A Pioneering New Surgical Tool Provides Hope for Patients with Inoperable Deep Bleeding in the Brain | Be Korea-savvy

A Pioneering New Surgical Tool Provides Hope for Patients with Inoperable Deep Bleeding in the Brain

The Apollo™ System arose from decades of research into advanced technology. (image: Kobizmedia/ Korea Bizwire)

The Apollo™ System arose from decades of research into advanced technology. (image: Kobizmedia/ Korea Bizwire)

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ALAMEDA, Calif. July 3 (Korea Bizwire)–The Apollo™ System, manufactured by California-based Penumbra, Inc., was  widely launched today following first-in-man clinical use at leading US  hospitals.

Apollo is an innovative new surgical tool that enables minimally  invasive removal of deeply seated tissue and fluids in the brain during  a single, efficient operation. With combined use of an endoscope and  image guidance, the Apollo System allows decompression and removal of  otherwise inoperable blood clots deep in the brain, among other uses.

Dr. Alexander Khalessi, Assistant Professor of Surgery and Neurosciences  at UC San Diego Medical Center and Surgical Director of Neurocritical  Care, successfully treated the first patient in the world using the  Apollo device. Dr. Khalessi explains: “Our first patient was a  41-year-old male who suffered a spontaneous bleeding deep in his brain  that completely shifted his ventricular system, interrupted fluid  circulation and compressed his midbrain. Despite standard measures  including a ventricular catheter to drain fluid, the overall pressure in  his brain was not well controlled. Of greater urgency, the patient was  essentially comatose with a fixed downward gaze consistent with a  Parinaud’s Syndrome. With evidence of midbrain compression and this  clinical sign, we knew this gentleman was at risk for time-sensitive,  irreversible damage to the connection between his brain and body.

“Large, decompressive open surgeries for this condition are not  supported in the published data. Ongoing research efforts include a  trial exploring minimally invasive approaches that involve the  implantation of a small catheter with gradual removal of the clot over  many days. For my patient, I was concerned his need was more urgent, and  that the Apollo System would facilitate the same surgical result in  minutes, rather than days.

“Following successful clot removal with the Apollo System, our patient’s  gaze improved and we were able to remove brain pressure monitors and  breathing support within 48 hours. As opposed to facing several weeks  comatose in the intensive care unit, our patient was transferred to the  hospital floor, was able to talk to his family, and has since  transitioned to a rehabilitation facility.

“This initial success led to our use of Apollo in a second, 51-year-old  patient with a massive hemorrhage; Apollo facilitated complete removal  through a small incision in the eyebrow. He left the intensive care unit  within 24 hours and like our first patient, went from a near fatal  situation in the hospital, to quickly beginning his recovery in a  rehabilitation facility.

“I remain hopeful we are finally making progress in an all too common  and horribly disabling and fatal disease,” Dr. Khalessi concluded.

Demetrius Lopes, MD, Section Chief of Cerebrovascular Neurosurgery at  Rush University Medical Center in Chicago, is also an early user. “I  think the arrival of the Apollo System is very timely. We have had great  initial experience in removing intraventricular blood. Use of the Apollo  System has resulted in faster patient recovery and a shortened stay in  the intensive care unit,” explained Dr. Lopes.

David Fiorella, MD, Professor of Clinical Neurological Surgery and  Radiology at Stony Brook University Medical Center, discussed his view  on the value of the Apollo System and compared it to alternative  techniques. “Our team at Stony Brook has had tremendous success thus far  using the Apollo System, in conjunction with neuroendoscopy and image  guidance, for the removal of hemorrhages in the brain. This technique  has the potential to be a truly important advance for our field, since  no other treatment has convincingly been shown to help patients with  this lethal disease. Usually patients with this type of hemorrhagic  stroke have very poor outcomes and extremely long hospital stays. Just  hours after treatment, our patients began showing improvement, and they  continued to improve rapidly during their hospital stays.

“While we were very pleasantly surprised by our patients’ impressive  clinical responses, some data indicates that these types of outcomes  might be expected. The investigators in the Minimally Invasive Surgery  and tPA in ICH Evacuation (MISTIE II) trial found that when they  achieved near complete removal of blood clots (to less than 10  milliliters remaining), they observed higher rates of good clinical  outcomes. However, this degree of clot reduction was not achieved in  most patients. In addition, with the MISTIE technique, clot reduction  required several days of drainage through a small catheter left in place  after surgery. With the new Apollo System, it seems that we may be able  to achieve the desired level of clot reduction immediately and safely in  most patients. Therefore, it is possible that we will continue to  observe clinical benefits that surpass our former expectations.

“While these early results are certainly impressive and give us  enthusiasm going forward, it is important to recognize that we are very  early on in our experience with this procedure. Much more data will be  required before we know exactly how effective it is and which patients  will benefit most,” Dr. Fiorella commented.

The Apollo System is the result of decades of research and development  work in the field of advanced aspiration and vibrational energy  technology by researchers at Penumbra. Advanced aspiration technology  was first developed and perfected in the field of acute ischemic stroke  where blood clots inside the arteries of the brain are starving brain  tissue of vital oxygen and nutrients. The Apollo System adds internal  energy generation to a specialized advanced aspiration tool to  surgically address deep bleeding in the brain, a particularly  devastating form of acute hemorrhagic stroke.

ABOUT The Apollo™ System

The Apollo System combines vacuum, irrigation, and a proprietary  internal vibrational energy to ensure rapid fluid and tissue removal  during minimally invasive neurosurgery through the smallest possible  channel without clogging. The Apollo System is used for the controlled  aspiration of tissue and/or fluid during surgery of the Ventricular  System. The Apollo disposable wand is inserted through the working  channel of a neuroendoscopic trocar.

ABOUT Penumbra

Penumbra, Inc. (www.penumbrainc.com)  is a medical device company with global headquarters located in Alameda,  California, and sales operations around the world.

Source: Penumbra (via BusinessWire)

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