy, and implants are reviewed and discussed.
- Dumont, T. M., Ma, D., Xiang, J., Choi, H., Natarajan, S. K., Siddiqui, A. H., & Meng, H. (2014). Endovascular treatment of posterior circulation aneurysms. Neurological Research, 35(9), 1779-1785. doi:10.3174/ajnr.A3933
- Dumont, T. M., Mokin, M., Sorkin, G. C., Levy, E. I., & Siddiqui, A. H. (2014). Aspiration thrombectomy in concert with stent thrombectomy. Journal of neurointerventional surgery, 6(4), e26.More infoIn the SWIFT and TREVO 2 trials, aspiration thrombectomy was not able to be performed. Outside these studies, in post-market application, the interventionist can use aspiration thrombectomy in addition to stent device thrombectomy. This technique is described in detail in the present report. Combined aspiration/stentriever thrombectomy may improve recanalization efforts, simplify a second thrombectomy attempt if necessary and may limit distal embolization.
- Dumont, T. M., Mokin, M., Wach, M. M., Drummond, P. S., Siddiqui, A. H., Levy, E. I., & Hopkins, L. N. (2014). Understanding risk factors for perioperative ischemic events with carotid stenting: is patient age over 80 years or is unfavorable arch anatomy to blame?. Journal of neurointerventional surgery, 6(3), 219-24.More infoSeveral studies have reported increased perioperative risk after carotid artery stenting (CAS) for patients ≥80 years of age; however, most have not considered unfavorable anatomic features noted more frequently in this population as a confounding variable. The purpose of this study was to show a correlation between poor aortic arch anatomy and perioperative ischemic complications after CAS.
- Dumont, T. M., Natarajan, S. K., Eller, J. L., Mocco, J., Kelly, W. H., Snyder, K. V., Hopkins, L. N., Siddiqui, A. H., & Levy, E. I. (2014). Primary stenting for acute ischemic stroke using the Enterprise vascular reconstruction device: early results. Journal of neurointerventional surgery, 6(5), 363-72.More infoPrimary stenting for acute ischemic stroke (AIS) using the Wingspan stent delivery system has been reported. Major technical limitations in that study were difficulties in delivering the device and a few cases in which the Enterprise vascular reconstruction device (stent) was used as a bailout procedure. The Enterprise, which has relatively less radial force and more flexibility than other intracranial stents, is an ideal device for revascularization as it is easily delivered through tortuous intracranial vessels. We tested the safety and effectiveness of this stent as the primary revascularization device for AIS in an FDA-approved investigational device exemption prospective cohort study.
- Eller, J. L., Dumont, T. M., Mokin, M., Sorkin, G. C., Levy, E. I., Snyder, K. V., Nelson Hopkins, L., & Siddiqui, A. H. (2014). Endovascular treatment of posterior circulation aneurysms. Neurological research, 36(4), 339-43.More infoEndovascular techniques are well suited for the treatment of posterior circulation aneurysms. This review describes the endovascular management of these aneurysms and discusses relevant technical advances.
- Eller, J. L., Dumont, T. M., Sorkin, G. C., Mokin, M., Levy, E. I., Snyder, K. V., Hopkins, L. N., & Siddiqui, A. H. (2014). The Pipeline embolization device for treatment of intracranial aneurysms. Expert review of medical devices, 11(2), 137-50.More infoFlow diversion is a new endovascular technique developed for treatment of intracranial aneurysms. It is based on stent-induced modification of blood flow within and around an aneurysm inflow zone, leading to gradual intra-aneurysmal thrombosis and subsequent atrophy, while preserving flow into the parent vessel and perforating branches. Flow-diversion technique is well-suited for the treatment of large, giant, wide-necked, and fusiform intracranial aneurysms because it does not rely on endosaccular packing with coils but rather on the strategy of placing a stent across the aneurysm "neck" or across the diseased segment of a vessel in case of a fusiform aneurysm. Over time, neointimal endothelium covers the flow diverter such that it becomes incorporated into the parent vessel wall and occludes the aneurysm from the circulation, effectively repairing the diseased parent vessel segment. This report describes in detail the Pipeline embolization device (ev3-Covidien, Irvine, California, USA), its mechanism of action and deployment technique, and reviews the pertinent literature regarding safety, efficacy and potential risks and complications associated with the use of this flow diverter.
- Eller, J. L., Dumont, T. M., Sorkin, G. C., Mokin, M., Levy, E. I., Snyder, K. V., Nelson Hopkins, L., & Siddiqui, A. H. (2014). Endovascular advances for extracranial carotid stenosis. Neurosurgery, 74 Suppl 1, S92-101.More infoCarotid artery stenting has become a viable alternative to carotid endarterectomy in the management of carotid stenosis. Over the past 20 years, many trials have attempted to compare both treatment modalities and establish the indications for each one, depending on clinical and anatomic features presented by patients. Concurrently, carotid stenting techniques and devices have evolved and made endovascular management of carotid stenosis safe and effective. Among the most important innovations are devices for distal and proximal embolic protection and new stent designs. This paper reviews these advances in the endovascular management of carotid artery stenosis within the context of the historical background.
- Eller, J. L., Jahshan, S., Dumont, T. M., Kan, P., & Siddiqui, A. H. (2014). Tandem symptomatic internal carotid artery and persistent hypoglossal artery stenosis treated by endovascular stenting and flow reversal. Journal of neurointerventional surgery, 6(4), e25.More infoPersistence of the hypoglossal artery into adulthood is a rare vascular anomaly and, when present, provides the predominant vascular supply to the posterior circulation. We describe a case of vertebrobasilar insufficiency associated with severe high-grade stenosis of the persistent hypoglossal artery and tandem stenosis of the proximal ipsilateral internal carotid artery, treated by an endovascular approach. The unique anatomical and technical challenges associated with this case are reviewed in detail.
- James, W. S., Rughani, A. I., & Dumont, T. M. (2014). A socioeconomic analysis of intraoperative neurophysiological monitoring during spine surgery: national use, regional variation, and patient outcomes. Neurosurgical focus, 37(5), E10.More infoIn the United States in recent years, a dramatic increase in the use of intraoperative neurophysiological monitoring (IONM) during spine surgeries has been suspected. Myriad reasons have been proposed, but no clear evidence confirming this trend has been available. In this study, the authors investigated the use of IONM during spine surgery, identified patterns of geographic variation, and analyzed the value of IONM for spine surgery cases.
- Ma, D., Xiang, J., Choi, H., Dumont, T. M., Natarajan, S. K., Siddiqui, A. H., & Meng, H. (2014). Enhanced aneurysmal flow diversion using a dynamic push-pull technique: an experimental and modeling study. AJNR. American journal of neuroradiology, 35(9), 1779-85.More infoNeurovascular flow diverters are flexible, braided stent-meshes for intracranial aneurysm treatment. We applied the dynamic push-pull technique to manipulate the flow-diverter mesh density at the aneurysm orifice to maximize flow diversion. This study investigated the hemodynamic impact of the dynamic push-pull technique on patient-specific aneurysms by using the developed high-fidelity virtual-stenting computational modeling technique combined with computational fluid dynamics.
- Mokin, M., Dumont, T. M., & Levy, E. I. (2014). Novel multimodality imaging techniques for diagnosis and evaluation of arteriovenous malformations. Neurologic clinics, 32(1), 225-36.More infoBrain arteriovenous malformations (AVMs) are abnormal communications between arteries and veins characterized radiographically by the presence of a nidus and early venous drainage. Estimation of hemorrhage risk and determination of treatment strategy rely on the location and hemodynamic properties of the AVM. This article describes modern noninvasive approaches to diagnosing and evaluating AVMs, including dynamic 4-dimensional computed tomographic and magnetic resonance angiography and perfusion imaging. The role and latest advances in digital subtraction angiography and intraoperative imaging are also described.
