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Buffalo, NY, United States

Lin N.,University at Buffalo Neurosurgery | Brouillard A.M.,University at Buffalo Neurosurgery | Krishna C.,Gates Vascular Institute Kaleida Health | Mokin M.,State University of New York at Buffalo | And 5 more authors.
Neurosurgery | Year: 2015

BACKGROUND: Coiling in conjunction with Pipeline embolization device (PED) placement could provide immediate dome protection and an intraaneurysmal scaffold to prevent device prolapse for intracranial aneurysms with high rupture risk and complex anatomy. OBJECTIVE: To report results after treatment of aneurysms with PED with coils (PED1coils group) or without (PED-only group) at a single-institution. METHODS: In this case-controlled study, records of patients who underwent PED treatment between 2011 and 2013 were retrospectively reviewed. RESULTS: Twenty-nine patients were treated with PED1coils and 75 with PED-only. No statistically significant between-group differences were found in terms of age, sex, aneurysm location, medical comorbidities, and length of follow-up. Aneurysms treated by PED1coils were larger (16.3 mm vs 12.4 mm, P = .02) and more likely to be ruptured (20.7% vs 1.3%, P = .001) or dissecting (34.5% vs 9.3%, P = .002). PED deployment was successful in all cases. At the latest follow-up (mean, 7.8 months), complete aneurysm occlusion was achieved in a higher proportion of the PED1coils group (93.1% vs 74.7%, P = .03). Device foreshortening/migration occurred in 4 patients in the PED-only group and none in the PED1coils group. Fewer patients required retreatment in the PED1coils group (3.4% vs 16.0%, P = .71). Rates of neurological complications (10.3% PED1coils vs 8.0% PED-only, P = .7) and favorable outcome (modified Rankin Scale score = 0-2; 93.1% PED1coils vs 94.7% PED-only, P = .6) were similar. CONCLUSION: PED1coils may be a safe and effective treatment for aneurysms with high risk of rupture (or rerupture) and complex anatomy. Coiling in conjunction with PED placement provided a higher aneurysm occlusion rate and reduced the need for retreatment. Copyright © 2014 by the Congress of Neurological Surgeons. Source


Mokin M.,University of South Florida | Nagesh S.V.S.,State University of New York at Buffalo | Ionita C.N.,State University of New York at Buffalo | Siddiqui A.H.,State University of New York at Buffalo | Siddiqui A.H.,Jacobs Institute
Journal of NeuroInterventional Surgery | Year: 2016

Background Recently, an in vitro cerebrovascular occlusion model of the intracranial circulation was developed for testing thrombectomy devices. The Cover accessory (Lazarus Effect; Campbell, California, USA) is a novel nitinol braided mesh device that surrounds the stent retrieval device and thrombus during the retrieval process to help prevent clot fragmentation and embolization. Methods Using the in vitro model, after introducing fresh clot into the middle cerebral artery, we compared rates of target vessel recanalization and embolization in new territories (areas in which clot had not been introduced) achieved with the Solitaire Flow Restoration (FR) stent retriever (Covidien, Irvine, California) in conjunction with the use of a conventional guide catheter (control group), a balloon guide catheter (BGC group), and the Cover device (Cover group). Results In a total of 51 thrombectomy experiments (20 in the control group, 20 in the BGC group, and 11 in the Cover group), successful recanalization (Thrombolysis in Cerebral Infarction 2b-3) was achieved more frequently in the Cover group than in the control group or in the BGC group (p=0.047 and p=0.020, respectively). Embolization of new ( previously unaffected) territories occurred in five (25%) experiments from the control group and in three (15%) experiments from the BGC group, whereas no embolization of new territories was seen with Cover device assisted thrombectomy. Conclusions Application of the Cover device in this experimental model resulted in higher successful recanalization rates, no embolic events, and was more effective than use of the conventional guide catheter or BGC. Source


Dodis Y.,New York University | Ganesh C.,New York University | Golovnev A.,New York University | Juels A.,Jacobs Institute | Ristenpart T.,University of Wisconsin - Madison
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics) | Year: 2015

