Special procedure helps improve stroke outcomes

to its previous position,” leaving patients with few, if Former surgical attempts any, side effects and deficits to clear such clots from the in brain function. Company brain tended to cause as videos include patients who much damage as the clot itself, return home in a day or two he said. and resume many normal

Of course, all surgical procedures functions within a week. have health risks. Jim Pearson, NICO Corp.

In this case, the co-founder, CEO and president, BrainPath is an access tool is a former resident of the circumference of a dime. Whitehall, where he said he Using imaging technology, first became involved in selling BrainPath is a clear plastic medical devices, later sheath covering a pointed emerging as a successful entrepreneur metal apparatus, known as a in corporate development port, that the neurosurgeon of medical technologies. guides through natural folds and fiber tracks of the brain He said no other technology to the location of the abnormality. currently on the market That is when the allows this type of minimally metal port is withdrawn, disruptive access leaving the sheath in place. through the brain, with the

Next, the pencil-sized NICO technology advancing Myriad — a multi-functional brain surgery in the direction scissors and suction device that minimally invasive — is inserted through the heart and joint surgeries open-ended sheath and used took years ago. to cut and suck away the clot Success to date of the or abnormal tissue to clear NICO procedure in limited the surgical area. In the case trials and published studies, of hemorrhagic strokes, the including 3,500 brain-tumor company reports, the surgeries, have attracted attention BrainPath procedure on average from various professional removes 95 percent of neurosurgical organizations the clot. and national and international

Of utmost importance is patient advocacy reaching the targeted abnormality organizations, the without damaging NICO website says. The healthy brain tissue responsible ENRICH study, Mr. Pearson for normal cognition said, could show sufficient and body function. success to make the technology BrainPath avoids such damage the new standard of care by easing along natural for hemorrhagic strokes. brain pathways and “displacing For now, the procedure is tissues like a ship’s being used for brain tumors, hull displaces water,” the vascular abnormalities and NICO website explains. secondary bleeds throughout “When the surgeon removes the brain in more than 60 the BrainPath sheath upon hospitals nationwide, including completion of the surgery, various large academic the brain tissue can return centers such as UPMC, with more than 300 surgeons trained to perform them. NICO literature also says the need is great, with 500,000 patients in the United States and 2 million worldwide being diagnosed annually with brain abnormalities.

Mark Bain, Cleveland Clinic’s director of cerebrovascular neurosurgery and neurointerventional radiology, said the clinic has used the NICO procedure on 50 patients with hemorrhagic strokes, with results supporting its potential as a standard of care for such strokes.

“It was a frustrating field because we didn’t have a solution for patients,” he said. “But we’ve had patients who couldn’t talk and we took out the hematoma [blood clot] and they began mouthing words in two or three days.

“With proper selection of patients with hematomas in certain locations of the brain, we’ve taken them out, and they may return to normal function,” Dr. Bain said. “The best patient I had, within a day, was moving her arms and legs and talking. Six months out, she still gets tired with speech and is a little weaker on one side.

“To think people will return to 100 percent normal may be wrong,” he said. “But certain patients are returning as close to normal function as they possibly can.” about their alcohol drinking habits with a 10-question survey about drink amounts, frequency and behavior such as whether a person is able to stop drinking, if drinking has caused a failure to meet expectations or if it caused feelings of remorse.

Participants were also asked if they used illicit drugs (except opioids) or had received counseling or hospital treatment in the past 12 months, including treatment for alcohol/drug abuse.

The first round of questions and assessments was before surgery. Annual follow-ups ended Jan. 31, 2015. Although gastric sleeve surgery is now the most common bariatric surgery, it was not in 2006 when the study first recruited participants and was not included in the comparison.

Before surgery, 97 out of 1,469 (6.6 percent) in the Roux-en-Y group had some alcohol use disorder symptoms; 36 out of 519 (6.9 percent) in the banding group reported symptoms.

By the fifth year, the cumulative reports of alcohol use disorder, illicit drug use and substance use treatment rose to 20.8 percent, 7.5 percent and 3.5 percent, respectively, for the Roux group.

In the banding group, the reports were 11.3 percent, alcohol use disorder; 4.9 percent, illicit drug use; and .9 percent, substance use treatment. Alcohol consumption doubled in the seven years after both types of surgery, the study reported.

Factors associated with a greater risk of developing alcohol use disorder and illicit drug use after surgery were “males and younger adults and those who smoke and who reported consuming alcohol regularly,” Ms. King said, “also those with less social support.”

Two “addictive” behaviors — binge eating and outof-control