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Research & Initiatives
Our clinical and translational research span across Ischemic Stroke, hemmorrhagic stroke, aneurysms, vascular malformations, traumatic brain injuries, and neurodegenerative disorders.
The Stroke & Applied NeuroScience Center is committed to improving the lives of our patients before, during, and after hospitalization for stroke and other neurological conditions.
BEFORE
Develop early detection and diagnosis to understand the the underlying cause of stroke and other neurological conditions through novel minimally-invasive techniques and machine learning.
DURING
Advance the treatment of stroke and neurological conditions through computational surgical simulations and medical device development.
AFTER
Improve quality-of-life for our patients after they leave the hospital through addressing the medical and mental health burden following stroke and other neurological conditions.
ESCAPE-MeVO
EndovaSCular TreAtment to imProve outcomEs for Medium Vessel Occlusions Stroke occurs when a blood clot causes a blockage in a blood vessel (artery) within the brain. This type of stroke is called an ischemic stroke and carries a high risk of disability or death. Stroke must be treated very fast. Any delay of even 10 minutes can result in the difference between an independent and a disabled outcome, and in some cases between life and death. Endovascular therapy (EVT) or Throm
PICASSO
Proximal Internal Carotid Artery Acute Stroke Secondary to Tandem or Local Occlusion Thrombectomy Trial The primary objective is to establish the efficacy of intra-arterial (IA) mechanical thrombectomy (MT) with extracranial proximal carotid artery acute stenting versus non-stenting approaches in patients with acute ischemic stroke (AIS) from intracranial vessel occlusion (IVO) in the anterior circulation and have a proximal carotid occlusive disease (occlusion or severe sten
MIRROR
Minimally Invasive IntRaceRebral HemORrhage Evacuation This registry will study the use of the Aurora® Surgiscope to provide surgical access and visualization in minimally invasive removal of hematoma in the brain. Many methods of hematoma removal are available and will be based on surgeon preference. The impact of patient selection and time to surgery from last known well time will be explored. Learn more: https://clinicaltrials.gov/study/NCT04494295
CHESS / BIOCHESS
Chronic Subdural Hematoma Treatment With Embolization Versus Surgery Study The goal of this clinical trial is to test in moderately symptomatic chronic subdural hematoma (CSDH) patients if middle meningeal artery embolization (MMAE) can be used as an alternative to conventional open surgery. The main questions it aims to answer are: • Compared to open conventional surgery, does MMAE reduce the need for rescue surgery or deaths? • What is the safety of MMAE and conventional op
BLOCK-SAH
Pterygopalatine Fossa (PPF) Block as an Opioid Sparing Treatment for Acute Headache in Spontaneous Subarachnoid Hemorrhage BLOCK-SAH is a phase II, multicenter, randomized, double-blinded, placebo-controlled clinical trial with a sequential parallel comparison design (SPCD) of bilateral pterygopalatine fossa (PPF) injections with 20mg ropivacaine + 4mg dexamethasone (active, PPF-block) compared to saline (placebo) for headache in survivors of aneurysmal subarachnoid hemorrhag
CITADEL
Citadel Embolization Device Study The purpose of this study is to gather safety and effectiveness data on Stryker Neurovascular's Next Generation Target Detachable Coil (hereafter referred to as the Citadel Embolization Device), when used with Target Detachable Coils, in the treatment of wide-neck intracranial aneurysms. In this study, use of the Citadel Embolization Device will be limited to a population of patients with unruptured or ruptured wide-neck aneurysms who meet
INVEST Feasibility
A Single Arm, Feasibility Study of Minimally Invasive Endoscopic Surgical Treatment with Apollo/Artemis for Supratentorial Intracerebral Hemorrhage INVEST Feasibility is a Mount Sinai physician led, multicenter single- arm feasibility study that intends to provide an assessment of enrollment and follow-up feasibility for patients who present with a supratentorial intracerebral hemorrhage (ICH) and are being treated with the Apollo or Artemis Minimally Invasive Surgical Treatm
INVEST Registry
Minimally Invasive Endoscopic Surgical Treatment with Apollo / Artemis in Patients with Brain Hemorrhage: A Prospective Multicenter Registry The primary objective of this multicenter prospective registry is to provide additional safety, technical outcomes and clinical outcomes data for minimally invasive endoscopic surgery (MIES) with Apollo or Artemis for the evacuation of supratentorial brain hemorrhage in adult patients who do not qualify for the concurrent INVEST Feasibil
MIND
A Prospective, Multicenter Study of Artemis a Minimally Invasive Neuro Evacuation Device, in the Removal of Intracerebral Hemorrhage MIND, sponsored by Penumbra Inc., compares the safety and efficacy of minimally invasive endoscopic surgical treatment with the Apollo / Artemis Neuro Evacuation Device for supratentorial intracerebral hemorrhage to standard medical management. The expectation is that patients treated with the minimally invasive Artemis Device have better outcom
EMBOLISE
