Cerebrovascular Disorders; Diagnostic Techniques, Neurological; Endothelium, Vascular; Neurosurgery; Radiology; Clinical Trial
Neurosurgery: Brain Aneurysm & AVM Program
My translational research interests can be divided along two thematic lines: (1) clinical trials implementation and design in neurological disease, and (2) advanced imaging in cerebrovascular disease.
Specialized Terms: Translational application of advanced imaging protocols in neurovascular disease; clinical trials
Extensive Research Description
1. CLINICAL TRIALS
I am currently involved in the following national and international, multi-center clinical trials.
STRATIS Registry. A prospective, multi-center, non-randomized, observational registry evaluating the use of Medtronic market-released neurothrombectomy devices, e.g., Solitaire Revascularization Device, in patients diagnosed with an acute ischemic stroke due to large intracranial vessel occlusion. [My role: site-PI.]
Brain Aneurysms / Subarachnoid Hemorrhage
ASTROH Trial. A multi-center, phase II randomized clinical trial of continuous low-dose IV heparin therapy in coiled low-grade aneurysmal SAH patients with significant hemorrhage burden. [My role: site-PI.]
CONFIDENCE Trial. A prospective, multi-center, single-arm, open-label clinical study to evaluate the safety and efficacy of Roadsaver carotid stent device used in conjunction with the Nanoparasol embolic protection system for the treatment of carotid artery stenosis in patients with elevated risk for adverse events following carotid endarterectomy. [My role: site-PI.]
CREST-2. Carotid revascularization for primary prevention of stroke (CREST-2) is two independent multicenter, randomized controlled trials of carotid revascularization and intensive medical management versus medical management alone in patients with asymptomatic high-grade carotid stenosis. [My role: sub-investigator, interventionist.]
CLEAR-III. A 500-patient phase-III randomized clinical trial using a recombinant tissue plasminogen activator (Activase) to quickly remove this blood from the ventricles.. [Mr role: sub-investigator.]
MISTIE-III. The purpose of this trial is to determine the safety of using a combination of minimally invasive surgery and clot lysis with rt-PA to remove intracerebral hemorrhage (ICH). [My role: site-co-PI, lead surgeon.]
Disorders of CSF Dynamics (NPH, Pseudotumor Cerebri)
SiiHT. Prospective, treatment trial in patients with pseudotumor cerebri and moderate-to-severe visual loss comparing maximal medical therapy (acetazolamide-plus-diet) and acetazolamide-plus-diet plus either optic nerve sheath fenestration or CSF shunting in restoring vision or preventing further visual loss. [My role: sub-investigator, site neurosurgeon.]
2. ADVANCED IMAGING RESEARCH
- Vessel wall magnetic resonance imaging identifies the site of rupture in patients with multiple intracranial aneurysms: proof of principle. Matouk C, Mandell DM, Gunel M, Bulsara KR, Malhotra A, Hebert R, Johnson MH, Mikulis DJ, Minja FJ. Vessel wall MRI identifies the site-of-rupture in patients with multiple intracranial aneurysms: proof-of-principle. Neurosurgery. 2013 Mar;72(3):492-6; discussion 496. doi: 10.1227/NEU.0b013e31827d1012.
- Matouk C, Turgeon PJ, Marsden PA. Epigenetics and stroke risk - beyond the static DNA code. Adv Genomics Genet. 2012 Oct;2:67-84.
- Matouk C, Kaderali Z, Terbrugge KG, Willinsky RA. Parent vessel occlusion for the treatment of complex aneurysms: long-term clinical and imaging follow-up. Am J Neuroradiol. 2012 Nov;33(10):1991-7.
- Alkins R, Matouk C, Cruz JP, Marotta T, Montantera W, Spears J. Carotid artery angioplasty and stenting for patients less than 70 years of age: a longitudinal cohort study. Can J Neurol Sci. 2012 May;39(3):338-42.
- Vessel wall MRI to differentiate between reversible cerebral vasoconstriction syndrome and central nervous system vasculitis: preliminary results. Mandell DM, Matouk C, Farb RI, Krings T, Agid R, Terbrugge K, Willinsky RA, Swartz RH, Silver FL, Mikulis DJ. Stroke. 2012 Mar;43(3):860-2. doi: 10.1161/STROKEAHA.111.626184. Epub 2011 Dec 8.
- Martin AR, Pablo Cruz J, Matouk C, Spears J, Marotta TR. The Pipeline flow-diverting stent for exclusion of ruptured intracranial aneurysms with difficult morphologies. Neurosurgery. 2012 Mar;70(1 Suppl Operative):21-8.
- Matouk C, Marsden PA. Epigenetic regulation of vascular endothelial gene expression. Circ Res. 2008 Apr 25;102(8):873-87.