Robert Kleven, PhD, MD
Hospital ResidentCards
About
Research
Publications
2025
Percutaneous Radiologic Gastrostomy Tube Placement Techniques
Kleven R, Ikeda I, Cornman-Homonoff J. Percutaneous Radiologic Gastrostomy Tube Placement Techniques. Seminars In Interventional Radiology 2025, 42: 009-016. PMID: 40342381, PMCID: PMC12058293, DOI: 10.1055/s-0045-1806797.Peer-Reviewed Original ResearchBalloon-assisted techniqueProcedure timeRetrograde techniqueIncidence of tube dislodgementPercutaneous endoscopic gastrostomy placementPatient's clinical presentationShorter procedure timeReduce radiation exposurePostprocedural infectionClinical presentationTube dislodgementInterventional radiologistsDecreased incidenceGastrostomy placementGastrostomy tubeGastric accessAntegrade techniquePreprocedural workupRadiation exposureAntegradePatient-centered careRetrogradeCare helpWorkupPatientsPercutaneous Radiologic Gastrostomy Placement in Challenging Clinical Scenarios
Ikeda I, Kleven R, Cornman-Homonoff J. Percutaneous Radiologic Gastrostomy Placement in Challenging Clinical Scenarios. Seminars In Interventional Radiology 2025, 42: 017-021. PMID: 40342380, PMCID: PMC12058298, DOI: 10.1055/s-0045-1805046.Peer-Reviewed Original ResearchPercutaneous radiologic gastrostomy placementUpper gastrointestinal tract obstructionPercutaneous radiologic gastrostomyClinical management optionsIncreased procedural riskGastrointestinal tract obstructionRadiologic gastrostomyEnteral accessPostsurgical anatomyNutritional supportProcedural riskGastrostomy placementClinical scenariosTechnical modificationsMedication administrationPatientsManagement options
2022
Effect of Recombinant Tissue Plasminogen Activator and 120-kHz Ultrasound on Porcine Intracranial Thrombus Density
Kleven R, Huang S, Ford S, Sakthivel K, Thomas S, Zuccarello M, Herr A, Holland C. Effect of Recombinant Tissue Plasminogen Activator and 120-kHz Ultrasound on Porcine Intracranial Thrombus Density. Ultrasound In Medicine & Biology 2022, 49: 539-548. PMID: 36336551, DOI: 10.1016/j.ultrasmedbio.2022.10.006.Peer-Reviewed Original ResearchConceptsRecombinant tissue plasminogen activatorTissue plasminogen activatorIntracerebral hemorrhageRt-PAD-dimerPlasminogen activatorTreated with recombinant tissue plasminogen activatorModel of intracerebral hemorrhageTreatment of intracerebral hemorrhageEffects of recombinant tissue plasminogen activatorInfusion of autologous bloodD-dimer assayIntracerebral hemorrhage modelNo enhancementRt-PA-induced thrombolysisHematoma evacuationThrombus densityDensity assaySurgical interventionClinical outcomesAutologous bloodThrombolytic efficacyDegree of lysisPorcineThrombus
2021
Accelerated sonothrombolysis with Definity in a xenographic porcine cerebral thromboembolism model
Kleven R, Karani K, Hilvert N, Ford S, Mercado-Shekhar K, Racadio J, Rao M, Abruzzo T, Holland C. Accelerated sonothrombolysis with Definity in a xenographic porcine cerebral thromboembolism model. Scientific Reports 2021, 11: 3987. PMID: 33597659, PMCID: PMC7889614, DOI: 10.1038/s41598-021-83442-3.Peer-Reviewed Original ResearchConceptsRt-PAThromboembolism modelRate of thrombus resolutionRecombinant tissue plasminogen activatorUltrasound contrast agentsPreclinical animal modelsRt-PA thrombolysisTissue plasminogen activatorRate of reperfusionModel in vivoContrast agentsTemporal bone windowInsufficient temporal bone windowThrombus resolutionThrombus clearanceBone windowClinical studiesPatient populationVascular occlusionCombined treatmentAnimal modelsPlasminogen activatorHuman clotsUltrasoundIn vitro
2020
Ultrasound-Responsive Cavitation Nuclei for Therapy and Drug Delivery
