MDNews - Minnesota

COVER FEATURE we can regenerate brain cells, we don’t know if they will function. These are two very different techniques focused on achieving the same result. If we are successful, improving a patient’s speech or arm function by 20%, 30% or 40% would be signifi cant.” The research objectives are particu- larly compelling given that neurologic dysfunction has the highest degree of patient disability of any disease. “During a stroke, the brain loses Dr. Subbarao Inampudi performing an interventional radiology procedure vascular patients,” he says. “I can state, without hesitation, that the Vascular/ Interventional Radiology Group at Abbott Northwestern is more collegial, as well-trained and technically superior. The result is a collaboration between our two specialties at Abbott that is based on friendship, trust and, most importantly, mutual respect. In my experience, it has no equal.” “If you have a hammer,” says Dr. Inampudi with a smile, “everything looks like a nail. I am an interventional radiologist. I have a few tools. I could apply them to everything, but I have the benefi t of my other colleagues who have expert knowledge in different areas of the same field. We use our collective knowledge for the fuller benefi t of the patient. We are looking for cures. If we cannot cure, we want to treat and prolong quality of life. At the end of the day, we believe that this approach best serves our patients.” CRL’s Neurovascular Group is similarly distinguished by innovative procedures and groundbreaking research. “Five years ago, most emergency rooms didn’t treat stroke as a time-sensitive emergency comparable to heart attack,” explains Dr. Tubman. “Evidence has 10 | Twin Cities MD NEWS  MDNEWS.COM confi rmed that the brain is like the heart; the faster you can deliver care, the better the chances of saving the part of the brain affected. Over the last fi ve years, new devices like the Penumbra System and Merci device have been developed to treat patients with acute stroke. These systems open an occluded carotid artery with a mechanical device, often obviating the need for thrombolytic drugs.” CRL’s stroke program has initiated research that takes a new direction from the traditional focus on clot removal. Sparked by the work of cardiologist colleagues using stem cells to regenerate heart cells, Dr. Tubman is participating in two studies exploring use of stem cells to regenerate brain cells. In one randomized study involving 10 national institutions and 100 patients who have suffered a middle cerebral artery inclusion, stem cells will be made from harvested patient marrow and injected into the brain via microcatheter — all within a 96-hour window. A second study injects off-the- shelf stem cells into stroke patients 36 hours after stroke. MRI imaging and neurological assessments will be used to measure improvement. “It is a leap to go from heart muscle to brain,” Dr. Tubman concedes. “Even if 32,000 neurons a second,” explains Dr. Tubman. “We have six hours from the onset of stroke to evaluate, transport and treat; it’s not much time. Community awareness measures can help a patient identify the symptoms of stroke, get them to the emergency room faster and address delays in patient transport to treatment. Although stroke can affect patients from childhood on, younger stroke patients tend not to be diagnosed early because stroke is assumed to be a disease of the elderly. These are challenging issues.” CRL is working to speed access to stroke care by building community stroke awareness. “It’s important for emergency rooms — especially in outlying communities — to know that we provide assessment backup to activate stroke treatment protocols quickly,” says Dr. Chepuri. “Our extensive teleradiology network enables an emer- gency doctor in North Dakota to send a stroke patient’s CT scan, along with a full patient history, to the computer of a CRL radiologist 24/7 and receive interpretive results within a half hour.” “Most practices have the technical capabilities to transfer imaging data quickly,” notes Dr. Chepuri, “but we also have dedicated software to transfer patient history and prior scans along with imaging. This enables our radiologists to make a more informed evaluation that takes the patient’s entire history into account. It is a value-added benefi t that differentiates our stroke patient care.” n

• Cover