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COV ER FE AT UR E procedures and more than 1,000 stroke consultations each year. "My training and experience enable me to enhance the treatment provided in this community, and the support and commitment of Health Quest's leadership confirm that I am in the right place," Dr. Nohara says. "The coalescence of the latest innovative treatment capabili- ties, administrative support and medical expertise provides the perfect atmosphere for optimizing stroke care." Cutting-edge Technology To allow Dr. Nohara to make the great- est use of her skills and training, Health Quest has invested in the Siemens Artis Q biplane angiography suite, which provides superior high-contrast resolution. Introduced at the 2013 American College of Cardiolog y meeting, the Siemens Artis Q operates with flat emitter technology to produce precise imagery with low-dose radiation, which benefits both patients and clinicians. "Catheter-based stroke treatment relies heavily on the physician's experience and knowledge of the brain's anatomy, but the procedure is predicated upon the physi- cian's ability to see what is happening in the vessels — it's critical to be in the right location," Dr. Nohara says. "The biplane angiography suite provides real-time front and side images of the brain, which is a major advantage in these procedures. It reduces our contrast load and increases our speed of action. There is an art to endovascular stroke treatment, and the and improve outcomes by expediting treatment once patients present at the hospital. TPA, which dissolves the blood clot and restores blood flow to the brain, is the only FDA-approved medication for stroke treatment. But the medication can only be provided within a narrow window of time after stroke. "Approximately only 10–20 percent of patients suffering a stroke present within the three- to four-hour time window for tPA treatment," Dr. Nohara says. "We are modifying our stroke protocols to be much more aggressive and deliver lifesaving therapy to more patients." When patients enter the hospital within an eight-hour period after the onset of a stroke, Dr. Nohara chooses from a vast armamentarium of treat- ment options, including intravenous tPA, which can be administered by any physician; intra-arterial tPA, which can only be administered by a neurointer- ventional surgeon; revascularization through angioplasty and stenting; and clot removal and retrieval. "In general, any patient who is revascu- larized has a chance for better outcomes," she says. "If one approach isn't working, then I identify factors, such as anatomical irregularities or clot composition, and employ alternative methods to snare the ability to assess your position in two planes is a necessity. "This machine is a huge investment in infrastructure," D r. Noh a ra a dd s. "It speaks volumes a b out t he ad m in- istration here that they are committed t o p r o v i d i n g t h e most technologically advanced equipment on the market." Improving Outcomes The technology — while exciting — is only part of what it takes for a successful outcome. Equally important is the ability to select the appropriate treatment for each patient and make adjustments as the case evolves. "Geriatric patients understand that stroke can be fatal, but they're typically more concerned with debilitating conse- quences, such as being rendered without the ability to speak or move," she says. "Their worst fear is becoming a burden to their families." Dr. Nohara has established protocols to mitigate cognitive and motor deficits The Siemens Artis Q, which provides superior high-contrast resolution, is housed in a newly designed space in Vassar Brothers Medical Center. Dr. Nohara (L) consults with a colleague about a patient. 8 | Mid Hudson MD NEWS ■ M D N E W S . CO M