Tibor Becske, M.D.

US pipeline trial (PUFS) results
Becske T.; Shapiro M.; Nelson P.K.
2011 ;17:51-51, Interventional neuroradiology
Purpose: To evaluate safety and effectiveness of Pipeline Embolization Device for the treatment of complex intracranial aneurysms. Materials and Methods: 108 patients with large and giant, wide neck aneurysms involving the petrous, cavernous, and paraclinoid segments of the internal carotid artery were enrolled in this prospective, multicenter, single arm study. All subjects but one underwent successful treatment of the target aneurysm with Pipeline. Clinical follow-up was performed at 30 days, 180 days, and 1 year post treatment. Angiographic follow-up was obtained at 180 days (n=99) and 1 year (n=91). Completeness of aneurysm occlusion was assessed by a core laboratory. The results were compared to a predefined target aneurysm occlusion rate derived from exhaustive literature review. Safety outcomes were similarly compared to a historically defined threshold. Results: Complete aneurysm occlusion was observed in a high proportion of cases at both time points of angiographic assessments, representing a highly statistically significant result as compared to the predefined target complete occlusion rate. The safety profile of the device was acceptable, with primary safety events statistically significantly below the predefined threshold. Conclusion: Pipeline Embolization Device is effective and safe for treatment of petrous, cavernous, and paraclinoid aneurysms
— id: 146276, year: 2011, vol: 17, page: 51, stat: Journal Article,

Metameric thoracic lesion: report of a rare case and a guide to management
Kalhorn, Stephen P; Frempong-Boadu, Anthony K; Mikolaenko, Irina; Becske, Tibor; Harter, David H
2010 May;12(5):497-502, Journal of neurosurgery. Spine
Metameric lesions of the spine are rare. The authors present a case of patient with a complex metameric vascular lesion of the thoracic spine and describe a management strategy for this entity
— id: 109568, year: 2010, vol: 12, page: 497, stat: Journal Article,

The vascular anatomy of the vertebro-spinal axis
Becske, Tibor; Nelson, Peter Kim
2009 Jul;20(3):259-264, Neurosurgery clinics of North America
This article discusses the vascular anatomy of the vertebra-spinal axis and covers such topics as vascular supply to the spine, spinal dura, and paraspinal musculature; vascular supply to the spinal cord; and spinal veins
— id: 102936, year: 2009, vol: 20, page: 259, stat: Journal Article,

Safety and efficacy of adjunctive balloon remodeling during endovascular treatment of intracranial aneurysms: a literature review
Shapiro, M; Babb, J; Becske, T; Nelson, P K
2008 Oct;29(9):1777-1781, AJNR. American journal of neuroradiology
BACKGROUND AND PURPOSE: Concurrent temporary inflation of a nondetachable balloon in the parent artery has been reported to be useful during endovascular coiling of complex, wide-neck aneurysms, facilitating truer coil reconstruction of the native vessel. Nevertheless, there exists concern that adjunctive use of balloon assistance may lead to increased adverse events during aneurysm coiling. MATERIALS AND METHODS: A literature search of all of the unassisted and balloon-remodeling studies published between 1997 and 2006 was conducted with application of strict selection criteria based on the reporting of complication incidence and outcome. The final cohort was analyzed to determine rates and clinical outcomes of iatrogenic aneurysm rupture and thromboembolism. Additional data were collected on the degree of initial and follow-up aneurysm occlusion rates. RESULTS: A total of 83 potential studies (4973 patients) were identified, from which 23 articles reporting results for 867 traditional-unassisted and 273 balloon-assisted coiled aneurysms met inclusion criteria for the analysis of thromboembolic complications, and 21 articles with 993 routinely coiled and 170 balloon-remodeled aneurysms were eligible for iatrogenic perforation analysis. No statistically significant difference was found in the rates of thromboembolism. Iatrogenic perforation rates were also comparable, though the overall numbers were too few for meaningful statistical analysis. Both initial and follow-up aneurysm occlusion rates were higher in balloon-assisted cases. CONCLUSION: This largest-to-date literature review and meta-analysis did not demonstrate a higher incidence of thromboembolic events or iatrogenic rupture with the use of adjunctive balloon remodeling compared with unassisted coiling. Balloon remodeling appears to result in higher initial and follow-up aneurysm occlusion rates
— id: 102600, year: 2008, vol: 29, page: 1777, stat: Journal Article,

