Clinical studies/trials

[Clinical studies/trials]

What are some of the most pivotal clinical trials in neurosurgery the past 10 years?

[Guest]

ISAT was big

[dispo]

ISAT is a good one. That was 2005, so 10 years might be a bit short of time span to include "pivotal" trials, or at the least you'll need to open it up to more specialized advances. I've been reading up on flow diversion (basically cerebrovascular stenting for aneurysm tx--it uses a finer mesh to divert the flow down the parent vessel and send less into the aneurysm so it can clot) and this is growing in popularity for difficult to treat aneurysms or ones that fail coiling. There a ton of different kinds, but we only have one approved in the US, and that is the Pipeline Embolization Device aka "pipeline". The study that the 2011 FDA approval was based on is from the PUFS trial -- Pipeline for Uncoilable or Failed Aneurysms.

For those unfamiliar, pipeline was originally indicated for wide-neck aneurysms. If you think about it, if the neck is about as wide as the pouch of the aneurysm, a coil can easily slip out or be pushed out of the way, whereas pipeline can span the entire neck with no risk of that. It can also be used in conjunction with coiling to keep the coils in. Pipeline (and flow diversion in general) poses a unique problem because there's so much bare metal, you need dual anti platelet therapy, which obviously is not without its own complications. This is a great thread idea, OP. I hope more people will chime in. If we're talking past 10 years, I imagine a lot is either gonna be endovascular like ISAT and PUFS or related to newer high tech stuff, which I would love to learn more about.

[Guest]

Aneurysms:
-ISUIA 1 and ISUIA 2
-ISAT
-BRAT
-UCAS (Japan)
-PUFS
-IntrePED
-ASPIRe

Stroke:
-NINDS
-ECASS-3
-MR CLEAN
-SWIFT PRIME
-ESCAPE
-EXTEND-IA
-REVASCAT

Decompressive Craniectomy for malignant MCA infarct:
-HeADDFIRST
-DECIMAL
-DESTINY
-HAMLET

Intracranial atherosclerosis:
-WASID
-GESICA
-SSYLVIA
-SAMMPRIS

Carotid Stenosis:
-ACAS
-ACST
-NASCET
-ECST
-SAPPHIRE
-CREST

AVMs:
-ARUBA

Traumatic Brain Injury:
-DECRA
-RESCUEicp

Intracerebral Hemorrhage:
-INTERACT 1 and 2
-ATACH I and II
-STICH
-CLEAR

Spinal trauma:
-NEXUS


and so on...

[Guest]

You sir, you da real mvp

[Guest]

ARUBA was bullshit

[Guest]

Second on the ARUBA comment

[Guest]

lots of trials on spine trauma at UCSF

[Guest]

(04-17-2017, 12:19 AM)Guest Wrote: lots of trials on spine trauma at UCSF

UCSD also with the spinal trials

[Chargers]

(04-17-2017, 12:29 AM)Guest Wrote:

(04-17-2017, 12:19 AM)Guest Wrote: lots of trials on spine trauma at UCSF

UCSD also with the spinal trials

who is in the lead for UCSD chair?