Erlanger hospital's stroke team has become the nation's first to implant a tiny electrode in a stroke patient using a navigation system developed by veterans of an Israeli Air Force engineering team.
Almost like an air traffic control system, the computerized navigation system provided Erlanger doctors with a real-time, three-dimensional view of a 73-year-old stroke patient's internal facial anatomy as they implanted a tiny device into the back of her throat last month, specialists said Tuesday.
Implanting the device is like "threading a needle," and precision is key, said Dr. Thomas Devlin, director of the Southeast Regional Stroke Center at Erlanger, at a news conference Tuesday.
"This is much like landing an airplane at an airport," he said after describing the procedure to hospital board members and community leaders.
If implanted at the right spot underneath a bundle of blood vessels, the device sends out an electric current to dilate the vessels and help restore blood flow to the brain after a stroke. The navigation system highlights the implant's trajectory in green if it's on target or yellow if it's off target.
A year ago, Erlanger became the first hospital in the country to implant the device without the aid of the navigation system, as part of an international research trial to study the effectiveness of the electrode, called the Ischemic Stroke System. Israeli medical device company BrainsGate developed the device.
The device is a tiny electrode that doctors say is one of the most promising innovations in stroke treatment in the research pipeline.
In the first year of the two-year trial, Erlanger has completed more implants than any of the other participants worldwide, Dr. Devlin said. The hospital has done the procedure 22 times without the navigation system and two since last month using the Guideview system, Dr. Devlin said.
Erlanger, one of six U.S. hospitals participating in the trial, has more experience than any of the other research participants worldwide - including teams in Germany, Spain and Hong Kong - likely because of its location in the middle of the so-called "stroke belt," and the large number of eligible patients, he said.
The Guideview system will make this new treatment accessible to stroke specialists who may not be as familiar with intercranial anatomy, said Dr. Peter Hunt, an ear, nose and throat specialist who has implanted the device during the research trial without the aid of the navigation system.
That stroke treatment's accessibility will be critical in the coming years: Strokes are expected to grow exponentially as the population continues to age, he said.
HOW DOES GUIDEVIEW WORK?The Guideview navigation system, developed by a team of Israeli engineers, gives physicians a road map while implanting a tiny device in the back of a stroke patient's throat. The Guideview technology allows a physician to superimpose a real-time video of his patient over a detailed picture from earlier CT scans of the patient's facial anatomy. Physicians can watch an image on screen that indicates where their surgical instruments are in relation to the bundle of blood vessels they are targeting. The system also allows U.S.-based doctors to communicate in real time through telemedicine with the Israeli researchers who have developed the navigation system and the device being implanted.
"Stroke is a growing problem. This (treatment) needs to be broadly applicable because of the potential volume," Dr. Hunt said.
Strokes typically are caused by a blood clot that blocks the supply of blood to the brain, killing brain tissue. The BrainsGate device, which is half the size of a toothpick, is inserted in the back of a patient's throat near blood vessels and is activated by an electrical signal. The signal sends current through those nerves, opening blood vessels and instantly increasing blood flow to the brain, Dr. Devlin said.
That rush of oxygen-rich blood can reduce damage from a stroke and has been shown to work up to 24 hours after a stroke, he said. Other treatments, such as clot-busting medicine, have a much shorter window of time in which they can be effective.
Erlanger board member Jim Worthington said the treatment innovation will benefit the Chattanooga community.
"I think it's going to mean a lot to Erlanger, but not only Erlanger, but the people who are afflicted and now have an opportunity to be helped," he said.
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