§ Born in Rosario, Argentina, 1966
§ Medical Degree from the School of Medical Sciences of the National University of Rosario, Rosario 1990.
§ Completed Neurosurgery residency program at the Clemente Alvarez Emergency Hospital, National University of Rosario, Rosario 1995.
§ Chief resident of the Neurosurgery Department at the Clemente Alvarez Emergency Hospital, National University of Rosario, Rosario 1996.
§ Fellow in Pediatric Neurosurgery, Garrahan National Hospital of Pediatrics, Buenos Aires 1997.
§ Fellow in Endovascular Neurosurgery and Interventional Neuroradiology, ENERI - Adventist Medical Center, Buenos Aires 2000.
§ Associate Neurosurgeon and Interventional Neuroradiologist, ENERI - Adventist Medical Center- FLENI, Buenos Aires 2002.
Dr. Cohen has full practice of neurosurgery with a special interest in stroke, vascular and tumoral lesions affecting the central nervous system, head - neck and spine, including:
§ Endovascular embolization of vascular lesions
§ Aneurysms
§ Arteriovenous malformations
§ Fistulas Angioplasty of intracranial vessels
§ Atherosclerosis
§ Vasospasm
§ Angioplasty of supraortic vessels
§ Carotid artery disease
§ Vertebral artery disease
§ Fibrinolysis for acute stroke
§ Preoperative embolization of tumors
§ Meningiomas, angiofibromas, paragangliomas
§ Percutaneous treatment of vascular masses
§ Facial angiomas and hemangiomas
§ Percutaneous vertebroplasty
§ Painful osteoporotic spine fractures
§ Vertebral tumors
Research interests
§ Innovative endovascular technologies
§ Stroke therapy
§ Vascular anatomy
Recent Publications (2001-2002)
Lylyk P, Cohen JE, Ceratto R, Ferrario A, Miranda C: Tratamiento Endovascular de Remanentes Aneurismaticos. Medicina (Buenos Aires), 2001, 61:57-62.
Lylyk P, Cohen JE, Ceratto R, Ferrario A, Miranda C: Combined Endovascular Treatment of Dissecting Vertebral Aneurysms by using Stents and Coils. Journal of Neurosurgery 94:427-432, 2001.
Lylyk P, Ceratto R, Cohen J, Miranda C, Vilca M, Ferrario A. Intracranial Arterial Reconstruction with Stent Placement and Combined Techniques (abstract). Stroke 32:369, 2001
Lylyk P, Ferrario A, Ceratto R, Cohen J, Miranda C, Vilca M Preliminary Experience in Carotid Artery Angioplasty and Stenting with a New Cerebral Protection Device (abstract). Stroke 32:374, 2001
Lylyk P, Cohen JE, , Ferrario A, Miranda C, Ceratto R: Unprotected and Protected Stent-Assisted Carotid Artery Angioplasty in Buenos Aires (abstract). Journal of Neurosurgery 96:166A, 2002
Cohen JE, , Ferrario A, Ceratto R, Miranda C, Lylyk P: Experience with Extracranial Vertebral Artery Stent-assisted Angioplasty (abstract). Journal of Neurosurgery 96:184A, 2002.
Accepted for publication
Lylyk P, Cohen JE, Ceratto R, Ferrario A, Miranda C: Partially clipped aneurysm treated with stent and coils. Journal of Endovascular Therapy, 2002
Lylyk P, Cohen JE, Ceratto R, Ferrario A, Miranda C: Experience with Angioplasty and Stenting of Intracranial Stenoses. American Journal of Neuroradiology, 2002
Presentations in Recent International Congresses (2001-2002)
Intracranial Arterial Dissections: Reconstruction with stents and coils, XXIX Brazilian Congress of Radiology. Lylyk P, Cohen J, Ceratto R, Miranda C, Ferrario A. Speaker. Salvador. November of 2001. Brazil
Endovascular Revascularization of Intracranial Atheromatose Lesions. Authors: Cohen J, Ferrario TO, Vilca M, Ramírez G, Ceratto R, Lylyk P.
Acrylic Percutaneous Vertebroplasty: Experience with 50 cases. Authors: Ramírez G, Ferrario A, Ceratto R, Cohen J, Lylyk P.
Experience in the Treatment of Non-Aneurysmatic Intracranial Arterial Dissections with Stents. Authors: Ceratto R, Ferrario A, Cohen J, Vilca M, Lylyk P.
Endovascular Treatment of Galen Vein Aneurysmatic Malformations. Authors: Ceratto R, Ferrario A, Cohen J, Ramírez G, Miranda C, Vilca M, Lylyk P. Punta del Este. December 2001, Uruguay.
