12
Feb
15

GROUNDBREAKING STUDIES FIND THAT NEUROINTERVENTIONAL SURGERY REDUCES STROKE MORTALITY

WASHINGTON, DC – February 11, 2015 – Two new clinical trials on the treatment of stroke (ESCAPE and EXTEND IA) demonstrate that neurointerventional surgery significantly increases the number of patients who are able to live independently without major neurological disabilities. The ESCAPE study, published today in the New England Journal of Medicine, also shows that neurointerventional surgery reduces stroke mortality by 50 percent.

ESCAPE (Endovascular treatment for Small Core and Anterior circulation Proximal occasion with Emphasis on minimizing CT to recanalization times) and EXTEND IA (Extending the Time for Thrombolysis in Emergency Neurological Deficits – Intra-Arterial) are two of three studies (together with SWIFT PRIME) that confirm the MR CLEAN study published in the New England Journal of Medicine late last year—which showed that the addition of inside-the-artery clot removal is more effective than IV-administered “clot-busting” tissue plasminogen activator (IV-tPA) treatment alone for the treatment of stroke.

“All three of these studies confirm what we are seeing in everyday practice. In many cases, instead of suffering major neurological disability, patients are able to go home to resume their lives,” said Dr. Peter Rasmussen, director of the Cerebrovascular Center, Cleveland Clinic in Cleveland, Ohio, and president of the Society of NeuroInterventional Surgery (SNIS). “Within-the-artery procedures, which are performed by neurointerventional surgeons, are not the appropriate treatment for every patient suffering from stroke, but for those patients experiencing the most severe types of ischemic strokes, they are life-saving, viable and effective therapies that offer many benefits over traditional treatments, including shorter recovery times and a better chance to return to normal activities.”

ESCAPE is the first study to show that the overall stroke mortality rate was reduced by 50 percent with neurointerventional surgery, from two in 10 patients for standard-of-care treatment to one in 10. ESCAPE and EXTEND IA showed better outcomes for those patients treated with neurointerventional surgery. In ESCAPE, nearly 30 percent of patients treated with IV-tPA treatment alone were able to live independently without major neurological disabilities. For patients receiving neurointerventional surgery, that number increased to 53 percent. EXTEND IA showed even better results, with 71 percent of patients who received neurointerventional surgery returning to independent living, compared with 40 percent in the standard treatment group.

According to Dr. Peter Mitchell, co-principal investigator of EXTEND IA and the director of neurointervention at the Royal Melbourne Hospital, two of the key differences in better outcomes for stroke patients were the use of more advanced brain imaging to select patients most likely to benefit and earlier treatment. The Royal Melbourne Hospital, where the EXTEND IA study was conducted, treats approximately 500 ischemic stroke patients a year and is one of the few stroke centers in the world to treat patients within 20 minutes of arriving in the emergency department.

According to Dr. Donald Frei, a neurointerventional surgeon at Radiology Imaging Associates in Denver, Colo., and president-elect of SNIS, treatment time is critical. While ESCAPE showed that neurointerventional surgery can be performed up to 12 hours from the onset of stroke, the success of the trial can be credited to fast treatment and the use of brain and blood vessel imaging. In ESCAPE, researchers were on average two hours faster in opening the blocked blood vessels than in previously reported trials.

“These positive studies are important milestones in the transformation of care for stroke patients, but it’s also important to understand that the comprehensive stroke centers that participated excel in providing this type care,” said Dr. Frei. “The results may not be replicable in every hospital. It’s important that when stroke occurs, the disease is identified quickly and patients are transported to facilities that are equipped to provide the best evidence-based interventions for ischemic and hemorrhagic stroke management.”

ESCAPE included 22 sites worldwide and patients in the U.S., U.K., Ireland and South Korea and evaluated the effect of endovascular treatment for patients with acute ischemic stroke caused by a clot obstructing one of the major intracranial arteries. The study was ended early because it crossed the pre-specified boundary for efficacy. The study included 316 patients who fit the criteria for neurointerventional surgery and arrived for treatment within 12 hours of their stroke who were randomized to standard medical care (which included the IV-tPA where appropriate) or standard medical care plus neurointerventional surgery.

The EXTEND IA trial compared IV-tPA to IV-tPA and neurointerventional surgery in patients with acute ischemic stroke receiving IV therapy within 4.5 hours of stroke onset. Patients were selected using CTA and CTP to identify those with large vessel occlusion and small core infarct with significant volume of “threatened” tissue. The trial was stopped early because of efficacy when 70 of the intended 100 patients had been randomized (35 to each arm) after the presentation of the MR CLEAN results prompted the DSMB to perform a pre-specified analysis.