Stent-assisted Gugliemi detachable coil repair of wide-necked renal artery aneurysm using 3-D angiography
Clark, Timothy W I; Sankin, Alex; Becske, Tibor; Nelson, Peter Kim; Fox, Martin
2007 Dec-2008 Jan;41(6):528-532, Vascular & endovascular surgery
PURPOSE: To report a wide-necked renal artery aneurysm treated successfully with stent-assisted Gugliemi detachable coil occlusion, assisted by three-dimensional (3-D) angiography. CASE REPORT: A 56-year-old woman with history of hypertension presented with a 2.5-cm wide-necked saccular aneurysm involving her distal right renal artery. A balloon-expandable stent was positioned across the neck of the aneurysm and multiple Gugliemi detachable coils were deployed through a microcatheter inserted through the interstices of the stent into the aneurysm sac, guided by 3-D angiography. Follow-up 3-D angiography at 6 months revealed a patent renal artery with continued exclusion of the aneurysm and preservation of renal blood flow. CONCLUSION: Stent-assisted coil occlusion assisted by 3-D angiography is a potential renal-sparing endovascular approach to treating wide-necked renal artery aneurysms with complex vascular anatomy
— id: 75854, year: 2007, vol: 41, page: 528, stat: Journal Article,

Rapid stent-supported revascularization in acute ischemic stroke
Fitzsimmons, B-F M; Becske, T; Nelson, P K
2006 May;27(5):1132-1134, AJNR. American journal of neuroradiology
We report the case of a patient with an acute middle cerebral artery occlusion emergently revascularized with a Neuroform self-expanding stent
— id: 69021, year: 2006, vol: 27, page: 1132, stat: Journal Article,

Recent steps toward a reconstructive endovascular solution for the orphaned, complex-neck aneurysm
Nelson, Peter K; Sahlein, Daniel; Shapiro, Maksim; Becske, Tibor; Fitzsimmons, Brian-Fred; Huang, Paul; Jafar, Jafar J; Levy, David I
2006 Nov;59(5 Suppl 3):S77-S92, Neurosurgery
OBJECTIVE: The purposes of this article are to summarize recent developments and concerns in endovascular aneurysm therapy leading to the adjunctive use of endoluminal devices, to review the published literature on stent-supported coil embolization of cerebral aneurysms, and to describe our experience with this technique in a limited subgroup of problematic complex aneurysms over a medium-term follow-up period. METHODS: Between January 2003 and June 2004, 28 individuals among 157 patients with cerebral aneurysms we evaluated were identified as harboring aneurysms with exceptionally broad necks. Out of these 28 patients, 16 were treated with a combination of stents and detachable coils, preserving the parent artery. Recorded data included patient demographics, the clinical presentation, aneurysm location and characteristics, procedural details, and clinical and angiographic outcome. RESULTS: Over an 18-month period, 16 patients with large cerebral aneurysms additionally characterized by neck sizes between 7 and 14 mm were treated, using combined coil embolization of the aneurysm with stent reconstruction of the aneurysm neck. Thirteen out of the 16 aneurysms were occluded at angiographic reevaluation between 11 and 24 months (mean angiographic follow-up, 17.5 mo). There were no treatment-related deaths or clinically evident neurological complications. Thirteen patients experienced excellent clinical outcomes, with good outcomes in two patients and a poor visual outcome in one patient (mean clinical follow-up, 29 mo). A single technical complication occurred, involving transient nonocclusive stent-associated thrombus, which was treated uneventfully with abciximab. CONCLUSION: Stent-supported coil embolization of large, complex-neck cerebral aneurysms seems to provide superior medium-term anatomic reconstruction of the parent artery compared with historic series of aneurysms treated exclusively with endosaccular coils. In the near future, increasingly sophisticated endoluminal devices offering higher coverage of the neck defect will likely enable more definitive endovascular treatment of complex cerebral aneurysms and further expand our ability to manipulate the vascular biology of the parent artery
— id: 71410, year: 2006, vol: 59, page: S77, stat: Journal Article,

