September 30, 2022 by John Fernandez
More Options for Stroke and Aneurysm Patients: Neuro-interventional Suite at Marcus Neuroscience Institute Offers Innovative Care
With a new neuro-interventional suite, the Marcus Neuroscience Institute at Boca Raton Regional Hospital has added to its arsenal in the fight against stroke, brain aneurysms and other serious brain conditions. Already a comprehensive stroke center, the Institute uses sophisticated tools such as artificial intelligence, the most advanced imaging equipment and robotic-assisted technology to care for patients.
The advanced neuro-interventional suite, made possible by the generosity of Bernie and Billi Marcus and The Marcus Foundation, is a component of the ongoing expansion at the Institute, part of Baptist Health South Florida. By placing state-of-the-art technology at the fingertips of the endovascular team, patients receive the most innovative treatments.
“At Marcus Neuroscience Institute, we have the ability to perform traditional, open surgery, yet we are also focused on offering the newest and least invasive options to patients whenever possible,” said Brian Snelling, M.D., a neurosurgeon and endovascular stroke specialist.
In the neuro-interventional suite, ruptured and unruptured brain aneurysms (the weakening and ballooning of an artery) can be treated without opening the skull. In a minimally invasive procedure, doctors thread a catheter through a vessel in the wrist to the aneurysm. A tiny metal coil in the microcatheter is deployed and seals off the aneurysm. The Institute also offers the more invasive aneurysm clipping. Depending on the location and size of the aneurysm and the patient’s medical history, physicians decide which treatment is best.
Brain cell death from stroke can occur quickly. In fact, stroke is one of the most time-sensitive conditions in medicine and is the fifth-highest cause of death in the United States. It is also the leading cause of disability.
Although there are several types of stroke, the most common is an ischemic stroke, which occurs when there is a blockage or narrowing of a blood vessel leading to or within the brain. It may be caused by a blood clot of a buildup of plaque. A hemorrhagic stroke is a bleed in the brain caused by an aneurysm.
“It’s very important to call 911 if you have any stroke symptoms,” Dr. Snelling said. “Do not drive to the hospital and do not delay because you believe you could be exposed to COVID-19. We have strict safety precautions, and anyone suspected of having a stroke is treated in a separate area.”
Time is critical for several reasons. Some strokes caused by a blood clot can be treated with a clot-busting drug such as tPA, but it must be administered within hours of the first sign of a stroke. In addition, the sooner a patient can be diagnosed and treated, no matter what type of stroke, the better the chance of a full recovery or of minimizing permanent damage.
To quickly recognize signs of a stroke and get help, think “BE FAST.” B ― Balance. E ― Eyes. F ― Face drooping. A ― Arm weakness. S ― Speech difficulty. T – Time to call 911. Other details that may help: If the person is having sudden coordination problems, trouble walking or a change in or loss of vision, they may be having a stroke. Ask the person to smile and to raise both hands in the air. If their grin is lopsided or uneven, or if one arm drifts downward, a stroke could be to blame. Another possible symptom is a sudden severe headache.
To help ensure patients receive rapid treatment, Boca Raton Regional Hospital was the first hospital in Florida to use Viz.ai, an artificial intelligence tool that can read CT results and diagnose a stroke in seconds. Through encrypted software, the stroke team is notified immediately.
“Viz.ai has allowed us to decrease treatment times and helps us quickly identify patients who may qualify for the most time-sensitive treatments,” Dr. Snelling said.
The Institute is also participating in translational and clinical stroke research. Khalid A. Hanafy, M.D., medical director of neurocritical care and research, has been awarded more than $1.5 million from the National Institutes of Health to develop the next generation of drugs to treat stroke and bring groundbreaking findings to the bedside.
A clinical trial currently offered is the TESLA Trial ―Thrombectomy for Emergent Salvage of Large Anterior Circulation Ischemic Stroke, which is a multicenter trial to determine if patients who, in the past, would not have been eligible for the removal of a clot because it was located in a section of the brain where damage was believed to be permanent, would now qualify for the procedure. “We don’t want to leave any patient behind if there is even a chance of improvement,” Dr. Snelling said.
In addition to Dr. Snelling and Dr. Hanafy, other members of the vascular team include Institute Director and Chair of Neurosurgery Frank Vrionis, M.D., who is fellowship-trained in skull base neurosurgery; Patricio Espinosa Prado, M.D.; Farrah Wolf, M.D.; and Douglas DeOrchis, M.D. They work closely with specialized emergency and critical care physicians, neurologists, neurosurgeons, interventional neuroradiologists, nurses with specialized stroke training and other stroke clinicians.