Of 695,000 people who suffer acute ischemic stroke in the U.S., 40 percent have a large-vessel blockage, which often leads to death or permanent disability. These neurointerventional procedures have potential life-saving benefits for almost 300,000 people in the U.S. who suffer a stroke with a large vessel blockage. Stroke is the leading cause of disability and the fourth cause of death in U.S. In 2010, stroke cost the U.S. an estimated $54 billion, including the cost of health care services, medications and missed days of work. Strokes cost $74 billion in health care expenditures annually for treatment due to disability.

Neurointerventional surgery is a critical piece of a system of stroke care that has helped reduce death rates from stroke by more than 35 percent from 2000 to 2010. This includes public education to reduce risk factors and recognize the symptoms of stroke, emergency medical services processes and protocols to appropriately assess patients and emergency transport guidelines that immediately deliver stroke patients to a comprehensive stroke center. SNIS works to develop general standards to define principles of practice that will produce high-quality care and provides guidance on standardized techniques, procedures and practices in the neurointerventional field, not only to improve health care outcomes but also to define the core practice from which this specialty can build and grow.

02
Feb
15

Best Friends Together Again

Today, the world lost a wonderful man and heaven gained a true angel.  Dave Bergman, former Chairman of the Board of The Joe Niekro Foundation and best friend of the late Joe Niekro, passed away this morning after a fearlessness battle with cancer.  There aren’t words to describe what this man meant to the entire Niekro family and the Joe Niekro Foundation and the incredible human he was.  As we watched Dave fight this dreaded disease for nearly three years, we all can say we learned a valuable lesson in heroism and courage.  Not once did we hear Dave complain, question why, give up or lose hope.  Instead, we saw a man who met the cancer demon head on and gave it a fight it had never imagined.  Today, Dave joined his best friend in heaven, leaving a legacy that will forever live on.

There aren’t many memories the Niekro family has without Dave in them.  From 1978 when he approached Joe in the Houston Astros locker room, calling him “Mr. Niekro”, to just this year when Dave spoke to me about how impressed he was on the progress of the foundation.  When I decided to start the foundation, Dave was the first person I called to ask if he would participate on the board.  I knew he would share the same passion that I did for the man he called his best friend.  Dave has been like my second Dad from the time I could walk and my heart is broken for the hole his passing leaves with us all.

I will never forget Dave stepping out of the elevator at St. Joseph’s Hospital in Tampa, FL after hearing the news of Dad’s aneurysm.  He had a look on his face that will stay with me forever.  Dave was the first one there when Dad died, and I can guarantee that Dad was the first one to meet Dave at the pearly gates today, with a fishing pole in one hand and a baseball glove in the other.  As most of you know, fishing was their passion and not a story they told didn’t have something about “snook fishing” in it.  Best friends, together again!

Dave, you will forever be missed and we are all so thankful for the service, love, compassion and support you gave to us all.

everglades IMG_0291

18
Jan
15

JNF Awards $90,000 in Research Grants

The Joe Niekro Foundation has announced the 2014 Joe Niekro Research Grant recipients.  A total of $90,000 has been awarded by the foundation, which is committed to supporting patients and families, research, treatment and awareness of brain aneurysmsAVMs and hemorrhagic strokes.  “We are thrilled to award these recipients with this critical funding needed to help support the advancements of neurological research,” states JNF Founder, Natalie Niekro.

The first awardee, Barrow Neurological Institute, has received a seed grant in the amount of $50,000 for the study Deconstructing the vascular tangle-A molecular biopsy of cerebral arteriovenous malformations by Dr. Joseph Zabramski and Dr. Yashar Kalani.  This groundbreaking study will aim to understand the pathogenesis of AVM formation and identify signaling pathways involved in vascular development and AVM formation.

JNF Founder Natalie Niekro along with Board of Directors Members (from left to right) Bill Michels, Kimberly Chapman, Gary Simms and Linda Michels present a $50,000 research grant to Drs. Yashar Kalani and Joseph Zabramski.

JNF Founder Natalie Niekro along with Board of Directors Members (from left to right) Bill Michels, Kimberly Chapman, Gary Simms and Linda Michels present a $50,000 research grant to Drs. Yashar Kalani and Joseph Zabramski.

A $20,000 grant will go to the University of Michigan for the project, Intraventrical injection of noncellular fluid from subarachnoid hemorrhage patient leads to ventricular enlargement and periventricular injury, by Dr. Aditya Pandey.  This current project aims to understand the role of human subarachnoid hemorrhage (SAH) non-cellular cerebral spinal fluid (CSF) in causing hydrocephalus and periventricular cellular injury.