We provide a formal treatment of backdoored pseudorandom generators (PRGs). Here a saboteur chooses a PRG instance for which she knows a trapdoor that allows prediction of future (and possibly past) generator outputs. This topic was formally studied by Vazirani and Vazirani, but only in a limited form and not in the context of subverting cryptographic protocols. The latter has become increasingly important due to revelations about NIST’s backdoored Dual EC PRG and new results about its practical exploitability using a trapdoor. We show that backdoored PRGs are equivalent to public-key encryption schemes with pseudorandom ciphertexts. We use this equivalence to build backdoored PRGs that avoid a well known drawback of the Dual EC PRG, namely biases in outputs that an attacker can exploit without the trapdoor. Our results also yield a number of new constructions and an explanatory framework for why there are no reported observations in the wild of backdoored PRGs using only symmetric primitives. We also investigate folklore suggestions for countermeasures to backdoored PRGs, which we call immunizers. We show that simply hashing PRG outputs is not an effective immunizer against an attacker that knows the hash function in use. Salting the hash, however, does yield a secure immunizer, a fact we prove using a surprisingly subtle proof in the random oracle model. We also give a proof in the standard model under the assumption that the hash function is a universal computational extractor (a recent notion introduced by Bellare, Tung, and Keelveedhi). © International Association for Cryptologic Research 2015. Source


Dumont T.M.,State University of New York at Buffalo | Dumont T.M.,Gates Vascular Institute | Mokin M.,State University of New York at Buffalo | Mokin M.,Gates Vascular Institute | And 11 more authors.
Journal of NeuroInterventional Surgery | Year: 2014

Objective: Several studies have reported increased perioperative risk after carotid artery stenting (CAS) for patients ≥80 years of age; however, most have not considered unfavorable anatomic features noted more frequently in this population as a confounding variable. The purpose of this study was to show a correlation between poor aortic arch anatomy and perioperative ischemic complications after CAS. Methods: Our prospectively maintained database was queried for all CAS procedures performed on symptomatic patients between 2009 and 2011. Retrospective analysis of consecutive CAS procedures was performed. The primary endpoint was perioperative (within 30 days) ischemic events (stroke, transient ischemic attack (TIA)). Event incidence was compared between groups dichotomized by age and anatomical features. Incidence of unfavorable arch (acute angle between aortic arch and treated common carotid artery) was compared between age groups. Results: Perioperative ischemic events included four ischemic strokes and three TIAs (all events ipsilateral to the treated vessel). Event incidence was more frequent in patients with unfavorable arch anatomy (7.9%) than in those with favorable aortic arch features (0.7%) (p=0.0073). Event incidence in patients ≥80 years of age (4.5%) was not statistically different than that in patients <80 years (2.3%) (p=0.428). Unfavorable aortic arch anatomy was increased in frequency in patients aged 80 years and over (<80 years, 29%; ≥ 80 years, 52%; p<0.001). Conclusions: In the present series, the incidence of perioperative complications was increased in patients with unfavorable aortic arch anatomy but not in patients ≥80 years. CAS represents a revascularization option for patients of all ages; however, patients with unfavorable aortic arch anatomy may represent a group at relatively high risk for periprocedural ischemic events. Source


Kanza Y.,Jacobs Institute | Samet H.,University of Maryland College Park
GIS: Proceedings of the ACM International Symposium on Advances in Geographic Information Systems | Year: 2015

When recording their GPS trajectories or posting geo-tagged content on social networks, people produce social spatio-temporal data that can be stored and shared, namely geosocial data. Much of these spatio-temporal data can be used by organizations and applications, for statistical analysis or to provide services that are based on data. By letting people sell the data they produce, to different consumers, both sides can benefit. Thus, we present here a visionary idea of a geosocial marketplace where people and organizations can sell, buy and exchange geosocial data, that is, trade with spatio-temporal data pertaining people. We discuss the involved challenges, such as how to define supply and demand, pricing data, privacy issues and measuring the amount of data being exchanged. We explain the importance of the approach and its applicability. We believe that the proposed vision could motivate followup research in the area of sharing and exchanging spatio-temporal data as well as determining appropriate price points. Source

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