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    Matthew J Gounis PhD

    TitleAssociate Professor
    InstitutionUniversity of Massachusetts Medical School
    DepartmentRadiology
    AddressUniversity of Massachusetts Medical School
    55 Lake Avenue North
    Worcester MA 01655
    Phone508-856-1884
      Other Positions
      InstitutionUMMS - Graduate School of Biomedical Sciences
      DepartmentBiochemistry and Molecular Pharmacology

        Overview 
        Narrative

        Matt received his BS and MS in Mechanical Engineering at SUNY Buffalo in 1997 and 2001, where he was awarded the AHA New York Affiliate pre-doctoral fellowship. He then moved to sunny Miami to work on his PhD in biomedical engineering with advisors Barry Lieber and Keith Webster in the area of new imaging modalities to quantify the functionality of vasculature following pro-angiogenic gene therapy. After obtaining his PhD in 2004 Matt spent a year as Research Assistant Professor in the Biomedical Engineering and Radiology Departments at the University of Miami. Thereafter, he took a short sojourn from academia and joined Cordis Neurovascular (a Johnson and Johnson Company) in 2005 where he was a Principal Engineer responsible for researching new therapies for cerebrovascular aneurysms.

        Matt joined UMMS in 2006 as an Assistant Professor and Director of the newly established New England Center for Stroke Research. He has been the recipient of numerous awards from ASME Bioengineering Division, Sigma Xi, the American Association of Neurological Surgeons, the American Society of Neuroradiology, and Johnson and Johnson. He is an active member of the ASME bioengineering division, having served previously as the Student Paper Competition and Exhibits chairs of the Summer Bioengineering Meeting.

        Matt and the team at NECStR are interested in the design of medical devices for minimally invasive treatment of cerebrovascular pathologies, animal models of cerebral aneurysms, arteriovenous malformations, and acute ischemic stroke; gene and stem cell therapy for arterial occlusive disease; and experimental fluid mechanics for medical device evaluation.

        Examples of on-going research projects:

        Mechanical Obliteration of Clot for the Treatment of Stroke:

        UMMS Team: Matt Gounis, Ajay Wakhloo, Ruby Chueh, Bo Hong, Marc Fisher,

        OmniSonics Medical Technologies Team: Elvira Lang, David Constantine, Anne Kulis, Max Fiore, Rich Ganz

        Stroke carries a severe toll in terms of loss of life and disability for patients and their families. Stroke is the third cause of death in the United States and the leading cause of disability in terms of cost of care and loss of productivity. According to the newest data from the American Stroke Association, each year approximately 700,000 individuals experience a new or recurrent stroke and 160,000 of these events are fatal. This project seeks to find a new treatment to give stroke victims an option other than rehabilitation.

        An ultra-thin thrombectomy wire is being developed that uses transverse ultrasound waves at its tip to selectively and safely disintegrate intracranial blood clot without damage to the adjacent structures. The proposed system challenges the paradigm of current available therapies which rely on either relatively slow pharmacologic action or en block removal of clot. The goal is to provide rapid and immediate perfusion of ischemic tissue as the cornerstone of effective treatment for acute ischemic stroke. There are currently only two FDA-approved therapies: (1) Pharmacologic clot dissolution with tissue plasminogen activator (tPA); and (2) Mechanical thrombectomy with retrieval or aspiration devices. tPA increases the risk of intracranial hemorrhage, and must be started within 3 hours of onset of the ischemic event thus limiting its use to less than 5% of current stroke victims.

        To overcome these limitations we are working with OmniSonics Medical Technologies to develop a low-profile and atraumatic thrombectomy device that uses tailored transmission of ultrasonic energy around an ultra-thin wire that can be advanced through standard neuroangiographic microcatheters. Recanalization is anticipated within seconds or minutes expanding the window of treatment opportunity that so far had to take into account the 2-hours average time tPA infusion requires for flow restoration. To date we have developed a large animal model of acute ischemic stroke and imaging endpoints to evaluate device safety and efficacy (Figure 1). Moreover, we have developed a population based model of the human internal carotid and middle cerebral arteries and use a mock circulation flow loop to evaluate device performance (Figure 2).