The final recipient, the SNIS Foundation who received a $20,000 award for the Joe Niekro Research Grant. This annual grant enables investigators to conduct pilot projects related to brain aneurysms, AVMs or stroke. It is the intention of the grant that the seed data from these projects will indicate feasibility and appropriateness of the research prior to applying for further funding; therefore, emphasis will be placed on research deemed to have the most potential for future funding.

Since inception, the Joe Niekro Foundation has awarded over $500,000 in research funding and has built a patient advocacy network that expands across the globe. The foundation provides education on the causes, risk factorsand treatments of these conditions, while funding the advancement of neurological research.

Click here to view the list of previously funded projects.

For more information about funding opportunities including program guidelines and contacts, visit http://www.joeniekrofoundation.com/research-grants/grant-guidelines/.

29
Dec
14

Groundbreaking Study Confirms That Neurointerventional Surgery Provides Significant Clinical Benefit

Study is most significant stroke treatment clinical trial since NINDS-2 says Society of NeuroInterventional Surgery

WASHINGTON, DC – December 17, 2014 – A new study published in the New England Journal of Medicine confirms that the addition of inside-the-artery clot removal is more effective than IV-administered “clot-busting” tissue plasminogen activator (IV-tPA) therapy alone for the treatment of stroke. These endovascular (or neurointerventional) procedures have potential life-saving benefits for almost 300,000 people in the United States who suffer a stroke with a large vessel blockage, says the Society of NeuroInterventional Surgery (SNIS).

Of 695,000 people who suffer acute ischemic stroke in the U.S., 40 percent have a large-vessel blockage, which often leads to death or permanent disability. MR CLEAN (Multicenter Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands) evaluated the effect of endovascular treatment for patients with acute ischemic stroke caused by a clot obstructing one of the major intracranial arteries. The study showed that inside-the-artery clot removal during early treatment nearly doubled the likelihood of a good neurological outcome and that it worked well for patients who had received IV-tPA and for those who had contra-indications for IV-tPA.

“The MR CLEAN Study confirms what we are seeing in everyday practice,” said Peter Rasmussen, MD, director of the Cerebrovascular Center, Cleveland Clinic in Cleveland, Ohio, and president of SNIS, “Within-the-artery procedures, which are performed by neurointerventional surgeons, are not the appropriate treatment for every patient suffering from stroke, but for many patients they are life-saving, viable and effective therapies that offer many benefits over traditional treatments, including shorter recovery times and a better chance to return to normal activities.”

According to Dr. Donald Frei, a neurointerventional surgeon at Radiology Imaging Associates in Denver, Colo., and president-elect of SNIS, MR CLEAN is the most significant randomized, controlled stroke treatment study since the NINDS-2 trial in 1995 and subsequent FDA approval of IV-tPA. While IV-tPA revolutionized stroke care, it must be administered within 4.5 hours. Neurointerventional surgery can be performed up to 6 hours from the onset of stroke, significantly expanding the treatment window.

“MR CLEAN is an important milestone in the transformation of care for stroke patients, but it is not the end of the story,” said Dr. Frei. “Neurointerventional surgery is a relatively young and rapidly changing field that typically outpaces clinical research, and we need to ensure that these treatments—their success evident in thousands of lives saved—continue to be evaluated in clinical trials. We are confident that when designed and implemented correctly, clinical studies will continue to show positive results.”

Frei also said that neurointerventional surgery is a critical piece of a system of stroke care that has helped reduce death rates from stroke by more than 35 percent from 2000 to 2010. This includes public education to reduce risk factors and recognize the symptoms of stroke, emergency medical services processes and protocols to appropriately assess patients and emergency transport guidelines that immediately get stroke patients to a hospital that is equipped to provide the best evidence-based interventions for ischemic and hemorrhagic stroke management.

SNIS works to develop general standards to define principles of practice that will produce high quality care and provides guidance on standardized techniques, procedures and practices in the neurointerventional field, not only to improve health care outcomes but also to define the core practice from which this specialty can build and grow.

Stroke is the leading cause of disability and the fourth cause of death in U.S. In 2010, stroke cost the U.S. an estimated $54 billion, including the cost of healthcare services, medications and missed days of work. Strokes cost $74 billion in healthcare expenditures annually for treatment due to disability.

For complete article, click here.

03
Sep
14

Chuck the Chicken Goes Viral

Don't be a ChickenWe are now on Day 3 of our Don’t be a Chicken Campaign in support of Brain Aneurysm/AVM Awareness Month and we want to applaud the nearly 8000 people who have jumped on board with us thus far.  We have 27 more days to go so keep up the great efforts!  Remember, this is all about spreading the importance of awareness and understanding the facts about brain aneurysms and AVMs.  So “chuck” being a chicken and hop on board with JNF as we continue to let the world know just how brave we are!!!!!

JNF

Supporting the Fighters

Admiring the Survivors

Honoring the Taken

And Never EVER Giving Up Hope!

