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ExploreHealth with Sentara
Medical Breakthroughs: ExploreHealth with Sentara highlights the latest in medical breakthroughs available at Sentara.
September 2008
Next-Generation of Drug Eluting Stents
Xience™ V Slowing Restenosis Rates in Patients with Coronary Artery Disease
Sentara hospitals were the first facilities in the region to offer the next-generation of drug-eluting stents, the Xience™ V Everolimus Eluting Coronary Stent System, which received FDA approval in July 2008.
Each year, over 1.2 million* coronary angioplasty procedures are performed on patients with coronary artery disease to restore blood flow to the heart that has been clogged by fatty deposits called plaque. During this minimally invasive procedure, a balloon catheter is used to literally push the plaque up against the artery wall to widen the opening for blood to flow.
Often, the cardiologist decides to use the balloon catheter to insert a stent into a clogged artery. A stent is a tiny wire mesh tube that remains in the artery to prop it open and restore blood flow to the heart.
Drug-eluting stents are coated with medication (everolimus, in the case of Xience™ V) which is released in a controlled fashion over time to prevent the artery from renarrowing (called restenosis), thereby decreasing the need for a follow-up procedure.
For more information on heart care, talk to your physician or visit www.sentara.com/heart.
*American Heart Association, www.americanheart.org
August 2008
Teleneurology for Stroke Care
Sentara Norfolk General Hospital is the first hospital in the region to employ telemedicine to enhance its stroke program.
"Brain attack." Ischemic (clotting) stroke. Hemorrhagic (excessive bleeding) stroke. TIA (transient ischemic attack, commonly known as a mini-stroke). These are all names to describe a stroke - when vital blood flow and oxygen is suddenly blocked from the brain. An estimated 780,000 strokes occur each year even though almost 80% of stokes can be prevented.*
Innovative use of Technology Saves Time
When a patient comes to the Emergency Department with symptoms of stroke, time is of the essence. Teleneurology takes advantage of telecommunication technology to instantly access a remote neurovascular specialist who has extensive training and experience in emergency stroke care - 24/7.
"Live" patient assessment is conducted via internet connection with a mobile two-way video link and PACS (picture archive and communication system) to transmit the patient's CT images for review. The goal is to quickly and expertly assess the patient so treatment can begin sooner.
This pilot program offers round-the-clock consultation to augment the stroke expertise already available at Sentara Norfolk General Hospital, the first hospital in the state to have earned the Joint Commission's Certificate of Distinction for Primary Stroke Centers. Two other Sentara hospitals, Sentara Virginia Beach General Hospital and Sentara Leigh Hospital, have also earned this certification from the Joint Commission.
To learn more about stroke symptoms, talk to your doctor, visit www.sentara.com/Sentara/Services/Neurosciences/ or call 1-800-SENTARA.
*National Stroke Association: Stroke Facts, www.stroke.org
During a stroke, 2 million brain cells die every minute, increasing the risk of brain damage, disability or death.*
The technology used for the Teleneurology Program for Stroke is similar to that of the eICU where doctors specializing in intensive care are remotely accessible 24/7 for ICU patients at Sentara.
July 2008
Medical Breakthroughs at Sentara
HeRO Vascular Access Device
(Hemodialysis Reliable Outflow)
A New Option For Long-Term Dialysis Patients
For over 336,000* people, renal dialysis is a lifesaving treatment for malfunctioning kidneys. Dialysis requires frequent vascular access to the person's veins in order to circulate the blood to cleanse the liquids and waste that normally would be removed by working kidneys. The cleansed blood is then returned back into the body.
The surgery combines endovascular and surgical skills to implant this device in patients who have lost all of the major veins in their chest area. The four components of the HeRO device - a catheter, pre-connected graft assembly, a crimp ring and a sleeve - are custom-fitted to the patient's anatomy as they are implanted. The sleeve is made of silicone to provide covering that reduces kinking. The HeRO device then provides the patient with a successful under-the-skin vascular access for ongoing dialysis.
Dialysis patients who are catheter dependent, have exhausted all other access options (such as grafts and fistulas), are receiving inadequate dialysis or have other compromising health issues may be good candidates for the HeRO device.
For more information, talk to your doctor, visit our Vascular Web site or call 1-800-SENTARA.
*National Kidney Foundation; 2005
June 2008
SIR-Sheres®
Selective Internal Radiation Sphere Therapy New Treatment for Advanced Liver Cancer
Sentara Norfolk General Hospital is the first in the area to begin using Selective Internal Radiation (SIR)® Spheres Therapy where microscopic radioactive resin beads are used to target advanced liver cancer.
Imagine millions of microscopic radioactive resin beads (spheres) traveling through the bloodstream with one mission: to target and destroy liver cancer cells. That’s exactly what SIR-Spheres ® Therapy is doing for patients with primary liver caner and inoperable secondary liver cancer (spread from colorectal and other primary cancers).