- Mokin, M., Khalessi, A. A., Mocco, J., Lanzino, G., Dumont, T. M., Hanel, R. A., Lopes, D. K., Fessler, R. D., Ringer, A. J., Bendok, B. R., Veznedaroglu, E., Siddiqui, A. H., Hopkins, L. N., & Levy, E. I. (2014). Endovascular treatment of acute ischemic stroke: the end or just the beginning?. Neurosurgical focus, 36(1), E5.More infoVarious endovascular intraarterial approaches are available for treating patients with acute ischemic stroke who present with severe neurological deficits. Three recent randomized trials-Interventional Management of Stroke (IMS) III, Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy (MR RESCUE), and Synthesis Expansion: A Randomized Controlled Trial on Intra-Arterial Versus Intravenous Thrombolysis in Acute Ischemic Stroke (SYNTHESIS Expansion)-evaluated the efficacy of endovascular treatment of acute ischemic stroke and, after failing to demonstrate any significant clinical benefit of endovascular therapies, raised concerns and questions in the medical community regarding the future of endovascular treatment for acute ischemic stroke. In this paper, the authors review the evolution of endovascular treatment strategies for the treatment of acute stroke and provide their interpretation of findings and potential limitations of the three recently published randomized trials. The authors discuss the advantage of stent-retriever technology over earlier endovascular approaches and review the current status and future directions of endovascular acute stroke studies based on lessons learned from previous trials.
- Mokin, M., Masud, M. W., Dumont, T. M., Ahmad, G., Kass-Hout, T., Snyder, K. V., Hopkins, L. N., Siddiqui, A. H., & Levy, E. I. (2014). Outcomes in patients with acute ischemic stroke from proximal intracranial vessel occlusion and NIHSS score below 8. Journal of neurointerventional surgery, 6(6), 413-7.More infoAcute ischemic stroke due to proximal intracranial vessel occlusion is associated with poor prognosis and neurologic outcomes. Outcomes specifically in patients with stroke due to these occlusions and lower National Institutes of Health Stroke Scale (NIHSS) scores (0-7 range) have not been described previously.
- Rughani, A. I., Dumont, T. M., & Tranmer, B. I. (2014). Editorial: Predicting surgical satisfaction using artificial neural networks. Journal of neurosurgery. Spine, 20(3), 298-9.
- Shakir, H. J., Garson, A. D., Sorkin, G. C., Mokin, M., Eller, J. L., Dumont, T. M., Popat, S. R., Leonardo, J., & Siddiqui, A. H. (2014). Combined use of covered stent and flow diversion to seal iatrogenic carotid injury with vessel preservation during transsphenoidal endoscopic resection of clival tumor. Surgical neurology international, 5, 81.More infoTranssphenoidal tumor resection can lead to internal carotid artery (ICA) injury. Vascular disruption is often treated with emergent vessel deconstruction, incurring complications in a subset of patients with poor collateral circulation and resulting in minor and major ischemic strokes.
- Shallwani, H., Dumont, T. M., Wach, M. M., Levy, E. I., & Siddiqui, A. H. (2014). Endoluminal stent reconstruction of low-grade, symptomatic carotid plaques: a treatment alternative-report of two cases. Journal of vascular and interventional neurology, 7(1), 43-6.More infoMedical treatment of low-grade (
- Sorkin, G. C., Dumont, T. M., Eller, J. L., Mokin, M., Hopkins, L. N., Snyder, K. V., Siddiqui, A. H., & Levy, E. I. (2014). Instent restenosis after carotid stenting: treatment using an off-label cardiac scoring balloon. Journal of vascular and interventional neurology, 7(1), 29-34.More infoTreatment of instent restenosis after carotid artery stenting because of circumferential or calcified lesions can be difficult and refractory to conventional balloon angioplasty. We describe the off-label use of a cardiac scoring balloon that was used for lesions refractory to angioplasty with other balloons.
- Sorkin, G. C., Dumont, T. M., Eller, J. L., Mokin, M., Snyder, K. V., Levy, E. I., Siddiqui, A. H., & Hopkins, L. N. (2014). Cerebrovascular neurosurgery in evolution: the endovascular paradigm. Neurosurgery, 74 Suppl 1, S191-7.More infoEndovascular technique represents an important, minimally invasive approach to treating cerebrovascular disease. In this article, we discuss the origins of endovascular neurosurgery as a discipline in the context of important technical milestones, evidence-based medicine, and future cerebrovascular neurosurgical training. Cerebrovascular neurosurgery has seen a steady, convergent evolution toward the surgeon capable of seamless incorporation of open and endovascular approaches to any complex vascular disease affecting the central nervous system. Neurosurgery must assume the leadership role in the multidisciplinary neurovascular team.
- Sorkin, G. C., Dumont, T. M., Wach, M. M., Eller, J. L., Mokin, M., Natarajan, S. K., Baxter, M. S., Snyder, K. V., Levy, E. I., Hopkins, L. N., & Siddiqui, A. H. (2013). Carotid artery stenting outcomes: do they correlate with antiplatelet response assays?. Journal of neurointerventional surgery, 6(5), 373-8.More infoLimited data exist regarding the use of antiplatelet response assays during neuroendovascular intervention. We report outcomes after carotid artery stenting (CAS) based on aspirin and P2Y12 assays.
- Wach, M. M., Dumont, T. M., Mokin, M., Kass-Hout, T., Snyder, K. V., Hopkins, L. N., Levy, E. I., & Siddiqui, A. H. (2014). Early carotid angioplasty and stenting may offer non-inferior treatment for symptomatic cases of carotid artery stenosis. Journal of neurointerventional surgery, 6(4), 276-80.More infoEarly intervention is desirable in patients presenting with stroke or transient ischemic attack (TIA) referable to carotid artery stenosis because of the high incidence of recurrent ischemic events within 48 h post-ictus. However, the optimal timing of performing carotid angioplasty and stenting (CAS) in these patients remains unclear amid concerns for an elevated risk of perioperative complications. The primary outcome of this study was the combined incidence of major perioperative complications (stroke, myocardial infarction (MI), death) based on timing of CAS relative to symptom onset.
- Yoon, J. W., Siddiqui, A. H., Dumont, T. M., Levy, E. I., Hopkins, L. N., Lanzino, G., Lopes, D. K., Moftakhar, R., Billingsley, J. T., Welch, B. G., Boulos, A. S., Yamamoto, J., Tawk, R. G., Ringer, A. J., & Hanel, R. A. (2014). Feasibility and safety of pipeline embolization device in patients with ruptured carotid blister aneurysms. Neurosurgery, 75(4), 419-29; discussion 429.More infoTreatment of internal carotid ruptured blister aneurysms (IC-RBA) presents many challenges to neurosurgeons because of the high propensity for rebleeding during intervention. The role of a Pipeline Embolization Device (PED) in the treatment of this challenging aneurysm subtype remains undefined despite theoretical advantages.