01
Sep
14

Don’t be a Chicken!!!

In support of BrDon't be a Chickenain Aneurysm Awareness Month (September), The Joe Niekro Foundation (JNF) encourages you to “Don’t be a Chicken.”

Brave survivors of brain aneurysms/AVMs and hemorrhagic strokes will represent The Joe Niekro Foundation during a month of mini-challenges to bring awareness to the importance of early detection and “Getting Scanned.” Don’t be a Chicken is designed to increase awareness of these devastating conditions by asking survivors, caregivers, friends and families to share their stories in attempt to educate the public on the warning signs and risk factors of a brain aneurysm and what to do if you experience “the worst headache of your life.” Courageous survivors and family members from across the country have come together to educate others on the importance of early detection and will be sharing their stories on the RUChickenJNF You Tube Channel, as well as across the foundation’s social media networks.

Plan to see quite a bit of the campaign’s mascot, “Chuck the Chicken” as the JNF will encourage individuals to make Chuck their Facebook profile picture. Signs of Chuck the Chicken have been created for survivors and supporters to download from the foundation’s website and Facebook page, take their picture with and then upload to social media. Throughout the month, Chuck will introduce new elements of the campaign and new challenges for the followers to participate in.

The Joe Niekro Foundation was founded by Natalie Niekro, daughter of the late knuckleball pitcher Joe Niekro, who lost his life to a brain aneurysm in October 2006. The foundation is committed to supporting patients and aiding in the research, treatment and awareness of Brain Aneurysms, AVMs and Hemorrhagic Strokes. The goal of the JNF is to raise awareness about the risk factors, causes and treatments of these conditions, while helping support the advancement of neurological research.  They provide public education and advocacy, support for patients and families, and develop awareness programs and educational materials for hospitals, clinics and other institutions nationwide.

It is estimated that 6 million people in the US have a brain aneurysm (1 in 50 people). Every eight minutes an aneurysm ruptures; killing 50% of those victims within minutes. Of the remaining half, 50% will suffer a delayed death and those remaining will usually suffer severe brain deficits.

One in every 200-500 people has a brain AVM; a dangerous, complex tangle of abnormal arteries and veins. Often the AVM ruptures and bleeds, causing severe brain deficits and sometimes death. The peak age for AVM hemorrhage is the late teens (age 15-20), but an AVM can rupture at any age.

Hemorrhagic strokes make up about 15% of all strokes, resulting in nearly one quarter of all deaths caused by or related to strokes. Approximately 10-15% of people who have this type of stroke will die before reaching the hospital.

“It’s important that we bring awareness to these silent killers and educate the public on the warning signs and risk factors associated with them. Far too many innocent lives are taken each year as a result of one of these conditions and we are here to help educate others before its too late,” says JNF Founder, Natalie Niekro.

Don’t be a Chicken kicks off September 1st . Follow the results at #RUchicken and #JNF or visit www.joeniekrofoundation.org.

For more information on The Joe Niekro Foundation, contact Natalie Niekro – nniekro@joeniekrofoundation.org.

 

27
Aug
14

Minnesota Twins to Host Brain Aneurysm Awareness Day

In honor of Brain Aneurysm Awareness Month, The Minnesota Twins will pay tribute to one of baseball’s most renowned pitchers and former Minnesota Twins Knuckleballer, Joe Niekro by hosting Brain Aneurysm Awareness Day on September 4th. Niekro spent 22 years in the major leagues, notching 221 wins and still holds the record, with his brother Phil, of the most successful brother combination in major league history, with 539 wins. On October 27, 2006, Joe passed away from a sudden brain aneurysm. Today, his legacy lives on through the Joe Niekro Foundation, committed to supporting patients and aiding in the research, treatment and awareness of Brain Aneurysms, AVMs and Hemorrhagic Strokes. The foundation strives to raise awareness about the risk factors, causes and treatments of these conditions, while helping support the advancement of neurological research.  JNF provides public education and advocacy, support for patients and families, and develops awareness programs and educational materials for hospitals, clinics and other institutions nationwide. Attending the day will be, Founder of The Joe Niekro Foundation, Joe’s daughter, Natalie, representatives from Abbott Northwestern Hospital and Stryker Neurovascular, along with several brain aneurysm/AVM/stroke survivors and family members. The group will be recognized during a special on-field ceremony before the game and will enjoy the game immediately following. An informational booth with literature on these conditions and the foundation will be set up on the main concourse during the game for anyone interested in stopping by.

If you would like to help or find out more about the foundation, visit www.joeniekrofoundation.org.

Natalie Niekro – Founder – The Joe Niekro Foundation – 602-318-1013 nniekro@joeniekrofoundation.org




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