Levy Awarded Dacey Medal for Cerebrovascular Research

By Dirk Hoffman

The international award was established in 2018 at the Joint Cerebrovascular Section meeting of the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons(CNS).

Its purpose is to highlight the importance of cerebrovascular research in the field of neurosurgery, foster scientific investigation in the areas of stroke and cerebrovascular disease, and recognize neurological surgeons who have made novel, outstanding, and continuous contributions to the basic, translational, and/or clinical understanding of cerebrovascular disease.

Levy, co-director of the Gates Stroke Center and Cerebrovascular Surgery at Kaleida Health’s Buffalo General Medical Center/Gates Vascular Institute, and president of UB Neurosurgery (UBNS), received the honor July 23 at the annual meeting of the Society of NeuroInterventional Surgery, which partners with the AANS/CNS CV Section to present the Dacey Medal.

“It was a huge honor to receive the Dacey Medal. It is truly one of the most meaningful awards of my career,” says Levy, who is also a professor of radiology at the Jacobs School.

“It is an award that I share with Buffalo because of all of the research and collaboration and the network that exists here that made all of this possible,” he adds.

Levy says the award recognizes all of the work that was first envisioned by L. Nelson “Nick” Hopkins, MD, SUNY Distinguished Professor of neurosurgery and former chair of the department, and that led to the University at Buffalo creating a paradigm shift in stroke treatment.

Led by Hopkins, UB’s team began pioneering new techniques back in the 1990s, using minimally invasive stroke treatments.

That work has continued under Levy, who completed his neurosurgery fellowship under Hopkins in 2003, joined the UB faculty in 2004 and was named chair of neurosurgery in 2013.

With almost 800 peer-reviewed publications in cerebrovascular disease research, Levy helped create a paradigm shift where thrombectomy became the new standard of care for stroke after a decade-and-a-half of intensive research.

“What started with the first animal model for intracranial stent in our labs at UB, we then took that knowledge to get the first FDA-approved ‘stent for stroke’ trial,” Levy says.

“We were able to build on this and were among the first to publish data ‘uncoupling’ time dependency from stroke care,” he says. “With multiple New England Journal of Medicine publications, we have galvanized organized medicine around stroke intervention care.”

“We have many firsts here at UB and certainly have remained global leaders in stroke care.”

Levy, a past president of the Congress of Neurological Surgeons, has an h-index score of 99.

The h-index is a standard scholarly metric in which the number of published papers, and the number of times their author is cited, is put into relation. The index’s creator noted that after 20 years of research, an h-index of 20 is good, 40 is outstanding, and 60 is truly exceptional.

Adnan Siddiqui, MD, PhD, professor and vice chair of neurosurgery at the Jacobs School and CEO and chief medical officer of the Jacobs Institute, started the Dacey Medal when he was chair of the AANS/CNS CV Section.

“I decided we should name the medal after Ralph G. Dacey Jr., MD, the longstanding chair of neurosurgery at Washington University in St. Louis and an incredible basic scientist and cerebrovascular surgeon with a storied history of conducting both clinical and translational research,” Siddiqui says. “We really wanted to honor people who dedicated their entire career to the development of the science of neurosurgery.”

This was the first year Siddiqui was not part of the committee as part of the selection process for the Dacey Medal, so he was able to nominate someone — and chose to nominate Levy.

“The reason I did this is Elad, from the get-go when he came to Buffalo in 2003, got into basic science and developed the translational research models for intercranial stenting,” he says.

Siddiqui notes Levy then took that idea into the clinic and got the very first FDA-approved trials for intercranial stenting and the first randomized trial.

That led to the first few clinical trials for stents for stroke, followed by Levy being the national PI (primary investigator) for the landmark global trial SWIFT PRIME, which resulted in the entire space changing, according to Kenneth V. Snyder, MD, PhD, assistant professor of neurosurgery, radiology and neurology.

“That ultimately showed mechanical thrombectomy in patients with large vessel occlusion showed improved outcomes compared to medicine (tissue plasminogen activator or tPA) alone,” Snyder says. “This work has led to a major change in the paradigm of stroke treatment and new American Heart Association/American Stroke Association acute ischemic stroke guidelines.”

Siddiqui agrees that the SWIFT PRIME trial findings essentially turned stroke into a surgical disease.

“Elad has been part in parcel of all of that, starting in the lab, all the way to this becoming law of the land, guidelines and best practices. He has shown great leadership.”

“I thought he made a really compelling argument for being a recipient of the Dacey Medal based on his more than two decades of dedicated work, taking an idea from the lab all the way to the clinic and executing it literally with perfection,” Siddiqui says.

Snyder says the qualities in the team that Levy has built allows for constant innovation.

“We study everything that we do. We are one of the few places in the world that use recordings of each case for teaching and learning,” Snyder says. “We have two video atlas neuroendovascular textbooks available by theme, illustrating this work, with more to come.”

Snyder also says partnering with, building and supporting the Jacobs Institute, along with Siddiqui’s leadership there, has allowed UBNS team members to constantly stay on the cutting edge of research and innovation for their patients.

“Dr. Levy has built one of the largest fellowships and neurovascular research divisions in the country and our vascular research lab has led to FDA-approved products, innovative AI solutions, small business grants and companies, and hosts of multidisciplinary research teams all focused on improving stroke outcomes,” Snyder says.

“Dr. Levy has taken the image and vision of Dr. Hopkins’ vascular center and has made it a functional reality.”

Snyder also points out that Levy does not lead from afar — he is front and center in the operating rooms alongside the other UBNS practitioners.

“The leadership it takes to build the ecosystem for constant learning and innovation starts at the top,” he says. “Dr. Levy still has the highest case volume of the department and does the most complex cases.”

Siddiqui says Buffalo truly is at the epicenter of neuroendovascular research and care.

“Factually speaking, if you went to any part of the world where there is neurointervention and asked them to name the top three places on the planet for neurointervention, Buffalo would be one of them,” he says. “That could be Sydney, Australia; or Seoul, Korea; or France or the United States.”

Siddiqui says the reason that Buffalo is at the very top of the list is that it has a long history of always being on the front edge of innovation, constantly bringing in new ideas to treat diseases.

“We are always trying new technologies, assessing the utility or futility of new directions, and then reporting on it,” he says. “And because of that, every new technology, every company and every doctor in the space is very interested in coming to visit Buffalo. We have had over 4,000 physicians visit from all over the world in the last decade to engage and observe what we do.”

“We are routinely getting referrals from all over the world. In the last month, I treated a patient from Pakistan and another patient from Qatar,” Siddiqui says. “Elad treats patients from Israel and the Middle East all the time. It’s a normal thing for us.”

UB’s reputation in the field also allows UBNS to be able to recruit “the best of the best,” Siddiqui says.

“People in the field know the incredible value we provide, in terms of the training experience with our fellows and residents, and also with our attendings.”