- Abla, A. A., Dumont, T. M., Kan, P., Hopkins, L. N., Siddiqui, A. H., & Levy, E. I. (2013). Stroke intervention for middle cerebral artery thrombus in a young patient with an ipsilateral Spetzler-Martin grade V arteriovenous malformation. Journal of neurointerventional surgery, 5(2), e10.More infoA patient (in their late 20s) was admitted with a right frontal stroke, left hemiparesis and hemianopsia, and a National Institutes of Health Stroke Scale (NIHSS) score of 11. CT perfusion imaging revealed an ischemic penumbra. A CT angiogram showed a Spetzler-Martin grade V arteriovenous malformation (AVM) in the right frontal lobe and a second, smaller AVM in the medial occipital region. Successful mechanical thrombectomy for middle cerebral artery thrombi improved flow from a Thrombolysis in Cerebral Infarction score of 0 to 2b. Following endovascular mechanical thrombectomy, the NIHSS dramatically improved from 11 to 2 and the patient was discharged home in 7 days. Evaluation 1 month after treatment disclosed a nearly complete recovery, with mild residual arm weakness (NIHSS 1). This case illustrates acute stroke intervention in the setting of an ipsilateral, large, high flow AVM in a young adult and is the first such reported case to our knowledge.
- Abla, A. A., Jahshan, S., Kan, P., Mokin, M., Dumont, T. M., Eller, J. L., Snyder, K. V., Hopkins, L. N., Siddiqui, A. H., & Levy, E. I. (2013). Results of endovascular treatment of middle cerebral artery aneurysms after first giving consideration to clipping. Acta neurochirurgica, 155(4), 559-68.More infoMiddle cerebral artery (MCA) aneurysms are among the more challenging aneurysms for endovascular treatment. We report a contemporary 5-year experience with endovascular therapy for MCA aneurysms at a high-volume neurovascular center.
- Dumont, T. M., & Hopkins, L. N. (2013). Stroke intervention: evolution of implementation of cutting-edge technologies. Neurosurgery, 60 Suppl 1, 5-8.
- Dumont, T. M., Eller, J. L., & Hopkins, L. N. (2013). Embolic protection for great vessel revascularization: is this best practice?. World neurosurgery, 80(6), e199-200.
- Dumont, T. M., Eller, J. L., Mokin, M., Snyder, K. V., Hopkins, L. N., Levy, E. I., & Siddiqui, A. H. (2013). Transfemoral endovascular treatment of atherosclerotic stenotic lesions of the left common carotid artery ostium: case series and review of the literature. Journal of neurointerventional surgery, 5(6), 539-42.More infoEndovascular treatment of atherosclerotic stenosis of the left common carotid artery ostium (LCCAO) represents a technical challenge. Unlike stenting of other supra-aortic trunk lesions, LCCAO stenting is not able to be performed from a retrograde approach through the brachial artery. Stenting may be performed via a retrograde approach with a carotid artery cut-down or with total endovascular technique via a transfemoral approach. A consecutive case series is presented to demonstrate the feasibility and safety of the endovascular transfemoral LCCAO stenting technique.
- Dumont, T. M., Eller, J. L., Sorkin, G. C., Mokin, M., Lo, T. P., Snyder, K. V., Hopkins, L. N., Siddiqui, A. H., & Levy, E. I. (2013). Aneurysm treatment with flow diversion: two live cases from the Gates Vascular Institute. Neurosurgery, 60 Suppl 1, 48-56.
- Dumont, T. M., Kan, P., Snyder, K. V., Hopkins, L. N., Levy, E. I., & Siddiqui, A. H. (2013). Stenting of the vertebral artery origin with ostium dilation: technical note. Journal of neurointerventional surgery, 5(5), e36.More infoEndovascular treatment of vertebral artery (VA) origin stenosis typically requires placement of the proximal end of the stent within the lumen of the subclavian artery or aorta to provide complete coverage of the ostial lesion. This configuration may complicate subsequent endovascular access into the stented VA. We describe a technique modification of VA origin stenting and angioplasty with a monorail angioplasty balloon system designed specifically for dilation of the ostial origin which may be helpful in conforming the proximal portion of the stent to the VA origin. Simplified endovascular access to the VA origin after angioplasty is demonstrated.
- Dumont, T. M., Kan, P., Snyder, K. V., Hopkins, L. N., Siddiqui, A. H., & Levy, E. I. (2013). Adjunctive use of eptifibatide for complication management during elective neuroendovascular procedures. Journal of neurointerventional surgery, 5(3), 226-30.More infoA rare complication of neuroendovascular procedures is acute thromboembolism. In the setting of intraprocedural or periprocedural embolism, thrombolytics present a potentially useful therapeutic strategy. A series of patients in whom eptifibatide (a platelet glycoprotein IIb/IIIa receptor inhibitor) was used in the treatment of iatrogenic thromboembolic events occurring during elective neuroendovascular procedures is described.
- Dumont, T. M., Mokin, M., Snyder, K. V., Siddiqui, A. H., Levy, E. I., & Hopkins, L. N. (2013). A paradigm-shifting technology for the treatment of cerebral aneurysms: the pipeline embolization device. World neurosurgery, 80(6), 800-3.
- Dumont, T. M., Mokin, M., Sorkin, G. C., Levy, E. I., & Siddiqui, A. H. (2013). Aspiration thrombectomy in concert with stent thrombectomy. BMJ case reports, 2013.More infoIn the SWIFT and TREVO 2 trials, aspiration thrombectomy was not able to be performed. Outside these studies, in post-market application, the interventionist can use aspiration thrombectomy in addition to stent device thrombectomy. This technique is described in detail in the present report. Combined aspiration/stentriever thrombectomy may improve recanalization efforts, simplify a second thrombectomy attempt if necessary and may limit distal embolization.
- Dumont, T. M., Rughani, A. I., Goeckes, T., & Tranmer, B. I. (2013). Chronic subdural hematoma: a sentinel health event. World neurosurgery, 80(6), 889-92.More infoTo propose that chronic subdural hematoma (CSDH) should be conceived as a sentinel event in elderly patients and offer an analysis of long-term survival after diagnosis.
- Dumont, T. M., Wach, M. M., Mokin, M., Sorkin, G. C., Snyder, K. V., Hopkins, L. N., Levy, E. I., & Siddiqui, A. H. (2013). Perioperative complications after carotid artery stenting: a contemporary experience from the university at buffalo neuroendovascular surgery team. Neurosurgery, 73(4), 689-93; discussion 693-4.More infoTechnological advances have resulted in diminishing perioperative complications reported during carotid artery stenting (CAS) trials. Because trial experience lags behind technological advances, an understanding of the incidence of perioperative complications after CAS remains in flux.
- Eller, J. L., Jahshan, S., Dumont, T. M., Kan, P., & Siddiqui, A. H. (2013). Tandem symptomatic internal carotid artery and persistent hypoglossal artery stenosis treated by endovascular stenting and flow reversal. BMJ case reports, 2013.More infoPersistence of the hypoglossal artery into adulthood is a rare vascular anomaly and, when present, provides the predominant vascular supply to the posterior circulation. We describe a case of vertebrobasilar insufficiency associated with severe high-grade stenosis of the persistent hypoglossal artery and tandem stenosis of the proximal ipsilateral internal carotid artery, treated by an endovascular approach. The unique anatomical and technical challenges associated with this case are reviewed in detail.
- Kan, P., Abla, A. A., Dumont, T. M., Snyder, K. V., Hopkins, L. N., Levy, E. I., & Siddiqui, A. H. (2013). Double-barrel stent-assisted coiling of a basilar artery fenestration aneurysm. Journal of neuroimaging : official journal of the American Society of Neuroimaging, 23(3), 496-9.More infoBasilar artery fenestration aneurysms are rare aneurysms, posing unique challenges for endovascular treatment. We report a case of successful treatment of a wide-necked basilar artery fenestration aneurysm with a novel double-barrel stent-assisted coiling technique.