Myocardial injury after hemorrhage into the lateral medulla oblongata
Jaster, J H; Fitzek, S; Fitzek, C; Smith, T W; Becske, T
2001 Sep 25;57(6):1145-1145, Neurology
— id: 69284, year: 2001, vol: 57, page: 1145, stat: Journal Article,

Neural tube defects
Becske T; Jallo GI
2000 ;:-, eMedicine
— id: 76070, year: 2000, vol: , page: , stat: Journal Article,

Subarachnoid hemorrhage
Becske T; Jallo GI
2000 ;:-, eMedicine
— id: 76071, year: 2000, vol: , page: , stat: Journal Article,

Dropped head syndrome
Jaster, J H; Bertorini, T E; Swims, M P; Dohan, F C Jr; Menke, P G; Becske, T; Monkemuller, K E
1997 Feb;48(2):551-551, Neurology
— id: 69285, year: 1997, vol: 48, page: 551, stat: Journal Article,

Solitary focal demyelination in the brain as a paraneoplastic disorder
Jaster, J H; Bertorini, T E; Dohan, F C Jr; O'Brien, T F; Wang, H; Becske, T; Menke, P G; Handorf, C R; Horner, L H; Monkemuller, K E
1996 Feb;26(2):111-115, Medical & pediatric oncology
Solitary focal demyelination (SFD) in the brain is an uncommon and poorly understood disorder of uncertain etiology that may represent an intermediate entity between multiple sclerosis and acute disseminated encephalomyelitis. In a few reported cases of SFD, the patient was briefly noted to have a nonneurological malignancy. We studied two patients who had solitary focal lesions in the brain. Utilizing magnetic resonance imaging and tissue biopsy, we found the characteristics of the brain lesions in these two patients to be those of SFD. In our combined experience over the past 10 years, we have encountered no similar brain lesions at our medical center. We found it remarkable that both of these patients also had malignancy outside of the nervous system. One had a seminoma, and the other a lymphoma. We conclude that some cases of SFD in the brain may occur as a paraneoplastic disorder associated with nonneurological malignancies
— id: 69288, year: 1996, vol: 26, page: 111, stat: Journal Article,

Cervical kyphosis after resolution of myopathic head drop. A case report
Jaster, J H; Bertorini, T E; Swims, M P; Dohan, F C Jr; Menke, P G; Becske, T; Monkemuller, K E
1996 Sep 1;21(17):2023-2025, Spine
STUDY DESIGN: This is a case report. OBJECTIVES: To present a case of cervical kyphosis after resolution of myopathic head drop. SUMMARY OF BACKGROUND DATA: Myopathic head drop is a severe and persistent local myopathy that never progresses beyond the neck extensor muscles. METHODS: A case is reported of a hospitalized psychiatric patient who experienced the sudden onset of severe neck extensor weakness consistent with myopathic head drop. RESULTS: Although myopathic head drop resolved after 2 years, it left a disabling residual skeletal deformity of the cervical spine. CONCLUSIONS: Myopathic head drop may be a cause of cervical kyphosis
— id: 69287, year: 1996, vol: 21, page: 2023, stat: Journal Article,

Stroke and cardiac arrest
Jaster, J H; Porterfield, L M; Bertorini, T E; Dohan, F C Jr; Becske, T
1996 Nov;47(5):1357-1357, Neurology
— id: 69286, year: 1996, vol: 47, page: 1357, stat: Journal Article,

Cardiac arrest following vertebrobasilar stroke
Jaster, J H; Porterfield, L M; Bertorini, T E; Dohan, F C Jr; Becske, T
1995 Aug;88(8):309-309, Journal of the Tennessee Medical Association
— id: 69289, year: 1995, vol: 88, page: 309, stat: Journal Article,