        Angiogram Graphics

        Figure 1: (A) 3D rotational angiogram showing the normal canine cerebrovasculature after a left internal carotid artery injection. Angiograms in the ventral plane before (B) and after (C) injection an embolus of autologous clot that leads to diffusion (D) and perfusion lesions (E) under MR. TTC staining four hours after stroke onset shows infarct of the left MCA distribution.

        Human Intercranial Circulation

        Figure 2: Modeling of the human intracranial circulation – from imaging, to computer model to physical model

        Molecular Imaging to Determine the Risk of Rupture of Cerebral Aneurysms

        UMMS Team: Alex Bogdanov, Matt Gounis, Ajay Wakhloo, John Weaver, Mike DeLeo

        Twenty five percent of all deaths associated with cerebrovascular disease in the USA are a result of hemorrhage and stroke caused by rupture of intracranial aneurysms. There is strong evidence suggesting that the progression from stable to unstable aneurysm involves local inflammation. As demonstrated recently, the extent of the inflammation is significantly higher in ruptured versus unruptured aneurysms. We hypothesize that molecular imaging of inflammatory marker presence could provide a strategy for predicting the tendency of aneurysm to develop instability and rupture. This would have a strong positive impact on accuracy of diagnosis and for differential patient management.

        Recent epidemiological evidence suggests that the elevated presence of myeloperoxidase (MPO) in blood is an important risk factor for coronary disease and atherosclerotic plaque rupture. In view of the above, we hypothesize that some of the MPO-specific effects in plaque progression could also contribute to intracranial aneurysm instability. By combining MRI with the use of MPO-specific paramagnetic contrast probe in small animal models we recently demonstrated that in artificial implant systems as well as experimentally induced inflammation there was stable MPO-specific increase of MR signal (Chen, JW et al. Radiology 240:473, 2006). The major objective of the proposed work is to develop and validate the MPO-specific probe which could be used for non-invasive assessment of potential instability of intracranial aneurysms. We propose to explore the above concept by establishing a team lead by PhD PI of molecular imaging probe development who will work closely with PhD bioengineer, an expert in aneurysm models, and PhD MRI scientist who will optimize rabbit aneurysm imaging protocols. The essential element of this proposal is collaboration with two MDs (a neuroradiologist and a neurosurgeon) who will evaluate rabbit data and supply human surgical material under a clinical protocol. The major goal of proposed research is to perform exploratory research directed at the testing of the molecular imaging approach using paramagnetic substrates in rabbit model of aneurysm in a 3T MRI setup with an ultimate goal of dramatically improving the ability to differentiate between likely and unlikely candidates for further interventional or surgical procedures. Two major aims are: Aim 1. Optimize rabbit model of aneurysm and correlate MPO activity in rabbit aneurysm with MPO activity in samples obtained from ruptured/unruptured resected human aneurysms. Aim 2. Perform feasibility MR imaging of MPO activity using MPO-specific paramagnetic susbtrate in experimental inflammatory lesions induced in rabbit aneurysm.

        Current Grants:

        NIH NIBIB 1R21EB007767-01, Funding Period: August 2007 – July 2010, Title: Mechanical Clot Obliteration for the Treatment of Stroke, PI: MJ Gounis

        NIH NINDS, 1R21NS061132, Funding Period: June 2008 – May 2010, Title: Molecular Imaging to Determine the Risk of Rupture of Cerebral Aneurysms, PI: AA Bogdanov Jr, co-PI: MJ Gounis