- Ma, D., Dumont, T. M., Kosukegawa, H., Ohta, M., Yang, X., Siddiqui, A. H., & Meng, H. (2013). High fidelity virtual stenting (HiFiVS) for intracranial aneurysm flow diversion: in vitro and in silico. Annals of biomedical engineering, 41(10), 2143-56.More infoA flow diverter (FD) is a flexible, densely braided stent-mesh device placed endoluminally across an intracranial aneurysm to induce its thrombotic occlusion. FD treatment planning using computational virtual stenting and flow simulation requires accurate representation of the expanded FD geometry. We have recently developed a high fidelity virtual stenting (HiFiVS) technique based on finite element analysis to simulate detailed FD deployment processes in patient-specific aneurysms (Ma et al. J. Biomech. 45:2256-2263,(2012)). This study tests if HiFiVS simulation can recapitulate real-life FD implantation. We deployed two identical FDs (Pipeline Embolization Device) into phantoms of a wide-necked segmental aneurysm using a clinical push-pull technique with different delivery wire advancements. We then simulated these deployment processes using HiFiVS and compared results against experimental recording. Stepwise comparison shows that the simulations precisely reproduced the FD deployment processes recorded in vitro. The local metal coverage rate and pore density quantifications demonstrated that simulations reproduced detailed FD mesh geometry. These results provide validation of the HiFiVS technique, highlighting its unique capability of accurately representing stent intervention in silico.
- Mokin, M., Dumont, T. M., Kass-Hout, T., & Levy, E. I. (2013). Carotid and vertebral artery disease. Primary care, 40(1), 135-51.More infoExtracranial carotid artery disease is commonly seen in patients presenting with stroke symptoms. It is also a frequent incidental finding in patients undergoing evaluation as part of a routine examination in the outpatient setting. Several diagnostic imaging modalities are currently available. Treatment strategies include medical and surgical management. Multiple randomized trials conducted over the past decade have laid a foundation for guidelines on the management of extracranial carotid disease. Evaluation and treatment of patients with vertebral artery stenosis is less understood. We review the evidence for the detection and treatment of patients with extracranial carotid artery and vertebral artery disease.
- Mokin, M., Dumont, T. M., Veznedaroglu, E., Binning, M. J., Liebman, K. M., Fessler, R. D., To, C. Y., Turner, R. D., Turk, A. S., Chaudry, M. I., Arthur, A. S., Fox, B. D., Hanel, R. A., Tawk, R. G., Kan, P., Gaughen, J. R., Lanzino, G., Lopes, D. K., Chen, M., , Moftakhar, R., et al. (2013). Solitaire FR Thrombectomy for Acute Ischemic Stroke: Retrospective Multicenter Analysis of Early Postmarket Experience after FDA Approval. Neurosurgery.More infoBACKGROUND:: The promising results of the Solitaire Flow Restoration (FR) With the Intention for Thrombectomy (SWIFT) trial recently led toFood and Drug Administration (FDA) approval of theSolitaire FR stent retriever device for recanalization of cerebral vessels in patients with acute ischemic stroke. OBJECTIVE:: To report the early postmarket experience with this device since its FDA approval in the United States, which has not been previously described. METHODS:: We conducted aretrospective analysis of consecutive acute ischemic strokes cases treated between March 2012 and July 2012 at 10 United States centers where the Solitaire FR was used as a single device or in conjunction with other intraarterial endovascular approaches. RESULTS:: A total of 101 patients were identified (mean age, 64.7 years; mean admission National Institutes of Health Stroke Scale [NIHSS] score, 17.6). Intravenous thrombolysis was administered in 39% of cases; other endovascular techniques were utilized in conjunction with the Solitaire FR in 52%. Successful recanalization (Thrombolysis in Myocardial Infarction 2/3) was achieved in 88%. The rate of symptomatic intracranial hemorrhage within the first 24 hours was 15%. In-hospital mortality was 26%. At 30 days, 38% of patients had favorable functional outcome (modified Rankin scale score ≤2).Severity of NIHSS score on admission was a strong predictor of poor outcome. CONCLUSION:: Our study shows that a variety of other endovascular approaches are used in conjunction with Solitaire FR in actual practice in the United States.Early postmarket results suggest that Solitaire FR is an effective tool for endovascular treatment of acute ischemic stroke.
- Mokin, M., Dumont, T. M., Veznedaroglu, E., Binning, M. J., Liebman, K. M., Fessler, R. D., To, C. Y., Turner, R. D., Turk, A. S., Chaudry, M. I., Arthur, A. S., Fox, B. D., Hanel, R. A., Tawk, R. G., Kan, P., Gaughen, J. R., Lanzino, G., Lopes, D. K., Chen, M., , Moftakhar, R., et al. (2013). Solitaire Flow Restoration thrombectomy for acute ischemic stroke: retrospective multicenter analysis of early postmarket experience after FDA approval. Neurosurgery, 73(1), 19-25; discussion 25-6.More infoThe promising results of the Solitaire Flow Restoration (FR) With the Intention for Thrombectomy (SWIFT) trial recently led to Food and Drug Administration (FDA) approval of the Solitaire FR stent retriever device for recanalization of cerebral vessels in patients with acute ischemic stroke.
- Sorkin, G. C., Jaleel, N., Mokin, M., Dumont, T. M., Eller, J. L., & Siddiqui, A. H. (2013). Ruptured mycotic cerebral aneurysm development from pseudoocclusion due to septic embolism. Surgical neurology international, 4, 144.More infoCerebral mycotic aneurysms are rare sequelae of systemic infections that can cause profound morbidity and mortality with rupture. Direct bacterial extension and vessel integrity compromise from septic emboli have been implicated as mechanisms for formation of these lesions. We report the 5-day development of a ruptured mycotic aneurysm arising from a septic embolism that caused a focal M1 pseudoocclusion.
- Dumont, T. M., & Hopkins, L. N. (2012). Comment. Neurosurgery, 71(4), 784.
- Dumont, T. M., & Rughani, A. I. (2012). National trends in carotid artery revascularization surgery. Journal of neurosurgery, 116(6), 1251-7.More infoSeveral randomized trials have emerged with conflicting data on the overall safety of carotid artery stenting (CAS) in comparison with carotid endarterectomy (CEA). The authors hypothesize that changes in national trends correspond to publication of randomized trials, including an increase in utilization of CAS after publication of trials favorable to CAS (for example, Carotid and Vertebral Artery Transluminal Angioplasty Study [CAVATAS] and Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy [SAPPHIRE]) and decrease in utilization of CAS after publication of trials favorable to CEA (for example, Endarterectomy versus Stenting in Patients with Symptomatic Severe Carotid Stenosis [EVA3-S] and Stent-Supported Percutaneous Angioplasty of the Carotid Artery versus Endarterectomy [SPACE]).
- Dumont, T. M., Kan, P., Jahshan, S., Eller, J. L., Snyder, K. V., Siddiqui, A. H., Hopkins, L. N., & Levy, E. I. (2012). Unyielding progress: carotid stenting cases from Millard Fillmore Gates Circle Hospital in Buffalo, New York. Clinical neurosurgery, 59, 50-8.
