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St. Joseph’s Hospital is the First in Florida to Offer Non-invasive Test to Predict Stroke Risk
06/14/2013

Hospital using three-dimensional technology to scan brain and neck to prevent stroke


St. Joseph’s Hospital in Tampa is the only hospital in the southeast United States  using Non-invasive Optimal Vessel Analysis (NOVA) to quantify the volume of blood flow through tiny blood vessels in the brain using three dimensional imaging.


The first of its kind, NOVA provides doctors with precise identification of each vessel for blood flow calculation in order to pinpoint specific areas of concerns, giving physicians a quantifiable idea of a patient’s risk for stroke.


“It’s very difficult to image vessels that small,” said St. Joseph’s Hospital Interventional Neuroradiologist Matthew Berlet. “This software provides a numerical evaluation of blood flow in the brain without an invasive test.” 


For patients like Sam Hachem, who had a 99 percent stenosis in critical artery of the brain, NOVA is truly a lifesaver.  He sought treatment at St. Joseph’s for his intracranial narrowing when medical therapies were not working. A stent was placed to open his artery but it was difficult to make sure there was no reoccurrence of his vessel narrowing without doing dangerous, invasive cerebral angiography.


“Mr. Hachem’s antiplatelet medication was not working to keep his stent open. After inserting the stent, I knew I needed a clear, accurate view of the blockages in his brain,” says Berlet.  “I knew about the NOVA technology and knew there were few places in the country with it. So I sent him to see Fady T. Charbel, MD, FACS, head of the Department of Neurosurgery at the University of Illinois at Chicago. It helped make sure the stent was staying open and that his antiplatelet therapy was working.”


Mr. Hachem returned the favor by donating the technology for St. Joseph’s. “Mr. Hachem specifically wanted St. Joseph’s Hospital to have this software for the Tampa community,” says Berlet.  “We now have such a rare commodity – and the community needs to know about the importance and availability of NOVA.”


The software is designed for patients currently diagnosed as being at-risk for stroke who are taking medication to prevent stroke.  NOVA takes preventative care one step forward by being able to tell if a patient is improving with their current medical therapy, or if their prescriptions need to be adjusted.


“Doctors will be able to tailor treatment and better detect what therapy may or may not be working,” Dr. Berlet says.  “This is the best tool we have to minimize a patient’s chance of a debilitating stroke.”


“You can essentially preview your disease.  We can see just how bad the blockage is and its exact location in the vasculature,” he says.  “Without this baseline imaging, the only way we would find out that therapy wasn’t working was when the patient would have a stroke.”


NOVA provides a patient a three dimensional view of the vascular system of the neck and head that is 10 times more sensitive than transcranial ultrasound [the current standard of care] and gives patients a numerical value that is extraordinarily important to managing their risk for stroke.


The scan measures blood flow in the brain in milliliters per minute, which is a quantitative numerical value that can be compared to normal values.  This determines the severity of the patient’s stenosis, or blockage.  The scan takes about 10 minutes and a report is instantly generated and printed, showing the patient’s stroke risk. 


There is no direct alternative to the NOVA MRA system, but a cerebral angiogram can give the degree of narrowing. Unfortunately it is an invasive and expensive test that does not give the quantitative blood flow. It can only provide the degree of narrowing of the blood vessel. Not to mention, the patient is exposed to ionizing radiation and there is a chance of stroke during the procedure itself. 


NOVA MRA can be expanded to use in triage for patients with stroke symptoms.  Since it provides a quick, quantitative result, Berlet said he would like this technology used to give clinicians an even better idea of which stroke patients can be helped with intervention [clot retrieval, angioplasty, stent stroke treatment] when they arrive at the ER with stroke symptoms.


“This technology is a breakthrough for treating stroke patients – we can use it to help prevent stroke in diabetics, hypertensive patients, obese patients and patients who smoke,” Berlet said.  “If you can show a diabetic their cerebral vasculature and show them where they could be in two, three or four years if they don’t turn it around…that’s life-saving preventative care.  If patients use this information and follow our recommendations, they can help to lessen their risk for stroke.”


“Stroke is the third leading cause of death,” he continued. “We now have the best technology to tell you how close you are to having a fatal stroke. Wouldn’t you want to know your risk?”



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