Reconstructive Endovascular Treatment of Dissecting and Fusiform Aneurysms with Combined Techniques. Authors: Lylyk P, Ceratto R, Cohen J, Miranda C, Ferrario TO, Vilca M. Speaker
Endovascular Reconstruction of the Aneurysm-Parent Vessel Complex by means of Stent Placement and Combined Techniques. Authors: Lylyk P, Cohen J, Ceratto R, Miranda C, Vilca M, Ramirez G, Ferrario A. Speaker
Fourth Annual Meeting of the AANS/CNS Section on Cerebrovascular Surgery and the American Society of Interventional and Therapeutic Neuroradiology. Hawaii. February 9-12, 2001. United States.
Intracranial Arterial Reconstruction with Stent Placement and Combined Techniques Authors: Lylyk P, Ceratto R, Cohen J, Miranda C, Ferrario A
Preliminary Experience in Carotid Artery Angioplasty and Stenting with a New Cerebral Protection Device. Speaker. Authors: Lylyk P, Ferrario A, Ceratto R, Cohen J, 26th International Stroke Conference. February 14 – 16th , 2001. Fort Lauderdale, United States.
Endovascular Reconstruction of the Aneurysm-Parent Vessel Complex by means of Stent Placement and Combined Techniques. Authors: Lylyk P, Cohen J, Ceratto R, Miranda C, Ferrario A. Speaker. Discussant: David Piepgras (Rochester, MN) 2001 American Association of Neurological Surgeons (AANS) Annual Meeting Toronto, Ontario, Canada. April 21-26, 2001.
Endovascular Treatment of 1108 Intracranial Aneurysms with Coils: Results, Complications, and Follow-Up (paper 296). Speaker
Reconstruction of the Aneurysm-Parent Vessel Complex by Means of stenting and Combined Techniques (paper 299) Speaker
Reconstructive Endovascular Treatment of Vertebral Dissecting and Fusiform Aneurysms (paper 300) Speaker
Angioplasty and Stenting of Intracranial Atherosclerotic Stenoses and Dissections (paper 314) Speaker. American Society of Neuroradiology Symposium and 39th Annual Meeting Hynes Convention Center, Boston, Massachussets, United States. April 23-27, 2001.
Endovascular Treatment of Cranial Base Lesions. Author: Cohen JE.
Experimental Animal Laboratory Models of Cerebral Vascular Pathology. Speaker Author: Cohen JE
International Course on Endovascular and Percutaneos Neuroradiology Buenos Aires, Argentina. September 1-4, 2001
Endovascular Treatment of Incompletely Clipped Aneurysms. Authors: Lylyk P, Cohen JE, Ceratto R, Ferrario A, Miranda C, Vilca M
Reconstructive Endovascular Treatment of Vertebral Dissecting and Fusiform Aneurysms . Authors: Lylyk P, Ceratto R, Cohen JE, Ferrario A, Miranda C.
Treatment of the Aneurysm-Parent Vessel Complex using Stents and Coils. Authors: Lylyk P, Cohen JE, Ceratto R, Ferrario A, Miranda C, Vilca M
Experience with Stent-assisted Angioplasty for the Management of Intracranial Atherosclerotic Lesions. Authors: Lylyk P, Ferrario A, Cohen JE, Ceratto R, Miranda C World Federation of Interventional and Therapeutic Neuroradiology WFITN 2001 Seoul, Korea. September 23-26, 2001.
Endovascular Treatment of Intracranial Aneurysms Combining Different Coils (p108) Authors: Lylyk P, Cohen JE, Ferrario A, Ceratto R, Miranda C
Experience in Carotid Artery Angioplasty and Stenting with a New Cerebral Protection Device (p 687). Authors: Lylyk P, Ferrario A, Cohen JE, Ceratto R, Miranda C
Experience with Stent-assisted Angioplasty for the Management of Intracranial Atherosclerotic Lesions (paper 688). Authors: Lylyk P, Cohen JE, Ceratto R, Ferrario A, Miranda C
Radiological Society of North America – 87TH. Scientific Assembly and Annual Meeting. Mc Cormick Place – Chicago, Illinois, United States. November 25-30, 2001.
Endovascular Treatment of 1108 Intracranial Aneurysms with GDC: Results Complications and Follow up. Authors: Lylyk P, Cohen JE, , Ceratto R, Ferrario A, Miranda C
Reconstructive Endovascular Treatment of Dissecting Vertebral and Fusiform Aneurysms. Authors: Cohen JE, Ferrario A, Miranda C, Ceratto R, Lylyk P. Annual Congress of the Israeli Association of Neurosurgery. Ein Guedi. January 24th, 2002, Israel
Unprotected and Protected Stent-Assisted Carotid Artery Angioplasty in Buenos Aires Authors: Lylyk P, Cohen JE, , Ferrario A, Miranda C, Ceratto R
Experience with Extracranial Vertebral Artery Stent-assisted Angioplasty (abstract). Authors: Cohen JE, , Ferrario A, Ceratto R, Miranda C, Lylyk P: Journal of Neurosurgery 96:184A, 2002.