- Dumont, T. M., Kan, P., Snyder, K. V., Hopkins, L. N., Siddiqui, A. H., & Levy, E. I. (2012). Revisiting angioplasty without stenting for symptomatic intracranial atherosclerotic stenosis after the stenting and aggressive medical management for preventing recurrent stroke in intracranial stenosis (SAMMPRIS) study. Neurosurgery, 71(6), 1103-10.More infoThe Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study stopped recruiting patients because of higher-than-expected perioperative morbidity of primary stenting in patients with symptomatic intracranial stenosis. An alternative treatment, submaximal angioplasty without stenting, performed concurrently with SAMMPRIS, may offer revascularization benefits with a lower incidence of stenting-related risks.
- Dumont, T. M., Rughani, A. I., Penar, P. L., Horgan, M. A., Tranmer, B. I., & Jewell, R. P. (2012). Increased rate of complications on a neurological surgery service after implementation of the Accreditation Council for Graduate Medical Education work-hour restriction. Journal of neurosurgery, 116(3), 483-6.More infoThe Accreditation Council for Graduate Medical Education instituted mandatory 80-hour work-week limitations in July 2003. The work-hour restriction was met with skepticism among the academic neurosurgery community and is thought to represent a barrier to teaching, ultimately compromising patient care. The authors hypothesize that the introduction of the mandatory resident work-hour restriction corresponds with an overall increase in morbidity rate.
- Dumont, T. M., Tranmer, B. I., Horgan, M. A., & Rughani, A. I. (2012). Trends in neurosurgical complication rates at teaching vs nonteaching hospitals following duty-hour restrictions. Neurosurgery, 71(5), 1041-6; discussion 1046.More infoIn 2003 the Accreditation Council for Graduate Medical Education implemented duty-hour restrictions for residents, with an unclear impact on patient care.
- Kan, P., Mokin, M., Abla, A. A., Eller, J. L., Dumont, T. M., Levy, E. I., & Siddiqui, A. H. (2012). Utility of intravascular ultrasound in intracranial and extracranial neurointerventions: experience at University at Buffalo Neurosurgery-Millard Fillmore Gates Circle Hospital. Neurosurgical focus, 32(1), E6.More infoIntravascular ultrasound (IVUS) generates high-resolution cross-sectional images and sagittal reconstructions of the vessel wall and lumen. As a result, this imaging modality can provide accurate measurements of the degree of vessel stenosis, allow the detection of intraluminal thrombus, and analyze the plaque composition. The IVUS modality is widely used in interventional cardiology, and its use in neurointerventions has gradually increased. With case examples, the authors illustrate the utility of IVUS as an adjunct to conventional angiography for a wide range of intracranial and extracranial neurointerventions.
- Kan, P., Mokin, M., Dumont, T. M., Snyder, K. V., Siddiqui, A. H., Levy, E. I., & Hopkins, L. N. (2012). Cervical carotid artery stenosis: latest update on diagnosis and management. Current problems in cardiology, 37(4), 127-69.More infoCarotid atherosclerotic disease is implicated in 15% to 30% of all ischemic strokes. Carotid endarterectomy has been the standard treatment for carotid artery atherosclerosis, but carotid angioplasty and stenting have emerged as a less-invasive treatment alternative. In this article, we review the recent literature on the epidemiology, pathophysiology, investigations, and treatment for atherosclerotic carotid artery disease, focusing on the role of carotid endarterectomy and carotid angioplasty and stenting in the treatment of symptomatic and asymptomatic carotid lesions.
- Kan, P., Siddiqui, A. H., Veznedaroglu, E., Liebman, K. M., Binning, M. J., Dumont, T. M., Ogilvy, C. S., Gaughen, J. R., Mocco, J., Velat, G. J., Ringer, A. J., Welch, B. G., Horowitz, M. B., Snyder, K. V., Hopkins, L. N., & Levy, E. I. (2012). Early postmarket results after treatment of intracranial aneurysms with the pipeline embolization device: a U.S. multicenter experience. Neurosurgery, 71(6), 1080-7; discussion 1087-8.More infoThe pipeline embolization device (PED) is the latest technology available for intracranial aneurysm treatment.
- Mokin, M., Kan, P., Kass-Hout, T., Abla, A. A., Dumont, T. M., Snyder, K. V., Hopkins, L. N., Siddiqui, A. H., & Levy, E. I. (2012). Intracerebral hemorrhage secondary to intravenous and endovascular intraarterial revascularization therapies in acute ischemic stroke: an update on risk factors, predictors, and management. Neurosurgical focus, 32(4), E2.More infoIntracerebral hemorrhage (ICH) secondary to intravenous and intraarterial revascularization strategies for emergent treatment of acute ischemic stroke is associated with high mortality. ICH from systemic thrombolysis typically occurs within the first 24-36 hours of treatment initiation and is characterized by rapid hematoma development and growth. Pathophysiological mechanisms of revascularization therapy-induced ICH are complex and involve a combination of several distinct processes, including the direct effect of thrombolytic agents, disruption of the blood-brain barrier secondary to ischemia, and direct vessel damage from wire and microcatheter manipulations during endovascular procedures. Several definitions of ICH secondary to thrombolysis currently exist, depending on clinical or radiological characteristics used. Multiple studies have investigated clinical and laboratory risk factors associated with higher rates of ICH in this setting. Early ischemic changes seen on noncontrast CT scanning are strongly associated with higher rates of hemorrhage. Modern imaging techniques, particularly CT perfusion, provide rapid assessment of hemodynamic parameters of the brain. Specific patterns of CT perfusion maps can help identify patients who are likely to benefit from revascularization or to develop hemorrhagic complications. There are no established guidelines that describe management of revascularization therapy-induced ICH, and great variability in treatment protocols currently exist. General principles that apply to the management of spontaneous ICH might not be as effective for revascularization therapy-induced ICH. In this article, the authors review current knowledge of risk factors and radiological predictors of ICH secondary to stroke revascularization techniques and analyze medical and surgical management strategies for ICH in this setting.
- Mokin, M., Kass-Hout, T., Kass-Hout, O., Dumont, T. M., Kan, P., Snyder, K. V., Hopkins, L. N., Siddiqui, A. H., & Levy, E. I. (2012). Intravenous thrombolysis and endovascular therapy for acute ischemic stroke with internal carotid artery occlusion: a systematic review of clinical outcomes. Stroke; a journal of cerebral circulation, 43(9), 2362-8.More infoStrokes secondary to acute internal carotid artery (ICA) occlusion are associated with extremely poor prognosis. The best treatment approach to acute stroke in this setting is unknown. We sought to determine clinical outcomes in patients with acute ischemic stroke attributable to ICA occlusion treated with intravenous (IV) systemic thrombolysis or intra-arterial endovascular therapy.
- Siddiqui, A. H., Abla, A. A., Kan, P., Dumont, T. M., Jahshan, S., Britz, G. W., Hopkins, L. N., & Levy, E. I. (2012). Panacea or problem: flow diverters in the treatment of symptomatic large or giant fusiform vertebrobasilar aneurysms. Journal of neurosurgery, 116(6), 1258-66.More infoThe use of flow-diverting stents has gained momentum as a curative approach in the treatment of complex proximal anterior circulation intracranial aneurysms. There have been some reported attempts of treating formidable lesions in the posterior circulation. Posterior circulation giant fusiform aneurysms have a particularly aggressive natural history. To date, no one approach has been shown to be comprehensively effective or low risk. The authors report the initial results, including the significant morbidity and mortality encountered, with flow diversion in the treatment of large or giant fusiform vertebrobasilar aneurysms at Millard Fillmore Gates Circle Hospital.
