Treating Strokes Through Translational Medicine
According to the American Heart Association, failing to treat strokes fully accounts for $33.9 billion in medical costs annually. With a narrow window of less than 6 hours to treat the onset of stroke symptoms, patients are customarily provided an IV-tPA clot buster, which has historically provided tenuous results.
With the approval of the FDA, many medical professionals and academia have embraced mechanical thrombectomies as a new treatment for strokes. A thrombectomy device is composed of an expandable wire mesh that is inserted into an occluded blood vessel via catheter and extracts the blood clot by pulling it back through the point of incision. Yet, thrombectomies may have serious complications, many of which are dependent on the experience of the doctor performing the procedure, such as damage to the vessel including perforation, dissection of the inner lining of the vessel, and vasospasm. David Brotman, a medical physicist and Fulbright awardee, was well aware of these issues and became involved in finding a solution while furthering his studies at Duke. Brotman has helped to develop a new invention that is attempting to disrupt and revolutionize the medical field. By creating a 3D printed replica of the cerebral vascular anatomy, attending and resident physicians undergoing thrombectomy training have an affordable and realistic model to practice on. The unique device serves as an anatomically accurate model of the cerebral vasculature and provides hand-on training for surgeons learning to navigate the blood vessel superhighway.
Cerebral Vasculature Model for Clot Removal in Stroke Patients
Thrombectomy training leads to less variability during the procedure, decreased procedure time, and more comfortability for surgeons, resulting in massive medical savings for stroke victims and lowered mortality rates. With a low price of approximately $14 per production of each model — the cost for printer supplies — the thrombectomy procedure simulator is set to become ubiquitous across all medical universities and hospitals. The thrombectomy simulator tool, called a Phantom, was created by Brotman and a team of radiologists at the University of Connecticut Health Center and is being praised as one of the next big technological breaks in cardiovascular medicine. As surgical training simulators are becoming more common across the medical field (consider how instrumental the video game Underground has been in helping surgeons hone their laparoscopic surgery skills), many medical schools and training programs are ready to implement these more modern methods.
Dr. Ketan Bulsara, Chief of Neurosurgery and Director of Neurovascular and Endovascular Surgery at UConn Health commented, “Creating these high-level 3-D models customized for individual patients has the potential to significantly improve outcomes and reduce operative times by enhancing surgical planning.” He also noted that this technology could potentially be used to visualize other conditions, such as brain tumors. Modeling the tumor in advance of surgery could personalize and improve patient care.
The Road to Revolutionizing Medicine: Free Global Availability
Brotman gained experience in diagnostic cardiac MRI imaging at Yale and, with the mentorship of Smita Sampath, PhD, Assistant Professor of Diagnostic Radiology at Yale, he was awarded a Fulbright scholarship in MRI technology. This allowed him a year in Switzerland to work with physicians and scientists such as Matthias Stuber, PhD (a renowned and eminent pioneer in MRI and Director of the Center for Biomedical Imaging at the University Hospital in Lausanne) to explore novel methods for imaging atherosclerotic plaques in the carotid arteries and how 3D technology could potentially revolutionize surgical training.
While continuing his graduate studies in Medical Physics at Duke, Brotman approached Dr. Clifford Yang, Associate Professor of Radiology at the University of Connecticut, and interventional radiologist Dr. Charan Singh, to develop a physical handheld vasculature model that would allow surgeons to get their feet wet before performing their first thrombectomy procedure on a patient.
Surprisingly, Brotman and his associates decided not to patent the technology. Brotman states that, “It’s not about the money, it’s about mitigating healthcare costs while improving patient safety. We want people to use this.” With the gap in stroke treatment expected to rise and drive up healthcare costs, Brotman hopes to make this available technology across the United States and third world countries, where he has already received requests to provide the data for producing these 3-D printed models to assist training physicians on these procedures.
One problem Brotman and his team faced was the bench-to-bedside problem of actually implementing this training device at hospitals. The technology currently resides at the University of Connecticut, though Brotman and his team plan to outsource the code to the public once enough awareness for this need has developed.
Brotman, who has since received his Master’s degree in Medical Physics from Duke University, maintains interests in leading future efforts to develop the next smart generation of imaging and therapeutic tools to improve patient care via translational medicine, which aims to bridge the gap between the bench-to-bedside problems.
Brotman is currently a clinical assistant at the Yale Cancer Center in Breast Oncology and is in the process of interviewing for medical school. Brotman is very passionate and enthusiastic about the future of medicine. “The next generation of medical students should be leaders who are able to work collaboratively with other disciplines to develop out-of-the box solutions to improve patient outcomes,” notes Brotman. He plans on applying for future grants during his medical studies to help support these interests and to combine his education with health care policy studies to further address gaps in patient care.
For more information, visit davidwbrotman.com and https://www.linkedin.com/in/david-brotman-5b3410139/ or contact David Brotman at firstname.lastname@example.org.