2002 Joint Annual Meeting of the AANS/CNS Section on Cerebrovascular Surgery and the American Society of Interventional and Therapeutic Neuroradiology, Addison, Texas, United States. February 3-7, 2002.
More in PubMed
Society Memberships
- Member of the Argentine College of Neurosurgeons
- Member of the Argentine Association of Neurosurgery
- Associated Member of the Argentine Stroke Association
- Associated Member of the Argentine Association of Diagnostic and Therapeutic Neuroradiology (AANDIT)
- Associated Member of the Ibero-Latinoamerican Society of Neuroradiology (SILAN)
- Member of the Israeli Society of Neuroradiology
Endovascular Surgical Approach to Intracranial–Spinal Vascular Diseases
Endovascular neurosurgery represents the embodiment of the dream of all neurosurgeon who treat the complex vascular and neoplastic lesions of the central nervous system: to access the already formed pathways that the vascular tree affords, and thus minimize or eliminate the morbidity seen with classic surgical techniques.
The minimally invasive approach to managing patients with complex cerebrovascular disorders by endovascular intervention has made enormous progress over the past two decades. This is mainly due to technological advances in imaging, which include magnetic resonance imaging, magnetic resonance angiography, computed tomography, ultrasonography, transcranial doppler, and high resolution rapid equence digital substraction angiography. In addition, safer access into the intracranial circulation with newer steerable microcatheters and microguidewires has broadened the indications of treatment. Refinement of embolic materials as detachable balloons, microcoils, particulate emboli, and liquid adhesives, has improved the overall safety for many neurological conditions that are either acute or require emergent therapy.
This neurosurgical and neuroradiological field requires many years of postgraduate intense and devoted training, exquisite technical skills and profound understanding of neurosciences.
Endovascular therapy of cerebral aneurysms
Intracranial aneurysms therapy utilizing detachable balloons was first reported back on the early 1970s. However, after the development of electrolytic detachable coils in 1991, the first therapy was abandoned and actually indicated only for selected cases. The occlusion technique with coils (GDC or Guglielmi detachable coils) involve the navigation of a microcatheter from a transfemoral arterial approach through the intracranial circulation directly into the aneurysm. Multiple soft platinum coils are delivered into the aneurysm and detached until complete occlusion of the aneurysm is achieved. The endovascular approach to intracranial aneurysms is still evolving and enriching with recently incorporated coils, microstents and embolic materials.
Angioplasty for intracranial and extracranial significant lesions
Patients who have failed conventional medical therapy for symptoms of cerebral ischemia can be considered for revascularization therapy by either balloon angioplasty and/ or stenting.
The majority of these patients are fragile and have diffuse atherosclerotic disease affecting several vascular territories. This promoted the development of sophisticated minimally invasive techniques with high rates of procedural success.
The majority of cases with atherosclerotic carotid or vertebral disease of the extracranial circulation will be treated with stents. Recently introduced cerebral protection devices regularly assist the angioplasty procedure.
Arteriovenous malformations and fistulas
The goal of endovascular embolization is to occlude the vascular malformation or fistula. However, when dealing with complex malformations of considerable size, embolization becomes part of a combined treatment plan that may include surgery or radiosurgery. This multimodality therapy has allowed the treatment of previously considered untreatable lesions.
Preoperative tumor embolization
In order to reduce operative blood loss and operative time, preoperative embolization is indicated in selected hypervascular tumors of the central nervous system, such as meningiomas, paragangliomas or angiofibromas. Selective intratumoral infusion of chemotherapic agents is also a promising field.
Vertebroplasty
Patients who suffered recent spinal fractures mainly osteoporotic fractures that are causing moderate to severe back pain despite standard therapy with rest and medications are the best candidates for vertebroplasty.
Vertebroplasty is a procedure performed under sedation and consists in the injection of a strong cement into the body of the diseased vertebra.
Frequently this procedure takes 1 to 2 hours and almost 90% of the patients will have a complete or significant reduction of their pain.
Intra-arterial thrombolytic therapy for acute stroke
Patients who present with acute ischemic stroke can now be managed by direct, local intraarterial thrombolytic therapy. The suddenly occluded cerebral artery can be reopened, but this has to be done within 6 hours after the initial symptoms.
Stroke is a devastating disease of the brain and constitutes a leading cause of morbidity and mortality in developed countries.
In an effort to foster the emergency treatment of stroke, we urge the public to view and respond to stroke as an emergency.
Time can help us to save your brain.
Symptoms suggesting Stroke
. Sudden numbness or weakness of face, arm or leg (especially on one side of the body)
. Sudden confusion, trouble speaking or understanding
- Expresing or comprehending words (aphasia)
- Slurring of words (dysarthria)
. Sudden trouble seeing in one or both eyes
- Loss of vision in one eye
- Loss of vision in one side
- Double vision
. Sudden trouble walking, dizziness, loss of balance or coordination
. Sudden severe headache with no known cause