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clot. We can use a balloon to open up the vessel if necessary and are approximately 90 percent accurate in being able to take out the clot." Each clot-retrieval procedure is per- formed swiftly, with the procedure itself sometimes lasting less than five minutes. "From a technical standpoint, these cases are challenging and require surgical excellence," Dr. Nohara says. "Entering the vasculature and removing the clot must be done carefully to avoid complica- tions. The body starts shutting down quickly after a stroke, and when you remove the clot and restore blood flow, the therapeutic effects are apparent. These interventions require precision and speed, and Health Quest has the physician expertise and technological advancements to provide the highest level of stroke care." Clinical Efficacy Recent clinical trials validate the effectiveness of acute ischemic stroke treatments that combine tPA with embo- lectomy. Results of a study published in 2014 by The New England Journal of Medicine, "A Randomized Trial of Intra a r teria l Treatment for Acute Ischemic Stroke," identified positive outcomes in patients receiving tPA and neurointerventional treatments during a five-year trial period. Researchers evaluated patients by the modified Rankin Score — a measure of disability after stroke or disabling neurological disorder — and found that combined tPA plus embolectomy inter- vention produced favorable outcomes when compared with tPA treatment alone. " This study was a head-to-head, rigorous trial of tPA versus tPA plus embolectomy, and it showed that tPA with embolectomy is superior — a finding confirmed by studies soon to be reported from Australia, Canada and the U.S." Dr. Nohara says. "The results show tPA "The medical team at Health Quest collaborates to provide the highest level of stroke treatment. We're making a difference, one patient at a time." — Alison J. Nohara, MD, Director of NeuroInterventional Surgery at Health Quest's Vassar Brothers Medical Center Dr. Nohara reviews her schedule with an administrator at her office. R A R E E X P ERTI S E NEUROINTERVENTIONAL SURGEONS ARE not readily accessible at many medical facilities, notes Alison J. Nohara, MD, Director of NeuroInterventional Surgery at Health Quest's Vassar Brothers Medical Center. "As I trained in the field, neurointer- ventional surgery was in its adolescence," she says. "There were no neurologists doing this at all, and there were very few neurosurgeons with such expertise." Dr. Nohara adds that, since she began training, the number of neurointerven- tional specialists has doubled but remains relatively small, despite the need for physicians with that skill set. Bolstered by Dr. Nohara's leader- ship, Health Quest's Division of NeuroInterventional Surgery combines the latest innovative technology — such as cerebral angiogram — and advanced medical expertise to treat: • Acute stroke • Aneurysm • Arteriovenous fistulas • Arteriovenous malformations (both brain and spinal) • Carotid stenosis • Cervical and intracranial stenosis • Epistaxis • Vertebral fracture M D N E W S . CO M ■ MD NEWS Mid Hudson | 9