Kooiman K, Roovers S, Langeveld S, Kleven R, Dewitte H, O'Reilly M, Escoffre J, Bouakaz A, Verweij M, Hynynen K, Lentacker I, Stride E, Holland C. Ultrasound-Responsive Cavitation Nuclei for Therapy and Drug Delivery. Ultrasound In Medicine & Biology 2020, 46: 1296-1325. PMID: 32165014, PMCID: PMC7189181, DOI: 10.1016/j.ultrasmedbio.2020.01.002.Peer-Reviewed Original ResearchConceptsBlood-spinal cord barrierDrug deliveryLess-invasive treatmentTreatment of tumorsUltrasound featuresDrug penetrationClinical studiesSpinal cordPre-clinicalBlood-BrainImmune systemImplementation of ultrasoundTherapeutic agentsUltrasound strategyLocal uptakeEffective therapeuticsDrug delivery vehiclesDrugTumorDelivery vehiclesMechanical activationUltrasoundMechanical oscillatorDeliveryTreatment
2019
The effect of 220 kHz insonation scheme on rt-PA thrombolytic efficacy in vitro
Kleven R, Karani K, Salido N, Shekhar H, Haworth K, Mast T, Tadesse D, Holland C. The effect of 220 kHz insonation scheme on rt-PA thrombolytic efficacy in vitro. Physics In Medicine And Biology 2019, 64: 165015. PMID: 31189149, PMCID: PMC8102059, DOI: 10.1088/1361-6560/ab293b.Peer-Reviewed Original ResearchIn vitro characterization of sonothrombolysis and echocontrast agents to treat ischemic stroke
Shekhar H, Kleven R, Peng T, Palaniappan A, Karani K, Huang S, McPherson D, Holland C. In vitro characterization of sonothrombolysis and echocontrast agents to treat ischemic stroke. Scientific Reports 2019, 9: 9902. PMID: 31289285, PMCID: PMC6616381, DOI: 10.1038/s41598-019-46112-z.Peer-Reviewed Original ResearchConceptsPlasminogen activator inhibitor-1Rt-PAIn vitro characterizationRecombinant tissue plasminogen activatorRt-PA thrombolysisActivator inhibitor-1Tissue plasminogen activatorRt-PA activityPresence of plasminogen activator inhibitor-1Ischemic stroke therapyWhole blood clotsAdjuvant techniquesPlasminogen activatorInhibitor-1Thrombolytic efficacyEchocontrast agentsLytic efficacyIn vitro systemStroke therapyIschemic strokeHuman whole blood clotsUltrasoundBlood clotsErratum to ‘Effect of clot stiffness on recombinant tissue plasminogen activator lytic susceptibility in vitro’ [Ultrasound Med Biol 44 (2018) 2710-2727]
Mercado-Shekhar K, Kleven R, Rivera H, Lewis R, Karani K, Vos H, Abruzzo T, Haworth K, Holland C. Erratum to ‘Effect of clot stiffness on recombinant tissue plasminogen activator lytic susceptibility in vitro’ [Ultrasound Med Biol 44 (2018) 2710-2727]. Ultrasound In Medicine & Biology 2019, 45: 1860. PMID: 31053428, PMCID: PMC6599611, DOI: 10.1016/j.ultrasmedbio.2019.04.013.Peer-Reviewed Original ResearchSonothrombolysis: Effect of 220kHz insonation scheme
Holland C, Kleven R, Karani K, Salido N, Shekhar H, Haworth K. Sonothrombolysis: Effect of 220kHz insonation scheme. Ultrasound In Medicine & Biology 2019, 45: s39. DOI: 10.1016/j.ultrasmedbio.2019.07.537.Peer-Reviewed Original ResearchFinite-difference modelContinuous waveRt-PATreatment periodThrombolytic efficacyFinite-differenceRecombinant tissue plasminogen activatorAcoustic fieldTemperature riseUS propagationTissue plasminogen activatorCumulative energyCW schemeUS schemeCavitation emissionsIschemic stroke therapyTemporal boneConstructive interferencePlasminogen activatorSchemePulsed USStroke therapyClot lysis
2018
Effect of Clot Stiffness on Recombinant Tissue Plasminogen Activator Lytic Susceptibility in Vitro
Mercado-Shekhar K, Kleven R, Rivera H, Lewis R, Karani K, Vos H, Abruzzo T, Haworth K, Holland C. Effect of Clot Stiffness on Recombinant Tissue Plasminogen Activator Lytic Susceptibility in Vitro. Ultrasound In Medicine & Biology 2018, 44: 2710-2727. PMID: 30268531, PMCID: PMC6551517, DOI: 10.1016/j.ultrasmedbio.2018.08.005.Peer-Reviewed Original ResearchConceptsSusceptible in vitroRt-PAHuman clotsLytic efficacyEfficacy of rt-PARecombinant tissue plasminogen activatorTreated with rt-PALytic susceptibilityClot elasticityRt-PA treatmentTherapeutic decision makingFood and Drug AdministrationTissue plasminogen activatorLarge vessel occlusionYoung's modulusLytic efficacy of rt-PAClot mass lossIntracerebral hemorrhageClot stiffnessPlasminogen activatorDrug AdministrationVessel occlusionThrombolytic efficacyBlood flowIschemic stroke
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