- Dumont, T. M., Rughani, A. I., & Tranmer, B. I. (2011). Prediction of symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage with an artificial neural network: feasibility and comparison with logistic regression models. World neurosurgery, 75(1), 57-63; discussion 25-8.More infoTo create a simple artificial neural network (ANN) to predict the occurrence of symptomatic cerebral vasospasm (SCV) after aneurysmal subarachnoid hemorrhage (aSAH) based on clinical and radiographic factors and test its predictive ability against existing multiple logistic regression (MLR) models.
- Hubbard, M. E., Jewell, R. P., Dumont, T. M., & Rughani, A. I. (2011). Spinal injury patterns among skiers and snowboarders. Neurosurgical focus, 31(5), E8.More infoSkiing and snowboarding injuries have increased with the popularity of these sports. Spinal cord injuries (SCIs) are a rare but serious event, and a major cause of morbidity and mortality for skiers and snowboarders. The purpose of this study is to characterize the patterns of SCI in skiers and snowboarders.
- Kan, P., Dumont, T. M., Abla, A. A., Siddiqui, A. H., Levy, E. I., & Hopkins, L. N. (2011). Myocardial Infarction after CAS and CEA: Why Does it Matter?. Endovascular Today, 71-74.More infoInvited; Not peer reviewed
- Murakami, K., Koide, M., Dumont, T. M., Russell, S. R., Tranmer, B. I., & Wellman, G. C. (2011). Subarachnoid Hemorrhage Induces Gliosis and Increased Expression of the Pro-inflammatory Cytokine High Mobility Group Box 1 Protein. Translational stroke research, 2(1), 72-9.More infoSubarachnoid hemorrhage (SAH) following cerebral aneurysm rupture is associated with high rates of morbidity and mortality. Surviving SAH patients often suffer from neurological impairment, yet little is currently known regarding the influence of subarachnoid blood on brain parenchyma. The objective of the present study was to examine the impact of subarachnoid blood on glial cells using a rabbit SAH model. The astrocyte-specific proteins, glial fibrillary acidic protein (GFAP) and S100B, were up-regulated in brainstem from SAH model rabbits, consistent with the development of reactive astrogliosis. In addition to reactive astrogliosis, cytosolic expression of the pro-inflammatory cytokine, high-mobility group box 1 protein (HMGB1) was increased in brain from SAH animals. We found that greater than 90% of cells expressing cytosolic HMGB1 immunostained positively for Iba1, a specific marker for microglia and macrophages. Further, the number of Iba1-positive cells was similar in brain from control and SAH animals, suggesting the majority of these cells were likely resident microglial cells rather than infiltrating macrophages. These observations demonstrate SAH impacts brain parenchyma by activating astrocytes and microglia, triggering up-regulation of the pro-inflammatory cytokine HMGB1.
- Rughani, A. I., Dumont, T. M., Lin, C., Tranmer, B. I., & Horgan, M. A. (2011). Safety of microvascular decompression for trigeminal neuralgia in the elderly. Clinical article. Journal of neurosurgery, 115(2), 202-9.More infoMicrovascular decompression (MVD) offers an effective and durable treatment for patients suffering from trigeminal neuralgia (TN). Because the disorder has a tendency to occur in older persons, the risks of surgical treatment in the elderly have been a topic of recent interest. To date, evidence derived from several small retrospective and a single prospective case series has suggested that age does not increase the complication rate associated with surgery. Using a large national database, the authors aimed to study the impact of age on in-hospital complications following MVD for TN.
- Tsen, A. R., Burrows, A. M., Dumont, T. M., & Horgan, M. A. (2011). Spinal epidural hematoma masquerading as atypical chest pain. The American journal of emergency medicine, 29(9), 1236.e1-3.
- Dumont, T. M., Stockwell, D. W., & Horgan, M. A. (2010). Venous air embolism: an unusual complication of atlantoaxial arthrodesis: case report. Spine, 35(22), E1238-40.More infoA unique case of a patient with intraoperative venous air embolism (VAE) during atlantoaxial arthrodesis has been discussed.
- Dumont, T. M., Visioni, A. J., Rughani, A. I., Tranmer, B. I., & Crookes, B. (2010). Inappropriate prehospital ventilation in severe traumatic brain injury increases in-hospital mortality. Journal of neurotrauma, 27(7), 1233-41.More infoIn the setting of acute brainstem herniation in traumatic brain injury (TBI), the use of hyperventilation to reduce intracranial pressure may be life-saving. However, undue use of hyperventilation is thought to increase the incidence of secondary brain injury through direct reduction of cerebral blood flow. This is a retrospective review determining the effect of prehospital hyperventilation on in-hospital mortality following severe TBI. All trauma patients admitted directly to a single level 1 trauma center from January 2000 to January 2007 with an initial Glasgow Coma Scale (GCS) score 20 min) arterial blood gas at presentation (n = 12) were excluded from the study. The remaining population (n = 65) was sorted into three groups based on the initial partial pressure of carbon dioxide: hypocarbic (Pco(2) < 35 mm Hg), normocarbic (Pco(2) 35-45 mm Hg), and hypercarbic (Pco(2) > 45 mm Hg). Outcome was based on mortality during hospital admission. Survival was found to be related to admission Pco(2) in head trauma patients requiring intubation (p = 0.045). Patients with normocarbia on presenting arterial blood gas testing had in-hospital mortality of 15%, significantly improved over patients presenting with hypocarbia (in-hospital mortality 77%) or hypercarbia (in-hospital mortality 61%). Although there are many reports of the negative impact of prophylactic hyperventilation following severe TBI, this modality is frequently utilized in the prehospital setting. Our results suggest that abnormal Pco(2) on presentation after severe head trauma is correlated with increased in-hospital mortality. We advocate normoventilation in the prehospital setting.
- Rughani, A. I., Dumont, T. M., Lu, Z., Bongard, J., Horgan, M. A., Penar, P. L., & Tranmer, B. I. (2010). Use of an artificial neural network to predict head injury outcome. Journal of neurosurgery, 113(3), 585-90.More infoThe authors describe the artificial neural network (ANN) as an innovative and powerful modeling tool that can be increasingly applied to develop predictive models in neurosurgery. They aimed to demonstrate the utility of an ANN in predicting survival following traumatic brain injury and compare its predictive ability with that of regression models and clinicians.
- Rughani, A. I., Lin, C., Dumont, T. M., Penar, P. L., Horgan, M. A., & Tranmer, B. I. (2010). A case-comparison study of the subdural evacuating port system in treating chronic subdural hematomas. Journal of neurosurgery, 113(3), 609-14.More infoThe Subdural Evacuating Port System (SEPS) was recently introduced as a novel method of treating chronic subdural hematomas (SDHs). This system is a variation of the existing twist-drill craniostomy methods for treating chronic SDH. Compared with craniotomy or bur hole treatment of chronic SDH, this system offers the possibility of treatment at bedside without general anesthesia. In comparison with existing twist-drill methods, the system theoretically offers the advantage of a hermetically closed system that can evacuate a hematoma without an intracranial catheter.
- Dumont, T., Rughani, A., Silver, J., & Tranmer, B. I. (2009). Diabetes mellitus increases risk of vasospasm following aneurysmal subarachnoid hemorrhage independent of glycemic control. Neurocritical care, 11(2), 183-9.More infoSymptomatic cerebral vasospasm (SCV) is a morbid sequela of subarachnoid hemorrhage (SAH). Its etiology is multifactorial and predicting onset can be challenging. Diabetes mellitus (DM) is known to affect vasoactive properties of vessels, but it has not been definitively correlated with SCV. We report that pre-existing DM is independently and strongly correlated with SCV, despite intensive glycemic control.
