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2010
Presented byFernando Viuela, M.d.
Professor of Radiology and Neurosurgery,
David Geffen School of Medicine at UCLA
Director, Leo G. Rigler Center for Radiologic Research
Co-Director, UCLA Stroke Center and Program
TIME IS BRAIN.A Proposal for
THE UCLA BRAIN STROKERESCUE PROGRAM
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UCLA BR A I N ST R O K E RE S C U E PR O G R A M DAVID GEFFEN
SCHOOL OF MEDICINE AT UCLA
Time is brain.One of the most miraculous moments in modern
medicine is to open up a blocked vessel early enough, when the
damage has not yet been
severe, and then restore the blood flow and watch the
incapacitated stroke patient return to a completely normal
state.
Every 45 seconds, someone in America has a stroke. Every 3.1
minutes, someone dies from one. Stroke is the third leading cause
of death and the leading cause of serious, long-term disability in
the United States. The economic costs of stroke have been estimated
to exceed $50 billion a year. In a typical acute ischemic stroke,
the brain loses 1.9-million neurons, 14-billion synapses, and 7.5
miles of myelinated
nerve fibers every minute.
In stroke, time really does equal brain. Every hour, the brain
suffering a stroke loses 200-million nerve cells and ages
nearly four years.
While stroke strikes the population indiscriminately, age and
vascular health are key factors. Our population is aging
rapidly, and obesity is epidemic, making the need for rescue so
relevant. Seventy-three million Baby Boomers had an
increased susceptibility to severe stroke the minute they
received their AARP card. Each year, those risks increase
exponentially.
Who doesnt have a friend or family member whose life has been
affected by stroke? There are 4,400,000 stroke
survivors in the United States alone. Every year, 750,000 people
here have a stroke 150,000 resulting in death. The
social impact upon families and the fiscal impact on our health
care system are catastrophic, yet innovations in this field
have been few and far between.
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VISION
The UCLA Brain Stroke Rescue Program represents an opportunity
to make a valuable investment in your future and
the future of the people you love. Our program, with its
multidisciplinary approach to treatment, is dedicated to
developing new and pioneering ways to rescue people from the
tragedy of stroke. Research has shown that speed,knowledge,
technology, and efficacy at all touch points along the way from
prevention, recognition, and
transportation to treatment, post-treatment, and rehabilitation
can make aprofounddifference in a stroke victims
outcome.
The UCLA Brain Stroke Rescue Program is about treating stroke
faster and better. Neuronal damage is reversible early,
but is progressive after stroke. There is a short therapeutic
window for optimal treatment.
The program utilizes integrated research and education to
discover and develop new, innovative therapies for acute
ischemic and hemorrhagic stroke. These groundbreaking
investigations are made through a multidisciplinary
collaboration of investigators from the disciplines of stroke
neurology, emergency medicine, pre-hospital care,
vascularneurosurgery, neuropathology, stroke genomics, diagnostic
and interventional neuroradiology, magnetic resonance
physics, and functional imaging.
While UCLA is allied with the few stroke organizations that
exist, there is currently no other entity dedicated to the
comprehensive lifesaving, life-enhancing difference that our
focus on rapid treatment can make. Our vision is to rescue
people from the tragedy of stroke through a rapid treatment
approach and multidisciplinary development of
cutting-edge interventional and radiologic techniques.
We appreciate your interest in joining with us to make the
vision of the UCLA Brain Stroke Rescue Program a reality.
MISSION
The mission of the UCLA Brain Stroke Rescue Program is
threefold:1. To develop and build the first real-time Stroke
Treatment Suite at Ronald Reagan
UCLA Medical Center
The capacity to diagnose and treat the cause of stroke without
moving the patient from room to room, floor to floor,
over several blocks, or across town saves approximately 90
minutes of transfer time. These 90 minutes are critical to
saving the patients life.
Creating the worlds firstreal-time Stroke Treatment Suite (STS)
at Ronald Reagan UCLA Medical Center is the firststep in an
important journey. With no stopping points along the way, the
real-time STS will offer the very first direct
route to lifesaving outcomes, addressing and helping to overcome
the $50-billion annual impact of stroke. UCLA will
serve as the model institution to assemble this kind of
facility.
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The dedicated STS will have a 3 TESLA (3T) magnetic resonance
imagingpositron emission tomography (MRI-PET)
unit, a rotating table, and a state-of-the-art Zeego angiography
unit. PET is a nuclear medicine imaging technique that
produces a 3-D picture of functional processes in the body;
matched with MRI, more detailed information is provided.
