Archive for January, 2011

Now options for patients with difficult to reach aneurysms

January 28, 2011  |  Media  |  No Comments

Neuroform EZ Stent System to treat aneurysms.

Demetrius Lopes, MD, neurosurgeon and blood vessel repair specialist at Rush University Medical Center, is again introducing new technology to treat brain aneurysms to Chicago.   Dr. Lopes is one of the foremost pioneers in the country treating brain aneurysms, stroke, AVMs and other blood vessel conditions through a minimally-invasive approach. 

Frequently endovascular-trained neurosurgeons, like Dr. Lopes, navigate special technology through the blood vessels in the body to the brain to repair a weakened vessel wall called an aneurysm.  The aneurysm can be thought of as a blister on the blood vessel wall.  Like blisters on the skin, a brain aneurysm can easily burst and cause a bleed into the brain.  Ruptured aneurysms can cause significant brain damage and even death if not treated immediately.  Optimally brain aneurysms are detected and treated before they rupture.

Dr. Lopes treats well over 100 aneurysms each year.  He uses stents, or small mesh-like tubes, as well as coils, glues and other innovative materials to fill the aneurysm which restores normal blood flow and prevents the aneurysm from rupturing or from causing further harm to the brain.  Now Dr. Lopes has yet another tool to treat even the most complex and hard to reach aneurysms using a minimally invasive approach.  In fact, Dr. Lopes was the first in the United States to use the new Neuroform EZ™ Stent System.

“Unlike previous stent systems, the Neuroform EZ stent allows me to treat aneurysms which have developed deep within the brain and on some of the smaller blood vessels,” comments Dr. Lopes.  “Other stent systems are not flexible enough to be used in these locations.  Even aneurysms which develop where arteries divide into two branches, or at a bifurcation, can now be treated.”

Patients with non-ruptured aneurysms should pay particular attention to a neurosurgeon’s experience and access to new technologies in treating these abnormalities in the brain.  As previously described, if a patient has an aneurysm deep within the brain or of a particularly difficult shape to treat, such as aneurysms that develop at a bifurcation, only programs like Rush with access to the latest technologies will be able to offer successful minimally-invasive treatment.

Dr. Lopes urges patients to do their homework.  “My goal is to continue to enhance the program at Rush so we have access to all proven treatment options for patients with brain blood vessel disorders.  Given the rapidly changing technology in this area of neurosurgery, only programs with specialists with their eye on these developments can offer the most complete array of solutions for patients.”

If you have any questions regarding the technology options for the treatment of aneurysms, please respond below or email Dr. Lopes at info@ChicagoStrokeMD.com

Improved Care for Stroke Patients: Moving Forward

January 27, 2011  |  Media  |  No Comments

Dr. Demetrius Lopes, endovascular-trained neurosurgeon and stroke treatment expert at Rush University Medical Center in Chicago, applauds efforts by the American Heart Association and American Stroke Association in refining the approach to stroke care in the United States.  The AHA and ASA have announced the development of 26 metrics which would be measured to assess a hospital’s ability to safely and effectively treat a stroke patient.   The organizations site the goals of high-quality and faster stroke care as the impetus for the new guidelines.

As reflected in the article published on-line in Stroke, the ASA and AHA strongly believe in the development and accreditation of comprehensive stroke centers, building upon the primary stroke center designation started nearly 10 years ago by the Joint Commission.  The authors of the study noted that “Experience with the establishment of primary stroke centers has demonstrated that designation of hospitals as stroke centers with formalized protocols for care and with mechanisms for monitoring their performance has been associated with improved performance.”   Moving toward a two-tiered system to include accreditation for Comprehensive Stroke Centers is believed to enhance stroke care and outcomes even further.

Dr. Lopes comments, “I think the data-driven metrics proposed by the AHA/ASA for Comprehensive Stroke Centers would push the organization and delivery of stroke care in the right direction.  In the end, it would have a great impact on improving stroke patient outcomes and quality of life.  Today, it is very disappointing to see the time lost in transferring patients from one institution to another.  Losing those precious minutes or in some cases hours, significantly reduces the available treatment options.”

Dr. Lopes’ program at Rush University Medical Center is among those that offer the full continuum of medical, surgical and endovascular interventions for patients suffering from stroke.  Dr. Lopes looks forward to an organized system whereby stroke patients are immediately directed to an institution which can optimally care for them. 

If you have any questions regarding the stroke treatment and prevention services offered at Rush University Medical Center, please respond in the space below or email Dr. Lopes at info@ChicagoStrokeMD.com.

WLS TV 7 Chicago Discusses Improved Treatment for Brain Aneurysms with Dr. Lopes

January 16, 2011  |  Media  |  No Comments

From http://abclocal.go.com/wls/index

January 14, 2011 (WLS) — A new device is allowing doctors to get at difficult brain aneurysms without having to open up the skull.

An aneurysm in the brain means a weakness in a blood vessel has caused a balloon like bubble to form. If it ruptures, there’s a chance it may be fatal.

Illustration of a brain aneurysm shows a "blister" on a blood vessel.

Shoring up the weakened vessel with a metal stent can help prevent an emergency. Doctors have been doing this with a minimally invasive approach. A catheter is snaked up a leg artery, navigated to the brain, and then a metal stent is placed in the weakened area.