Embolization of the Middle Meningeal Artery with ONYXT Liquid Embolic System (LES) In the Treatment of Subacute and Chronic Subdural Hematoma The study is a prospective, multi-center, randomized, interventional, open label, controlled medical device clinical study, sponsored by Medtronic, evaluating the performance of the Onyxâ„¢ LES for MMA embolization for patients with symptomatic subacute or chronic subdural hematoma (SDH). The Onyxâ„¢ LES for embolization of MMA is investiga
OPEN-UP
Operative Procedures vs. Endovascular Neurosurgery for Untreated Pseudotumor Working in tandem with Barrow Neurological Institute/Dignity Health, this study aims to determine whether dural venous sinus stenting is as safe and effective as cerebral spinal fluid (CSF) shunting in halting or improving moderate-to-severe visual loss in patients with idiopathic intracranial hypertension (IH). Patients diagnosed with intracranial hypertension as well as moderate to severe visual lo
MRI For I|H: Magnetic Resonance Imaging for Idiopathic Intracranial Hypertension and Additional Cerebral Spinal Fluid Pathologies
This research work targets the contribution of cerebrovascular pathology to idiopathic intracranial hypertension (IIH) otherwise known as pseudotumor cerebri. Cerebrovascular abnormalities often mimic symptoms of IIH and are also found coincident with the disease. It is unclear what specific vascular abnormalities are in subjects with true pseudotumor. The objective of this study is to address this knowledge gap by refining non-invasive vascular MR techniques.
Transradial: Registry of Transradial Access for Angiography.
Disruption of the cerebral blood flow during acute ischemic stroke disrupts oxygen and glucose delivery to cells, leading to injury of cellular organelles such as mitochondria. Mitochondrial dysfunction has been recognized as one of the major contributors to neuronal death after stroke. We are studying a treatment called mitochondrial transplant, where a patient's healthy mitochondria are injected into an artery in the brain that supplies tissue damaged from an ischemic strok
Biodegradable Stents: In vitro medical device testing
Our lab has developed a proving ground for newly developed endovascular medical devices. We are able to treat 3D-printed models of common cerebrovascular diseases (such as aneurysms or arteriovenous malformations) with medical devices the same way they would be used in surgery. We then use a suite of benchtop and computational methods to test the efficacy and safety of these devices. This suite includes computational fluid dynamics, particle image velocimetry, microtomographi
AHA Platelets: Improving the computational modeling of cerebral aneurysms treated with flow-diverting stents utilizing platelet activation simulations
With support from the American Heart Association we use computer representations of actual patients' brain blood vessels with cerebral aneurysms to simulate blood flow in and around the aneurysms before and after treatment with flow-diverting stents. We apply a special computer modeling technique that simulates thousands of individual platelets within the computer simulation of blood flow to understand how flow-diverting stents cause platelets to activate, leading to clotting
Model Seeding: Cerebral aneurysm risk stratification using hemodynamic modeling and endothelial genetics
This study will investigate diseases of the brain and its blood vessels to identify the hemodynamic factors associated with treatment success or failure after cerebral angiograms for stroke and hemorrhage, while in parallel interrogating the genetic and molecular biology of the disease mechanisms. This project is supported by an Institute of Translational Health Sciences Research Innovation Award.
Clot Analysis: Composition of acute intravascular emboli
Despite a reduction in stroke incidence and age-standardized death rates, stroke remains the second leading cause of death and a major cause of disability worldwide. Several large-scale studies have shown that conventional risk factors predict less than one half of future cardiovascular events. Stroke prevention strategies may therefore be based on an incomplete set of biological and environmental risk factors. Using next generation sequencing technologies, we are studying th
Emboli Monitoring: Detection of Peripheral Arterial Emboli using Doppler Ultrasound
This project aims to uncover the relationship between blood clots outside the brain and the occurrence of emboli in the cerebral vasculature as well as their associated risk of stroke. The occurrence of emboli in the cerebral vasculature is thought to correspond with the risk of stroke. Therefore, by performing peripheral arterial Doppler ultrasound scans on patients at risk of stroke as well as standard-of- care cerebral transcranial Doppler (TCD) ultrasound scans in adult c
Vasospasm CFD
This retrospective study incorporates computational fluid dynamics (CFD), computed tomography angiograms (CTA), and Transcranial Doppler (TCD) wave forms obtained from patients presenting with subarachnoid hemorrhage (SAH) and vasospasm. CTA images taken prior to balloon angioplasty treatment of vasospasm are analyzed using computer simulations. Using this data, we hope to develop an effective model for predicting the likelihood of vasospasm and its location in SAH patients.