- Bisson, E. F., Dumont, T., & Tranmer, B. (2007). Spontaneous spinal epidural hematoma in a child with hemophilia B. The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques, 34(4), 488-90.
- Deshmukh, V. R., Hott, J. S., Dumont, T., Nakaji, P., & Spetzler, R. F. (2006). Treatment of recurrent previously coiled anterior circulation aneurysm with minimally invasive keyhole craniotomy: report of two cases. Minimally invasive neurosurgery : MIN, 49(2), 70-3.More infoThe use of minimally invasive techniques has not yet been reported for the treatment of recurrent aneurysms after coil embolization. A 47-year-old man with a long history of headaches had an anterior communicating aneurysm that had previously been coil embolized. Three-year follow-up angiography showed a significant recurrence. A 50-year-old woman with subarachnoid hemorrhage and acute visual loss underwent coil embolization of a large ophthalmic artery aneurysm, which recurred 3 months later. In both cases, a keyhole fronto-orbital one-piece craniotomy was performed. In the first patient, the aneurysm was clip ligated. The coil mass, which had eroded through the dome, was excised. In the second patient, the anterior clinoid was removed and the aneurysm was clip ligated. Postoperative angiography showed no residual aneurysm and no evidence of branch or parent vessel compromise in either patient. Both patients had an uncomplicated postoperative course. Recurrent previously coiled aneurysms are technically challenging to treat. A minimal fronto-orbital craniotomy provides a sufficiently capacious working space for successful treatment of some recurrent aneurysms of the anterior circulation.
- Garand, S. A., Kareti, L. R., Dumont, T. M., & Seip, C. (2006). Thoracoscopic repair of tracheoesophageal fistula in a septuagenarian. The Annals of thoracic surgery, 81(5), 1899-901.More infoWe report the case of a 79-year-old female with clinical and radiographic evidence of congenital H-type tracheoesophageal fistula. Past medical history included recurrent pneumonia and episodic cough with food or fluid intake. She exhibited Ohno's sign during the dysphagia evaluation. A video swallow study demonstrated evidence of aspiration. Esophagogram and bronchoscopy identified the fistulous tract. Repair of the anomaly was performed using a minimally invasive thoracoscopic approach. In our experience, excellent visualization and magnification of the anatomic field with use of thoracoscopy allowed for relative ease of dissection and resection of the tract with minimal postoperative morbidity.
Presentations
- Dumont, T. M. (2021). Cytotoxic Irrigation for Brain Metastatic Lesions. Western Neurosurgery Society Annual Meeting September 2021. Santa Fe, NM.
- Dumont, T. M. (2021). Cytotoxic irrigation may reduce local brain metastatic tumor recurrence. 2021 Western Neurosurgery Society Annual Meeting. Albuquerque, NM.
- Dumont, T. M., & Avila, M. (2021). Parkinson Disease, Dysphagia and Cervical Spine Surgery. AANS/CNS Spine Summit 2021.
- Dumont, T. M., & Burket, A. (2021). Cytotoxic irrigation for brain metastatic lesions. CNS Tumor Section. Austin, TX.
- Avila, M., Martirosyan, N., & Dumont, T. M. (2019, Spring). Penetrating Spinal Cord Injury in Civilians: analysis of a national database. AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves. Miami, FL.
- Dumont, T. M. (2019, April). Embolization of Middle Meningeal Artery for Chronic Subdural Hematoma: A Systematic Review and Meta-Analysis. American Association of Neurological Surgeons, 87th Annual Meeting. San Diego, CA.
- Dumont, T. M. (2019, April). Evolution of Open Surgery for Unruptured Intracranial Aneurysms - Less Cases, Increased Difficulty, More Morbidity. American Association of Neurological Surgeons, 87th Annual Meeting. San Diego, CA.
- Dumont, T. M. (2019, April). Patient Protection and Affordable Care Act and Neurosurgery: Neutralizing Bias in Trauma Care?. American Association of Neurological Surgeons, 87th Annual Meeting. San Diego, CA.
- Hurlbert, R. J., Dumont, T. M., Avila, M., & Martirosyan, N. (2019, Spring). Complications Related to Immobilization of Cervical Spine Fractures with a Halo Vest. 35th Annual Meeting of the AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves. Miami, FL: AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves.
- Ramey, W. L., Walter, C. M., Zeller, J., Dumont, T. M., Lemole, G. M., & Hurlbert, R. J. (2017, October). Neurotrauma after Jumping Over the United States-Mexico Border Wall: Demographics and Cost Analysis. EANS 2017 Annual Meeting Controversies and Solutions in Neurosurgery, Venice, Italy in October 1 - 5, 2017. Venice, Italy: EANS.
- Dumont, T. M. (2016, Fall). Completion of the Circle of Willis is gender- and age- relative. Arizona Neurosurgical Society (AZNS) Conference.
- Bina, R., Lemole, G. M., & Dumont, T. M. (2015, Fall). Measuring quality of neurosurgical care: Readmission is affected by patient factors.. Arizona Neurosurgical Society Annual Meeting. Tucson, Arizona: Arizona Neurosurgical Society.More infoOral Presentation at regional meetingI was senior author of project.
- Dumont, T. M., & Sonig, A. (2015, Fall). Submaximal Angioplasty for Symptomatic Intracranial Atherosclerosis - A Prospective, Phase I Study. 2015 Congress of Neurological Surgeons Annual Meeting. New Orleans, Louisiana: Congress of Neurological Surgeons.More infoPresented by Dr. Sonig. Winner of Galbraith Award (Resident Abstract Award - Cerebrovascular Section)I was lead author on this presentation and project, unable to attend meeting due to personal reasons (birth of son).
- Skoch, J., Patel, S., Dumont, T. M., Taylor, J., Abruzzo, T., & Vadivelu, S. (2015, Fall). Predicting symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage with an artificial neural network in a pediatric population. 44th Annual Meeting of the AANS/CNS Section on Pediatric Neurological Surgery. Seattle, WA: AANS/CNS Section on Pediatric Neurological Surgery.More infoAward Candidate Presentation. Presentation delivered by Dr. Skoch.
- Dumont, T. M. (2014, Summer). A Socioeconomic Analysis of Intraoperative Neurophysiologic Monitoring in Spine Surgery. 2014 Western Neurosurgery Society Annual Meeting. Sun Valley, Idaho: Western Neurosurgery Society.
- Dumont, T. M. (2014, Summer). Submaximal Angioplasty for Symptomatic Intracranial Atherosclerosis – A Prospective, Phase I Study. 2014 Western Neurosurgery Society Annual Meeting. Sun Valley, Idaho: Western Neurosurgery Society.
- Fennell, V. S., & Dumont, T. M. (2014, Spring). Morbidity and Mortality of Endovascularly Treated Intracerebral Aneurysms: Does Specialty Matter?. 2014 American Association of Neurological Surgeons Annual Meeting. San Francisco, California: American Association of Neurological Surgeons.More infoOral Presentation performed by Dr. Fennell. Winner of Depuy Synthes Award (AANS resident abstract award).I was lead author on this project.
