User:Janweh64/new/Jay Yadav

Jay S. Yadav is an American neurologist and cardiologist. He is a researcher focused on the development of techniques for the detection and intervention of stroke, as well as other similar cardiovascular diseases and cerebrovascular diseases.

Early life
Yadav attended Yale University, graduating with a Bachelor of Science. He received his medical degree from the West Virginia University School of Medicine. He then joined Duke University Medical Center, where he completed his residency in internal medicine. With neurology as his chosen specialty, he continued to work at Duke as a resident and later becoming chief resident. Afterward, Yadav completed a fellowship in neuroimaging at the DENT Neurologic Institute and a fellowship in cardiology at the University of Alabama at Birmingham and Duke University.

Carotid artery stenting
In March 1994, Yadav joined Gary Roubin in a collaborative study at the University of Alabama Hospital on the use of stents in the carotid artery. In August 1996, Roubin and Yadav et al. published a report on the possible use of stents to support balloon angioplasty when treating carotid artery stenosis. In November 1996, Yadav and Roubin et al. published a study on the possible use of carotid artery stenting (CAS) to treat the recurrence of stenosis in patients that had previously undergone carotid endarterectomy (CEA), which is the long-established procedure of surgically removing blockages. In January 1997, they published a report on the use of CAS as an alternative to CEA and recommended a larger "randomized trial comparing percutaneous stenting with carotid endarterectomy."

According to Camilo R. Gomez et al., these early trials indicated that stenting possibly improves "the safety and efficacy of balloon angioplasty." A larger study spanning 8 years from December 2000 to July 2008 and involving 2,502 patients, Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) found no long-term significant difference in the safety of CAS versus CEA, "with younger patients having a slightly better outcome with carotid-artery stenting and older patients having a better outcome with carotid endarterectomy." However, a 2015 review published in the European Heart Journal, stated that:"Despite the fact that high-quality multi-centre registries and high-volume single-centre experiences have consistently described favourable CAS outcomes, the evidence has not been considered sufficient in the neurologist community to recommend CAS."

Embolic protection device
In 1998, Yadav joined the staff of the Cleveland Clinic. He continued to study and develop Angioguard, a filter device he invented to be used in conjunction with CAS. When inserted into the carotid artery, the main artery that supplies blood to the brain, the device is intended to catch and remove any debris released during following angioplasty and stenting procedure. In 1999, Yadav and his colleagues sold the device, along with the company that shares its name, to Cordis, a subsidiary of Johnson & Johnson, for $40 million. As the inventor of the device, Yadav would continue to receive royalties as "deferred payments." In 2001, he became the head of Cleveland Clinic's vascular intervention unit.

In 2004, Yadav et al. published the findings of SAPPHIRE, a randomized clinical trial involving 334 patients comparing CAS (with the use of Angioguard) versus CEA. :Table 1 In October 2005, Yadav became the chair of the Cleveland Clinic Foundation Innovations. However, the clinic declined renewal of his contract, essentially terminating his employment. In an August 2006 statement, the Cleveland, Ohio institution claimed that Yadav "had failed to adhere to the Cleveland Clinic's conflicts-of-interest (COI) policies." Yadav denied the allegations and filed a lawsuit against the academic hospital in December 2006. The Wall Street Journal reported,"Yadav says he properly disclosed the deferred payments as early as 2002 in a document filed with a clinic review board. The document, which was reviewed by [The Wall Street Journal], states Dr. Yadav was entitled to deferred payments tied to sales [of the device]. In 2003, he made a similar disclosure to the Food and Drug Administration, according to a copy of that filing."

According to Yadav, he was contacted by the editors of the New England Journal of Medicine, who had published his papers, and "they chose not to amend [his] disclosure for the SAPPHIRE article or make any corrections." The Food and Drug Administration (FDA) finalized approval of the device for the use in patients in September 2006. In May 2010, the Cleveland Clinic settled the lawsuit with Yadav, the two parties stating in a joint announcement that: "The clinic acknowledges that Yadav did, in fact, appropriately disclose his interests in medical devices he had been researching at the clinic. Moreover, says the statement, an independent review commissioned by the clinic concluded "that the integrity of Dr Yadav's research regarding Angioguard/Cordis was not compromised by his financial relationships with Angioguard/Cordis.""

Blood pressure monitoring device
Together with Mark Allen and David Stern, Yadav developed a surgically implantable MEMS device used to measure blood pressure in a patient's circulatory system. Originally, the tiny sensor was designed by Allen at Georgia Institute of Technology for use in jet engines. In 2000, the researchers established CadioMEMS, LLC to develop the device for medical use, with Yadav serving as chairman and CEO. The device, used to measure pulmonary artery pressure, was introduced at the 14th Annual International Symposium on Endovascular Therapy.

In 2010, St. Jude Medical acquired a 19% stake in CardioMEMS for $60 million, with the option to acquire the company entirely pending FDA approval of the device. In 2014, the FDA approved the use of the device on patients with heart failure categorized as Class III by the New York Heart Association Functional Classification system. Subsequently, St. Jude exercised its option to purchase the remain shares of the company for $375 million.