        Various Grants from Biomedical Device Industry



        Bibliographic 
        selected publications
        List All   |   Timeline
        1. Wakhloo AK, Gounis MJ. Revolution in aneurysm treatment: flow diversion to cure aneurysms: a paradigm shift. Neurosurgery. 2014 Aug; 61 Suppl 1:111-20.
          View in: PubMed
        2. Gounis MJ, Vedantham S, Weaver JP, Puri AS, Brooks CS, Wakhloo AK, Bogdanov AA. Myeloperoxidase in human intracranial aneurysms: preliminary evidence. Stroke. 2014 May; 45(5):1474-7.
          View in: PubMed
        3. Wakhloo AK, Gounis MJ, Chueh JY, Pierot L. Advances in stroke: advances in interventional radiology 2013. Stroke. 2014 Feb; 45(2):365-7.
          View in: PubMed
        4. Vogl TJ, Pflugmacher R, Hierholzer J, Stender G, Gounis M, Wakhloo A, Fiebig C, Hammerstingl R. Cement directed kyphoplasty reduces cement leakage as compared with vertebroplasty: results of a controlled, randomized trial. Spine (Phila Pa 1976). 2013 Sep 15; 38(20):1730-6.
          View in: PubMed
        5. van der Bom IM, Gounis MJ, Ding L, Kühn AL, Goff D, Puri AS, Wakhloo AK. Target delineation for radiosurgery of a small brain arteriovenous malformation using high-resolution contrast-enhanced cone beam CT. J Neurointerv Surg. 2014 Jun 1; 6(5):e34.
          View in: PubMed
        6. van der Bom IM, Gounis MJ, Ding L, Kühn AL, Goff D, Puri AS, Wakhloo AK. Target delineation for radiosurgery of a small brain arteriovenous malformation using high-resolution contrast-enhanced cone beam CT. BMJ Case Rep. 2013; 2013.
          View in: PubMed
        7. Gounis MJ, Wakhloo AK, Chueh JY. Preclinical investigations for thrombectomy devices--does it translate to humans? Stroke. 2013 Jun; 44(6 Suppl 1):S7-S10.
          View in: PubMed
        8. Chueh JY, Kühn AL, Puri AS, Wilson SD, Wakhloo AK, Gounis MJ. Reduction in distal emboli with proximal flow control during mechanical thrombectomy: a quantitative in vitro study. Stroke. 2013 May; 44(5):1396-401.
          View in: PubMed
        9. Gounis MJ, Nogueira RG, Mehra M, Chueh J, Wakhloo AK. A thromboembolic model for the efficacy and safety evaluation of combined mechanical and pharmacologic revascularization strategies. J Neurointerv Surg. 2013 May; 5 Suppl 1:i85-9.
          View in: PubMed
        10. Zarate B, Gutierrez J, Wakhloo AK, Gounis MJ, Reyes-Sánchez A. Clinical evaluation of a new kyphoplasty technique with directed cement flow. J Spinal Disord Tech. 2012 May; 25(3):E61-6.
          View in: PubMed
        11. Samaniego EA, Tari-Capone F, Linfante I, Silva CF, Spilberg G, Gounis M, Wakhloo AK, Dabus G. Wingspan experience in the treatment of symptomatic intracranial atherosclerotic disease after antithrombotic failure. J Neurointerv Surg. 2013 Jul; 5(4):302-5.
          View in: PubMed
        12. van der Bom IM, Moser RP, Gao G, Sena-Esteves M, Aronin N, Gounis MJ. Frameless multimodal image guidance of localized convection-enhanced delivery of therapeutics in the brain. J Neurointerv Surg. 2013 Jan 1; 5(1):69-72.
          View in: PubMed
        13. Nogueira RG, Levy EI, Gounis M, Siddiqui AH. The Trevo device: preclinical data of a novel stroke thrombectomy device in two different animal models of arterial thrombo-occlusive disease. J Neurointerv Surg. 2012 Jul; 4(4):295-300.
          View in: PubMed
        14. Mehra M, Henninger N, Hirsch JA, Chueh J, Wakhloo AK, Gounis MJ. Preclinical acute ischemic stroke modeling. J Neurointerv Surg. 2012 Jul; 4(4):307-13.
          View in: PubMed
        15. Mehra M, Hurley MC, Gounis MJ, King RM, Shaibani A, Dabus G, Labdag FE, Levy EI, Bendok BR. The impact of coil shape design on angiographic occlusion, packing density and coil mass uniformity in aneurysm embolization: an in vitro study. J Neurointerv Surg. 2011 Jun; 3(2):131-6.
          View in: PubMed
        16. Gounis MJ, DeLeo MJ, Wakhloo AK. Advances in interventional neuroradiology. Stroke. 2010 Feb; 41(2):e81-7.
          View in: PubMed