In the past not every aneurysm was accessible this way. Now a newer kind of delivery system called the Neuroform EZ is helping surgeons get to those difficult areas, smaller vessels, deeper in the brain.

Rush University Medical Center is using this system. Neurosurgeon Demetrius Lopes says it will help make this minimally invasive treatment an option for more patients.

“It seems like every two years we see a tremendous new advancement which makes us very excited about where we are heading with this,” Lopes said. “Patients go home with 24 hours of the hospital, and these are things you could not talk about a few years ago…Come into the hospital, repair your brain aneurysm, and go home within 24 hours. It is very exciting to be part of that.”

Along with a shorter hospital stay, the hospital says other benefits include minimal blood loss and the option of local anesthesia.

Quality of Life for Stroke Patients

January 3, 2011  |  Media  |  No Comments

For the first time in over fifty years, the Center for Disease Control (CDC) reported that stroke is no longer the third leading cause of death in the United States.  Dr. Demetrius Lopes, stroke expert and fellowship-trained endovascular neurosurgeon at Rush University Medical Center in Chicago applauds these results and attributes the drop in deaths to the proliferation of certified stroke centers.  In Illinois alone, there are thirty-three stroke centers certified by the Joint Commission.   The American Heart Association is also optimistic on the improvements in stroke care in this country.  They recently released a top 10 list of advances in stroke care, which include:

  •  Clot-busting drugs found most effective in the first 4.5 hours after stroke and perhaps harmful afterward.
  • Scientists identified a new way the body clears clots from brain vessels, thus restoring blood flow.
  • Opening narrowed neck arteries by surgery or stent has similar risks and benefits, but surgery appears better for those over 70.
  • New AHA hospital guidelines improve outcomes of stroke patients.
  • Researchers identified the 10 major risk factors for a stroke and found that reducing blood pressure and smoking, and encouraging physical activity and a healthy diet could significantly cut the number of strokes around the world.
  • An international study found that ultrasound can detect silent micro-clots in patients at risk for stroke and help determine which patients might benefit from surgery or stenting.
  • Robot-assisted therapy can improve arm function after stroke, although not more than intensive care from a physical therapist.
  • Patients with the genetic disorder Ehlers-Danlos syndrome are at risk for brain bleeds, but the risk can be managed with the use of beta-blockers, which lower blood pressure.
  • Dramatically lowering blood pressure early after a hemorrhagic stroke can prevent the bleeding from spreading, thereby improving outcomes.
  • Physical activity, even walking and other moderate exercise, reduces the risk of stroke in women.

Stroke specialists, like Dr. Lopes, are leading the way in enhancing the understanding of optimal treatments and prevention for stroke.  While mortality rates are important, Dr. Lopes suggests that stroke treatment has a long way to go, since stroke is still the leading cause of disability in this country.  “Improving the quality of life of stroke survivors is what drives the stroke specialists at Rush University Medical Center.  We believe that mortality is an old paradigm, and what patients really want from us is better quality of life and the ability to return to work.”   Stroke research at Rush led by Dr. Lopes and his colleagues focuses on changing early treatment protocols and refining patient selection criteria for various advanced stroke therapies. “As highlighted in the top 10 list above from the American Heart Association, we are beginning to better understand which patients respond better to which treatments,” comments Dr. Lopes.  “It is the responsibility of comprehensive stroke centers, like the center at Rush, to have all treatment options available.”

Dr. Lopes welcomes comments to his blog in the area provided below.  He also accepts email inquiries at info@chicagostrokemd.com.

Endovascular-trained Neurosurgeons Offer Surgical and Non-surgical Solutions

January 3, 2011  |  Media  |  No Comments

 The American Heart Association recently published its top 10 advancements in stroke care for 2010. Among those cited on the list were the results of the CREST study.  The CREST study demonstrated that carotid endarterectomy, the surgical procedure to treat carotid stenosis, was more effective than carotid stenting, the minimally-invasive endovascular approach performed by many cardiologists and interventional radiologists, for patients patients over 70 years of age.  In addition, it showed that stenting may actually be better for patients under 70 years of age.

Dr. Demetrius Lopes, endovascular –trained neurosurgeon at Rush University Medical Center in Chicago explains that results like those in the CREST study continue to refine our approach to treating stroke.  “Stroke medicine is now at a point where we’re defining which approaches are more or less effective for specific subsets of the population.” 

Interestingly, it’s because of these treatment nuances that neurosurgeon stroke specialists, like Dr.Lopes, become even more critical to leading stroke programs.  “Stroke-trained neurosurgeons are the only physicians that can offer either surgical approaches or endovascular approaches for the treatment of stroke.  Leading programs, like Rush University Medical Center, are able to offer the right treatment for the right patient.” 

When a stroke patient enters the emergency room, a stroke-trained (also referred to as endovascular-trained) neurosurgeon can effectively treat the patient in accordance with the latest guidelines regardless of whether the patient is 50 or 85 years old.  When time is of the essence – or when time is a decisive factor in a patient’s ability to lead a normal life – having a neurosurgeon who can offer a comprehensive continuum of treatments is optimal.

Dr. Lopes welcomes feedback to his blogs using the space below.  He also accepts email questions via info@chicagostrokemd.com