- Nael, K., Khan, R., Choudhary, G., Meshksar, A., Dumont, T. M., Tay, J., Drake, K., & Coull, B. (2014, Summer). A Six Minute MRI Protocol for Evaluation of Aucte Ischemic Stroke: Pushing the Boundaries. 2014 International Stroke Conference.More infoPresentation delivered by Dr. Nael. International Meeting
- Sheen, W., & Dumont, T. M. (2014, Spring). A socioeconomic analysis of intraoperative neurophysiologic monitoring in spine surgery: National utilization, regional variation, costs and outcomes. 2014 American Association of Neurological Surgeons Annual Meeting. San Francisco, California: American Association of Neurological Surgeons.More infoPeer-reviewed oral presentation at National Meeting delivered by Dr. Sheen. I was lead author.
- Dumont, T. M. (2013, Fall). Submaximal Antioplasty Prospective Registry: Preliminary Report. 2013 Congress of Neurological Surgeons Annual Meeting. San Francisco, California: Congress of Neurological Surgeons.More infoOral Presentation at National Meeting
- Dumont, T. M. (2013, Spring). Pre and Post-Treatment Temporal Parametric Analysis of Neurovascular Disease Using Gamma Variate Fitting of Time Density Curves From DSA Sequences. 2013 Annual Meeting of the American Association of Physicists in Medicine.
- Dumont, T. M. (2013, Summer). Pre and Post-Treatment Temporal Parametric Analysis of Neurovascular Disease Using Gamma Variate Fitting of Time Density Curves From DSA Sequences. 2013 Annual Meeting of the American Association of Physicists in Medicine.More infoElectronic Poster at National Meeting
Poster Presentations
- Dumont, T. M. (2019, Spring). An algorithm of management of acute type II odontoid fracture. American Association of Neurological Surgeons Annual Meeting 2019 San Diego, CA.
- Dumont, T. M. (2019, Spring). Anatomical correlation between radicular pain and rostral take-off from the thecal sac. American Association of Neurological Surgeons Annual Meeting 2019 San Diego, CA.
- Dumont, T. M. (2019, Spring). Complications related to immobilization of cervical spine fractures with a halo vest. American Association of Neurological Surgeons Annual Meeting 2019 San Diego, CA.
- Dumont, T. M., Lemole, G. M., Avila, M., & Araoye, I. (2019, April). High-Grade Meningiomas: Epidemiology, Financial Burden and Impact on Hospital Stay. American Association of Neurological Surgeons, 87th Annual Meeting. San Diego, CA.
- Dumont, T. M. (2018, January). Current Status of the PulseRider in the Treatment of Bifurcation Aneurysms: A Systematic Review. AANS/CNS Joint Cerebrovascular Annual Meeting. Los Angeles, CA.
- Dumont, T. M. (2017, April). Vascular anatomy does not predict revascularization failure in octogenarians with acute ischemic stroke. AANS 2017 Annual Scientific Meeting.
- Dumont, T. M. (2017, February). The Effect of Vascular Anatomy on Revascularization Rates during Stroke Intervention: Is it Time to Improve Access?. AANS/CNS Cerebrovascular Section Annual Meeting. Houston, TX.
- Dumont, T. M. (2017, July). Endovascular Recanalization of Intracranial Arterial Stenosis in Patients with Medical Failure. AANS 2017 Annual Scientific Meeting.
- Nisson, P. L., Mooney, M. A., Abassifard, S., Walter, C. M., Janke, H., Kim, H., Dumont, T. M., Lemole, G. M., Lawton, M., & Spetzler, R. (2017, October). The Mortality and Incidence of Residual for Posterior Fossa Arteriovenous Malformations. Congress of Neurological Surgeons, 66th Annual Meeting, Boston, MA, October 7-11, 2017. Boston, MA: Congress of Neurological Surgeons.
- Bina, R. W., Lemole, G. M., & Dumont, T. M. (2016, Spring). Measuring Quality of Neurosurgical Care: Readmission is Affected by Patient Factors. 2016 Congress of Neurological Surgeons Annual Meeting; San Diego, California.
- Palejwala, S. K., Rughani, A. I., & Dumont, T. M. (2016, Spring). Socioeconomic and Regional Differences in the Treatment of Cervical Spondylotic Myelopathy. 2016 Congress of Neurological Surgeons Annual Meeting; San Diego, California.
- Fanous, A., Natarajan, S. K., Jowdy, P., Dumont, T. M., Mokin, M., Yu, J., Goldstein, A., Budny, J., Hopkins, L. N., Snyder, K. V., Siddiqui, A. H., & Levy, E. I. (2015, Fall). High Risk Factors in Symptomatic Patients Undergoing Carotid Artery Stenting. 2015 Congress of Neurological Surgeons National Meeting. New Orleans, LA: Congress of Neurological Surgeons.More infoPoster presentation at National Meeting
- James, W. S., & Dumont, T. M. (2015, Fall). Trends in the Treatment of Aneutysms by Surgeons Trained in Both Open and Endovascular Techniques. 2015 Congress of Neurological Surgeons National Meeting. New Orleans, LA: Congress of Neurological Surgeons.More infoElectronic Poster at national meeting
- Martirosyan, N., & Dumont, T. M. (2015, Spring). Higher utilization of lumbar fusion for elective treatment of lumbago and chronic pain syndromes for patients with private insurance. American Association of Neurological Surgeons 2015 National Meeting. Washington, D.C.: American Association of Neurological Surgeons.More infoElectronic Poster at national meeting
- Martirosyan, N., & Dumont, T. M. (2015, Spring). Increased rate of inadvertent durotomy during lumbar microdiskectomy at teaching institutions. American Association of Neurological Surgeons National Meeting, 2015. Washington, D.C.: American Association of Neurological Surgeons.More infoElectronic poster at national meetingI was senior author
- Dumont, T. M., Sorkin, G. C., Wach, M., Eller, J. L., Mokin, M., Natarajan, S. K., Baxter, M., Snyder, K. V., Levy, E. I., Hopkins, L. N., & Siddiqui, A. H. (2013, Fall). Carotid Artery Stenting Outcomes: Do They Correlate with Antiplatelet Response Assays?. 2013 Congress of Neurological Surgeons National Meeting. San Francisco, CA: Congress of Neurological Surgeons.More infoElectronic Poster at National Meeting
- Sorkin, G. C., Dumont, T. M., Eller, J. L., Mokin, M., Snyder, K. V., Siddiqui, A. H., Hopkins, L. N., & Levy, E. I. (2013, Fall). In-Stent Restenosis after Carotid Stenting: Treatment Using an Off-Label Cardiac Scoring Balloon. 2013 Congress of Neurological Surgeons National Meeting. San Francisco, CA: Congress of Neurological Surgeons.More infoPoster at National Meeting
- Yoon, J. W., Lopes, D. K., Moftakhar, R., Billingsley, J. T., Welch, B. G., Yamamoto, J., Dumont, T. M., Siddiqui, A. H., Levy, E. I., Boulos, A. S., Hopkins, L. N., Tawk, R. G., Ringer, A. J., & Hanel, R. A. (2013, Fall). Feasibility and Safety of Piepeline Embolization Device in Patients with Ruptured Blister Aneruysms. 2013 Congress of Neurological Surgeons National Meeting. San Francisco, CA: Congress of Neurological Surgeons.More infoPoster Presentation at National Meeting
Others
- Dumont, T. M. (2016, January). Mini-Craniotomy versus Burr-Hole for treatment of Chronic Subdural Hematoma (MiChroS) Trial.More infoA prospective, randomized study to compare two common surgical approaches to a common neurosurgical disease. Single site study with 8 patients enrolled to date (2/2014-1/2016)