NEUROSURGEONS AT HACKENSACK MERIDIAN HEALTH DISCUSS HOW THEY ARE MAKING SIGNIFICANT STRIDES IN STROKE CARE THROUGH ADVANCEMENTS IN TECHNOLOGY, INNOVATIVE SURGICAL TECHNIQUES, AND COMPREHENSIVE APPROACHES TO CARE

BY JENNIFER KELLY PHOTOS BY AMESSE PHOTOGRAPHY

When it comes to stroke care, time is of the essence. Immediate treatment and rapid access to crucial, life-saving medications and interventions is what saves lives and limits complications. That’s why Hackensack Meridian Health (HMH) has developed the most comprehensive cerebrovascular and stroke program in the region, with 12 high-level stroke centers providing care for thousands of stroke patients annually. Delivering emergency clot-busting treatments, like tissue plasminogen activator (tPA) and mechanical thrombectomy, plus exploring the application of a new device to treat intracranial aneurysms, HMH’s hospitals are continuously recognized by the American Heart Association/American Stroke Association and Healthgrades for stroke excellence. The hospital group is also a consistent nationwide leader in success rates, research, and patient outcomes.

“Our main focus is to address what used to be the second leading cause of death,” noted Dr. Brian T. Jankowitz, chief of Neurosurgery at JFK University Medical Center. “I like to believe we’ve done a good job because, according to the CDC, stroke has dropped down to the fifth leading cause of death.”

Dr. Jankowitz, a board certified neurosurgeon with a special focus on cerebrovascular surgery, currently serves as co-chair of the Stroke and Neurovascular Program at the Hackensack Meridian Neuroscience Institute at JFK. He says his work there is focused on innovative treatments for ischemic and hemorrhagic stroke, including carotid disease, intracranial stenosis, brain aneurysms, arteriovenous malformations (AVMs), and vascular malformations of the spine.

“JFK and the Neuroscience Institute are dedicated to remaining on the cutting edge,” he said. “We pride ourselves in offering the most up-to-date, safe, and effective therapies in one of the fastest growing sectors of healthcare.”

To ensure patients have access to the newest technology and medicine, Dr. Jankowitz says HMH actively participates in all manners of research including National Institutes of Health (NIH), private, and industry funded studies.

“One such trial that I am proud to be the national leader of involves the application of a new device to treat intracranial aneurysms called the Seal device,” he said. “ JFK is one of only 20 centers nationwide to offer this technology, and we were the first hospital in New Jersey to offer this to our patients.”

This trial is just one part of HMH’s multi-disciplinary approach to stroke prevention and care. Dr. Pinakin R. Jethwa, director of Cerebrovascular Neurosurgery at Hackensack Meridian Neuroscience Institute at Jersey Shore University Medical Center, is pioneering numerous innovative treatments for brain aneurysms, vascular tumors, stroke, and vascular malformations of the brain and spine changing the game for patients and their recovery.

“The technology we utilize at Jersey Shore and surrounding hospitals can now tell us whether or not there is irreversible damage and how devastating the stroke will be,” Dr. Jethwa said. “This really assists in our decision making and helps to identify which procedure is best for each patient.”

Dr. Jethwa employs a comprehensive approach to surgery, utilizing novel, minimally invasive techniques to give patients better quality of life with less pain, less blood loss, and less time in the hospital. “The image quality and resolution on our new ARTIS icono biplane system is simply amazing,” Dr. Jethwa said, speaking about the impact of a relatively new piece of interventional imaging technology now in use at HMH. “With the high resolution and ease of use, I have been able to treat patients I would not have been able to in the past. Our treatments are now safer, faster, and delivered with less radiation.”

Dr. Jethwa says because of the collaboration at HMH’s comprehensive stroke program, thousands of patients are saved each year. “Each stroke program is run by an individual director at each site so patients benefit from the variety of practice patterns,” he said. “Because we are such a big system, there are a huge number of experts and specialists in the field. This program allows all of us to bounce ideas around, resulting in the best care for each and every patient in the program.”

Continuous developments in technology also help to advance the network’s stroke efforts.

“The amount of developments that have been made in stroke care over the past 10 years is truly unprecedented,” noted Dr. Reza J. Karimi, co-director of cerebrovascular disease and director of vascular neurosurgery at Hackensack Meridian Neuroscience Institute at Hackensack University Medical Center. “What was once a very bad disease with hardly any solutions and very bad outcomes has evolved. Now, in most cases, with rapid treatment, we see dramatic improvement. Innovation has most certainly changed the landscape.”

Together, Dr. Karimi and his team also specialize in using innovative treatments for brain aneurysms, vascular tumors, stroke, and vascular malformations of the brain and spine. Dr. Karimi performs some of the most complex and intricate surgeries – brain aneurysm coiling, brain aneurysm microsurgery (clipping), minimally invasive neurosurgery, and arteriovenous malformations embolization – all with very high success rates.

“Similar to stroke care, we’ve seen dramatic developments in the way we treat aneurysms,” Dr. Karimi said. “About 90% of cases can now be treated with minimally invasive procedures rather than open surgery.”

Defining “coiling” as a way to block blood flow to the aneurysm, thus reducing the risk of further bleeding and rupture, Dr. Karimi said it’s just one of the drastic changes in care keeping HMH at the forefront.

“We are witnessing the development of technology that is turning the unsurvivable into something very survivable.”

“At Hackensack I’ve been a part of several device trials, various coils or stents designed to treat complex brain aneurysms,” he said. “We were most recently selected to be part of a Citadel Embolization Device trial, which is a new type of coil that will allow us to treat wide-neck brain aneurysms with more safety.” HMH was chosen for this trial, Dr. Karimi noted, because of the network’s exceptional outcomes.

“The benchmark measured by the best centers in the world was 64%,” he explained. “That means 64% of patients who suffered an aneurysm live disability free. That’s the national number. But when we looked at our data, 86% of HMH patients survived disability free and were not debilitated in any way.”

For Dr. Karimi, who admittedly works in a field with little to no forgiveness those numbers are extremely promising. “We are witnessing the development of technology that is turning the unsurvivable into something very survivable,” he said

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