Alzheimer's CFD
In this National Institute on Aging (NIA) funded R03 project we are developing a method for whole brain mechanical simulation of the flow of cerebrospinal fluid. By incorporating patient specific tissue displacement measurements from state-of-the-art MRI techniques we can calculate maps of tissue stiffness and CSF flux to study how these mechanical aspects of brain function are altered during the development of Alzheimer’s Disease. This tool when fully implemented will be use
Aneurysm CFD
Our National Institute of Health (NIH) National Institute of Neurological Disorders and Stroke (NINDS) R01 funded project titled Computational modeling of platelets and thrombosis in cerebral aneurysm treatment seeks to develop hemodynamic risk factors for aneurysm recurrence after treatment through developing a clinically applicable modeling toolkit based on novel simulation methods through investigating the pre and post treatment hemodynamics of adult patients undergoing co
How a game-changing transplant could treat dying organs
Early success with a procedure called a mitochondrial transplant offers a glimmer of hope for people fighting for survival after cardiac arrest, stroke, and more. Read full article.
Pupillometry
Neurologic disorders such as stroke and traumatic brain injury remain leading causes of death and disability globally. By developing and validating a quantitative smartphone-based pupillometry application, we hope to revolutionize the methods in which neurologic injuries are diagnosed and monitored – allowing for expedited intervention. PupilScreen combines the power of machine learning algorithms with native smartphone hardware to provide accessible and accurate pupillary li
Stroke Biomarkers
Peripheral Biofluid Biomarkers for Stroke The collaborative effort amongst Drs. Michael Levitt M.D., Christopher Burke M.D., Michael MacCoss Ph.D., and Andy Hoofnagle M.D., PhD investigates acute ischemic and hemorrhagic stroke through the exploration of biomarkers in neurological and cardiac patients. Dr. Christopher Burke: https://www.uwmedicine.org/bios/christopher-burke MacCoss Lab Website: https://maccosslab.org/ Hoofnagle Lab Website: https://staff.washington.edu/ahoof
Louis Kim, MD awarded $25K grant from The Bee Foundation
Congratulations to Dr. Louis Kim who, along with his team, was awarded the 2019 TBF Preventative Research Grant in the amount of $25,000 for the "Molecular Basis of Endothelial Dysfunction for Personalized Risk Stratification in Intracranial Aneurysms." The mission of The Bee Foundation is to raise awareness of brain aneurysms and increase funding for innovative research that changes lives. Source: https://neurosurgery.uw.edu/news-and-resources/louis-kim-md-awarded-25k-grant-
Michael Levitt, MD selected to receive Royalty Research Grant
Congratulations to Dr. Levitt whose proposal "Genetic correlates of wall shear stress in a patient-specific 3D-printed cerebral aneurysm model" was selected to receive a $40,000 award. A total of 111 proposals were submitted to the Office of Research requesting support from the RRF. Of these, only 30 were selected to receive funding, which is a success rate of 27%. In other words, the competition was intense. Source: https://neurosurgery.uw.edu/news-and-resources/michael-levi
Stroke Mitochondria
Autologous Mitochondrial Transplant for Ischemic Stroke Disruption of the cerebral blood flow during acute ischemic stroke disrupts oxygen and glucose delivery to cells, leading to injury of cellular organelles such as mitochondria. Mitochondrial dysfunction has been recognized as one of the major contributors to neuronal death after stroke. We are studying a treatment called mitochondrial transplant, where a patient's healthy mitochondria are injected into an artery in the b
Neurological damage from stroke is #Solvable
As part of The Rockefeller Foundation's #Solvable campaign, UW's own Dr. Melanie Walker explains how advances in science and medicine can reverse previously permanent neurological damage from stroke and other injuries: https://youtu.be/v4TnhgXhBC8 For more information about #Solvable, visit : https://www.reekefellerfoundation.org/solvable/solvable-videoseries/neurologiealdamagestrokesolvable/ https://web.archive.org/web/20210104124036/https://www.rockefellerfoundation.org/vi
Stroke victim's mother grateful for Dr. Kim's surgical expertise
Following her son's stroke, Amy Roost, had to take a leap of faith when she agreed to risky surgery in the hopes of eliminating the possibility of future strokes. Read the full article here: https://www.guideposts.org/caregiving/family-caregiving/following-her-sons- stroke-could-she-let-go-and-let-god Source: https://neurosurgery.uw.edu/news-and-resources/stroke-victims-mother-grateful-dr-kims-surgical- expertise
Dr. Louis Kim Interviewed on KOMO News about emergency surgery to save stroke patient
Dr. Louis J. Kim, Vice-Chair and Chief of Neurological Surgery at Harborview Medical Center was featured in a KOMO news story about a stroke patient, Sue McNeely, who underwent life-saving angioplasty after suffering a stroke while driving. Dr. Kim, who performed the emergency surgery says "Time really is brain. The longer you wait before you receive treatment, the more chances of permanent damage to your brain." Harborview Medical Center is the only comprehensive stroke cent
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