MDNews - Long Island

M D N E W S . CO M ■ MD NEWS Long Island | 1 7 DISTINGUISHED STROKE PHYSICIANS PROVIDING THE FULL spectrum of stroke care requires a level of skill that can only be gained from decades of experience. At Neurological Surgery PC (NSPC), patients from Long Island and beyond have access to leaders in stroke treatment. John Pile-Spellman, MD, FACR, interventional and endovascular neuroradiologist at NSPC, is board-certified in radiology and has more than 25 years of experience in diagnosing, managing and treating cerebral aneurysms, tumors and malformations, and stroke. He specializes in developing clini - cally relevant imaging and treatment paradigms, and his work in the field has earned him international recognition as a leader in interventional neuroradiology. He served fellowships in neuroradiology at Massachusetts General Hospital and in interventional radiology at New York University Medical Center. Before his tenure at NSPC, Dr. Pile-Spellman served as vice chair of research and director of interventional MRI at Columbia University Medical Center. Most recently, his honors include ranking as one of "America's Top Doctors" from 2001 to 2014, inclusion in New York Magazine's "Best Doctors in New York" list from 2002 to 2014 and receiving the Saddek Hilal Faculty Research Award from Columbia University. Dr. Pile-Spellman is a member of the Alpha Omega Alpha Medical Honor Society and belongs to more than 20 professional organizations and societies. He is published in more than 160 peer- reviewed journals. Jonathan Brisman, MD, board-certified neurosurgeon at NSPC, specializes in treating carotid stenosis, brain aneurysms and cerebral aneurysms, as well as in neuroendovascular surgery and microneurosurgical techniques. He is the first endovascular surgeon on Long Island, and one of approximately 100 neurosurgeons trained in both neuroendovascular and microneurosurgical specialties. He currently serves as the Director of Cerebrovascular and Endovascular Neurosurgery at Winthrop-University Hospital and South Nassau Communities Hospital. He served fellowships in interventional neuroradiology at Roosevelt Hospital in New York City and in microvascular neurosurgery at Swedish Hospital in Seattle. Prior to joining NSPC, Dr. Brisman served as assistant professor of neurosurgery at Seton Hall University and as director of cerebrovascular and endovascular services at the New Jersey Neuroscience Institute at JFK Medical Center in Edison. He has published more than 37 articles in peer-reviewed neurosurgery journals, and his written work on topics including carotid artery disease, intracranial aneurysms, arteriovenous malformation, subarachnoid hemorrhage and vasospasm also appears in textbooks. Dr. Brisman is a member of many neurological associations and serves on the editorial board of the American Journal of Neuroradiology. In recent years he was selected as a "Top Doctor: New York Metro Area" by Castle Connolly, and is one of two Long Island neurosurgeons listed in New York Magazine's "Best Doctors of 2013." for endarterectomy. Patients who may be appropriate candidates for carotid artery stenting include patients who: + have suffered a mild stroke or one or more TIAs in the past six months and who present with a carotid artery narrowed by at least 50 percent + have asymptomatic stenosis greater than 75 percent and who have reason- able life expectancy + have low risk for complications related to stenting + are aware of the risks and benefits of stenting as opposed to endarterectomy + have a severe systemic illness, such as COPD or emphysema, and who may be at risk under anesthesia + have had a prior endarterectomy, spine or other neck surger y that makes an open procedure, such as an endarterectomy, a greater risk + have significantly poor intracranial collaterals that can make cross clamp- ing during endarterectomy difficult + have tandem lesions in the distal internal carotid and proximal inter- nal carotid + have occlusions that are difficult to reach surgically. Anatomical areas that pose contraindicative challenges for endarterectomy include those high up the neck, under the jaw or beneath the skull base. + have radiation-induced stenosis from prior radiation or a tumor in the area + take antiplatelet agents that cannot be stopped for carotid surgeries such as endarterectomies The Need for Both Procedures Major clinical trials support end- arterectomy's efficacy at preventing future strokes in patients with symp- tomatic carotid stenosis, but the body Dr. Brisman studies a patient's carotid angiogram prior to carotid stenting.

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