Patients will be transferred from the emergency room directly to
the table located in the center of the STS. The table
will be moved to the 3T MRI-PET unit, and an emergency MRI-PET
will show the status of the brain and identifybrain tissue to be
rescued. The table will then be moved to the Zeego angio unit, and
an immediate endovascular
procedure will be performed, aiming to remove the cerebral clot
and reestablish normal brain circulation.
Stroke is a disease that progresses rapidly over the course of a
few hours. Real-time imaging allows us to instantly
identify the activity in every artery of the brain. Another
major advantage of the STS is the ability to perform serial
scans to guide therapy. The instant availability of an MRI-PET
will help us decide whether further treatment is
warranted and safe. There is solid evidence that certain types
of early changes on MRI are predictive of clinical
outcome, but the accuracy of the data could be improved
substantially with access to real-time MRI-PET before,
during, and after endovascular intervention.
The use of real-time imaging and therapy for patients with acute
stroke will reveal new knowledge of brain responses
immediately after the reestablishment of blood supply to the
brain, using interventional techniques.
This new research information will be collected and reviewed by
stroke neurologists, interventional neuroradiologists,
neuro-intensivists, and neuroradiologists from the UCLA Brain
Stroke Rescue Program. One miraculous room at UCLA
will enable the brain power within the program to revolutionize
the approach to stroke treatment, saving lives and
thwarting disabilities.
2. To develop new interventional techniques to reestablish rapid
normal brain circulationin patients with acute ischemic stroke
While there have been remarkable advances in the treatment of
heart attacks and various forms of cancer, stroke
remains one of the last unsolved, potentially fatal diseases.
UCLA has been a pioneer in this area. Dr. Pierre Gobin was
a member of the UCLA Division of Interventional Neuroradiology,
when he developed the first Food and Drug
Administration (FDA)-approved endovascular device for the
mechanical treatment of acute stroke in 2000.
The UCLA Brain Stroke Rescue Program will allow UCLA
neuroscientists to build upon this success. It will support
the development of new devices and techniques used in emergency
procedures to treat the cause of acute blockage of
brain arteries eliciting an acute stroke.
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3. To develop new real-time MRI-PET techniques that will allow
the accurate assessment
ofbrain responses during and after the emergency reestablishment
of normal
circulation
Currently, the images that are available to be used for
evaluating stroke patients are not real-time and, because of
the
delay, are not as effective for determining the best course of
treatment. Real-time images will be the most important
factor in the immediate management of the stroke, resulting in
better outcomes for the patient.
GIVING OPPORTUNITIES
Development & Construction of Real-time Stroke Treatment
Suite $12 million
A gift of $12 million will underwrite the development and
construction of the STS and provide the funds to purchase
and install the 3T MRI-PET unit and Zeego angiography unit. The
funding for this 16-month project includes
architectural and mechanical drawings, construction, and
installation of the equipment. A time line and construction
budget of $11.39 million is attached. The remaining funds will
be used to purchase advanced neurointerventional
devices and other specialized equipment to perform therapeutic
procedures.
Funding of Research $3 million
Additional funding in the amount of $3 million will support
cutting-edge research that will result in the development of
new real-time MRI-PET techniques to assess brain responses
during stroke and new interventional techniques to
reestablish normal brain circulation.
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ADDENDUM
The UCLA Brain Stroke Rescue Program comprises some of the
leading experts and innovators in the field of modern
diagnosis and management of acute cerebral stroke.
Fernando Viuela, M.D.
Co-Director
Born in Mercedes, Uruguay, on April 5, 1945, Dr. Fernando Viuela
received his M.D. degree
from the University of Uruguay in December 1970. He completed
his post-medical education at
the University of Western Ontario, Canada, from 1974 to 1979. He
arrived at UCLA in July 1986 as Professor of
Radiology and Director of the Division of Interventional
Neuroradiology and is also currently Professor of Neurosurgery,
Director of the Leo G. Rigler Center for Radiologic Research,
and Co-Director of the UCLA Stroke Center and
Program.
Among Dr. Viuelas academic achievements to date, he has
presented 337 lectures on ischemic and hemorrhagic
strokes at national and international meetings and has authored
or co-authored 294 manuscripts in peer-reviewed
journals and six book chapters focusing on ischemic and
hemorrhagic strokes. He has been awarded 40 industry and
National Institutes of Health (NIH) contracts and grants on
research related to his field of expertise, as well.
