We are actively involved in patient-oriented research aimed at improving the diagnosis and treatment of patients with neurovascular disorders such as stroke. Current areas of interest include the development of improved guiding systems, the evaluation of new interventional devices, and the measurement of the hemodynamic and metabolic effects of endovascular therapy. 

A new system for steering the tubes and devices used inside of the vessels is being evaluated by Dr. Moran, primarily.  This system is the result of a collabortative effort between Mallinckrodt Institute of Radiology, the Department of Neurological Surgery, and Stereotaxis, Inc..   Magnets outside of the head are used to steer these tools. 

We are participating in clinical trials of new devices for the treatment of aneurysms, narrowing of the arteries of the neck, and acute stroke.   One new device is a liquid embolic agent used to fill aneurysms, Onyx (TM).  This has been approved for use in Europe and currently is in clinical trials in the United States.  An example of an aneurysm treated with this agent is shown in the angiograms and PET images link.

We are also involved in a trial of balloon angioplasty and stenting for carotid artery narrowing sponsored by the National Institutes of Health (Carotid Revascularization with Endovascular versus Surgery Trial or CREST).  An example of a narrowed carotid artery treated with a balloon and stenting is shown in  the angiograms and PET images link.

Some of of our research involves a technique called positron emission tomography (PET). PET uniquely allows the quantitative measurement of cerebral blood flow, cerebral blood volume, cerebral metabolic rate for oxygen and oxygen extraction fraction in humans. The  PET scanner in the Neurology Neurosurgery Intensive Care Unit  provides the capability to study cerebral hemodynamics and metabolism in patients with acute cerebrovascular disease, such as subarachnoid hemorrhage due to aneurysm rupture, spontaneous intracranial hemorrhage, and stroke. 

Important and unique information regarding the pathophysiology and treatment of acute cerebrovascular disease can now be acquired. Dr. Derdeyn, for example, is primarily interested in the responses of the brain blood vessels and the brain itself to reduced pressure in the arteries. This includes the effects of  endovascular therapy on cerebral hemodynamics and metabolism. One example is shown in the colorful PET image at the bottom of this page.  Other areas of inquiry include: the development of Magnetic Resonance (MR) techniques to provide similar, non invasive physiologic measurements, a method to measure relative oxygen extraction fraction in patients with cerebrovascular disease, and a study of the effects of medical therapy on cerebral blood flow and metabolism in patients with atherosclerotic disease. 
 

Links to Stroke Center and Neuroradiology Section at Washington University