        17. Hong B, Patel NV, Gounis MJ, DeLeo MJ, Linfante I, Wojak JC, Wakhloo AK. Semi-jailing technique for coil embolization of complex, wide-necked intracranial aneurysms. Neurosurgery. 2009 Dec; 65(6):1131-8; discussion 1138-9.
          View in: PubMed
        18. DeLeo MJ, Gounis MJ, Hong B, Ford JC, Wakhloo AK, Bogdanov AA. Carotid artery brain aneurysm model: in vivo molecular enzyme-specific MR imaging of active inflammation in a pilot study. Radiology. 2009 Sep; 252(3):696-703.
          View in: PubMed
        19. Linfante I, Delgado-Mederos R, Andreone V, Gounis M, Hendricks L, Wakhloo AK. Angiographic and hemodynamic effect of high concentration of intra-arterial nicardipine in cerebral vasospasm. Neurosurgery. 2008 Dec; 63(6):1080-6; discussion 1086-7.
          View in: PubMed
        20. Cesar L, Miskolczi L, Lieber BB, Sadasivan C, Gounis MJ, Wakhloo AK. Neurological deficits associated with the elastase-induced aneurysm model in rabbits. Neurol Res. 2009 May; 31(4):414-9.
          View in: PubMed
        21. Wakhloo AK, Mandell J, Gounis MJ, Brooks C, Linfante I, Winer J, Weaver JP. Stent-assisted reconstructive endovascular repair of cranial fusiform atherosclerotic and dissecting aneurysms: long-term clinical and angiographic follow-up. Stroke. 2008 Dec; 39(12):3288-96.
          View in: PubMed
        22. Wakhloo AK, Gounis MJ. Retrievable closed cell intracranial stent for foreign body and clot removal. Neurosurgery. 2008 May; 62(5 Suppl 2):ONS390-3; discussion ONS393-4.
          View in: PubMed
        23. Gounis MJ, Lieber BB, Webster KA, Wakhloo AK. A novel angiographic methodology for the quantification of angiogenesis. IEEE Trans Biomed Eng. 2008 Mar; 55(3):996-1003.
          View in: PubMed
        24. Bendok BR, Parkinson RJ, Hage ZA, Adel JG, Gounis MJ. The effect of vascular reconstruction device-assisted coiling on packing density, effective neck coverage, and angiographic outcome: an in vitro study. Neurosurgery. 2007 Oct; 61(4):835-40; discussion 840-1.
          View in: PubMed
        25. Miskolczi L, Nemes B, Cesar L, Masanari O, Gounis MJ. Contrast injection via the central artery of the left ear in rabbits: a new technique to simplify follow-up studies. AJNR Am J Neuroradiol. 2005 Sep; 26(8):1964-6.
          View in: PubMed
        26. Shellock FG, Gounis M, Wakhloo A. Detachable coil for cerebral aneurysms: in vitro evaluation of magnetic field interactions, heating, and artifacts at 3T. AJNR Am J Neuroradiol. 2005 Feb; 26(2):363-6.
          View in: PubMed
        27. Seong J, Sadasivan C, Onizuka M, Gounis MJ, Christian F, Miskolczi L, Wakhloo AK, Lieber BB. Morphology of elastase-induced cerebral aneurysm model in rabbit and rapid prototyping of elastomeric transparent replicas. Biorheology. 2005; 42(5):345-61.
          View in: PubMed
        28. Lieber BB, Sadasivan C, Gounis MJ, Seong J, Miskolczi L, Wakhloo AK. Functional angiography. Crit Rev Biomed Eng. 2005; 33(1):1-102.
          View in: PubMed
        29. Wakhloo AK, Lieber BB, Seong J, Sadasivan C, Gounis MJ, Miskolczi L, Sandhu JS. Hemodynamics of carotid artery atherosclerotic occlusive disease. J Vasc Interv Radiol. 2004 Jan; 15(1 Pt 2):S111-21.
          View in: PubMed
        30. Sadasivan C, Lieber BB, Gounis MJ, Lopes DK, Hopkins LN. Angiographic quantification of contrast medium washout from cerebral aneurysms after stent placement. AJNR Am J Neuroradiol. 2002 Aug; 23(7):1214-21.
          View in: PubMed
        31. Gounis MJ, Lieber BB, Wakhloo AK, Siekmann R, Hopkins LN. Effect of glacial acetic acid and ethiodized oil concentration on embolization with N-butyl 2-cyanoacrylate: an in vivo investigation. AJNR Am J Neuroradiol. 2002 Jun-Jul; 23(6):938-44.
          View in: PubMed
        32. Lieber BB, Gounis MJ. The physics of endoluminal stenting in the treatment of cerebrovascular aneurysms. Neurol Res. 2002; 24 Suppl 1:S33-42.
          View in: PubMed
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