Dr. Viuela is a founding member and president of the American
Society of Interventional Neuroradiology, World
Federation of Interventional Neuroradiology, and Ibero-Latin
American Society of Diagnostic and Therapeutic
Neuroradiology. In addition, he is an honorary member of 19
scientific professional organizations, including the
Japanese Society of Interventional Neurosurgery, Russian Society
of Neurosurgery, and Peruvian Society of
Neurosurgery.
Jeffrey L. Saver, M.D.
Co-Director
Dr. Jeffrey Saver, Professor of Neurology, David Geffen School
of Medicine at UCLA and director of
the UCLA Stroke Center and the UCLA Stroke and Vascular
Neurology Program, earned his medical
degree at Harvard Medical School and completed his internship in
Medicine and residency in Neurology at Brigham &
Womens Hospital. His fellowship in Cognitive Neuroscience was
done at the University of Iowa Hospitals and Clinicsand in
Cerebrovascular Disease at Rhode Island Hospital. He is
board-certified in Neurology, Vascular Neurology, and
Addiction Psychiatry.
Dr. Savers research focuses on the prevention, diagnosis, and
treatment of stroke; neuroimaging; clinical trial design;
and neurocognitive consequences of stroke. His work has been
supported by grants from the National Institutes of
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Health, National Institute of Neurological Disorders and Stroke,
the American Heart Association (AHA), and the
National Stroke Association. He is the author or co-author of
more than 175 research articles.
Among his many accolades, in 2010, he was named Physician
Volunteer of the Year, one of the top honors given by the
AHA to volunteers in the Western States Affiliate, which covers
California, Nevada, and Utah. It is given to an
individual who has demonstrated the most distinguished
commitment and service to the AHA during the past fiscal
year and over time. He was recognized for his years of exemplary
service to the AHA/American Stroke Association at the
national, affiliate, and division levels. In particular, Dr.
Saver was cited for his tireless efforts in establishing true
stroke
systems of care in Los Angeles over the last 10 years. His work
was instrumental in the Emergency Medical Service
Commissions passage of a new stroke destination policy in Los
Angeles that recognizes primary-stroke-center status as
a factor for selecting a receiving hospital for a stroke
patient.
He also has been acknowledged for his accomplishments as chair
of the California Stroke Work Group. Under his
leadership, the members recently completed stroke system
implementation recommendations, a model document that
will raise the standard of stroke care throughout the State of
California. Dr. Saver, who has served on several national
AHA committees, recently published research noting improved
outcomes in hospitals, using the AHAs Get With The
Guidelines, a stroke quality improvement program.
Medical Advisory Committees
Chairman Jeffrey L. Saver, M.D.Education Nestor Gonzalez,
M.D.
Sidney Starkman, M.D.
Imaging Developments Noriko Salamon, M.D., Ph.D.J. Pablo
Villablanca, M.D.
Telemedicine Latisha Ali, M.D.Therapeutic Innovations Gary R.
Duckwiler, M.D.
David S. Liebeskind, M.D.
Satoshi Tateshima, M.D., Ph.D.
Translational/Clinical Research S.Thomas Carmichael, M.D.,
Ph.D.Nestor Gonzalez, M.D.Reza Jahan, M.D.
Neuro-critical Care Paul M. Vespa, M.D., FCCM, FAANNeuronal
Repair and Rehabilitation S. Thomas Carmichael, M.D., Ph.D.
Bruce Dobkin, M.D.
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ST R O K E TR E A T M E N T SU I T E
Stroke Treatment Suite 3T MRI-PET
Stroke Treatment Suite
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TIME
ISBRAIN
T
imeLineBudget
Month1
Month2
Month3
Months4
14
Month15
Month16
TOTALS
UCLAConstruction
InitiateProject
Architectural&Mechanical
Drawings
$27,0
00
$163,0
00
Construction
$2,2
00,0
00
SeimensHealthcare
OrderMRI-PET&Ze
ego
Order
equipment
$4,0
00,0
00
$4,1
00,0
00
InstallEquipm
ent
$900,0
00
TOTALS
$27,0
00
-
$163,0
00
-
$7,1
00,0
00
$4,1
00,0
00
$11,3
90,0
00