And Outpatient Therapy
This non-surgical, outpatient therapy places a catheter in the femoral artery of the upper thigh which is threaded through the major blood vessel of the liver (hepatic artery). Through this catheter, the microscopic spheres are delivered directly to the tumor where they become trapped.
For about two weeks, the injected spheres radiate the tumor, destroying the cancerous cells from the inside. SIR-Spheres® can safely deliver many times more radiation than conventional techniques. Generally patients receive two separate treatments one month apart.
Improving Quality of Life
While SIR-Spheres® therapy is not considered a cure; it can extend the survival, sometimes by years, and improve patients’ quality of life. In some cases, it can also shrink the liver tumors enough to allow for surgical removal.
Not all people with advanced liver cancer are suitable for this type of therapy. Talk to your physician or call 1-800-SENTARA for more information.
May 2008
SPY® Technology
Real-Time Imaging of Arteries Before and After Heart Bypass Surgery
SPY® Technology, an intra-operative imaging system used before and during heart bypass surgery at Sentara Heart Hospital and Sentara Virginia Beach General Hospital, helps to confirm successful bypass surgery - before the patient even leaves the operating room.
When the arteries that carry blood to the heart are clogged, your physician may recommend you have coronary artery bypass graft surgery (CABG or "cabbage"). During a CABG, cardiac surgeons perform the delicate operation of restoring blood to the heart by grafting blood vessels that bypass the blockage. Typically, three to four grafts may be done during surgery.
Traditionally, surgeons rely on their expertise and experience to determine if these new grafted arteries are functioning properly. Spy® Technology, the first fluorescent imaging system cleared by the FDA for use in CABG surgery, gives the surgeon a real-time tool to test for restored blood flow.
Real-Time Pictures of the Heart's Blood Flow
A fluorescent imaging agent injected into the bloodstream lights up when stimulated by the SPY system infrared laser. The illuminated light shows where the blood is flowing through the arteries and veins. The camera captures the live images of the heart on a computer screen and save a copy for medical review.
SPY® provides information that is similar to that from an X-ray angiogram used for evaluating coronary artery blockages. However, an angiogram is typically performed after surgery and generally not in the operating room due to the equipment and the exposure of the staff to harmful X-rays.
Clinical studies have shown that SPY can reduce serious complications that can be a result of bypass surgery such as graft failure and postoperative myocardial injury. The SPY system offers an additional assurance of success to the high quality of cardiac care available to our patients.
¹American Heart Association
Coronary artery bypass graft (CABG) surgery is one of the most common surgeries in the U.S. with an estimated 469,000¹ surgeries each year.
Within minutes, the SPY® technology allows cardiac surgeons to check the blood flow of newly grafted arteries and make any necessary revisions before the patient leaves the operating room.
April 2008
MammoSite® Targeted Radiation Therapy
Shortening Breast Cancer Treatment
Five days of targeted radiation, delivered directly inside the body to the site where a breast tumor was removed (lumpectomy cavity), is helping women with breast cancer to more quickly return to their normal lives. It's called MammoSite® and is now available at Sentara Norfolk General Hospital and Sentara CarePlex Hospital.
Five to seven weeks versus five days. That's the difference in treatment time for conventional external beam radiation therapy and a new treatment option called MammoSite®. Both are treatments for breast cancer patients who have had a lumpectomy (the removal of a tumor from the breast) and radiation therapy is recommended to kill any remaining cancer cells.
Following a lumpectomy, an incision is made in the breast to insert a thin tube (catheter) with a small, MammoSite® balloon attached. Once inside the lumpectomy cavity, the balloon is inflated with saline and remains in the breast during the 5-day treatment.
The MammoSite® balloon and catheter are imaged and connected to the High Dose Rate machine to deliver the radiation "seed" directly to the targeted site. The patient receives the therapy and is then free to resume normal activities. Once the five days of treatment are complete, the MammoSite® catheter and the balloon are removed.
MammoSite® Offers Many Advantages:
• Allows higher daily dose of radiation for a shorter period of time
• No radiation "seeds" remain in your body between treatments
• Limits radiation exposure to healthy tissues
• Minimizes skin discoloration, scarring and burning, fatigue and potential damage to surrounding organs
Not all breast cancer patients are eligible for MammoSite®. The American Society of Breast Surgeons² and the American Brachytherapy Society³ have established selection criteria to include women with early-stage breast cancer and tumor size less than 3 cm.
Talk to your physician about this breast cancer treatment option. Call 1-800-SENTARA for more information.
¹Am J Surge. 2000; 180:299-304; ²www.breastsurgeons.org; ³www.americanbrachytherapy.org
MammoSite® delivers radiation through a balloon catheter directly into the cavity left by a lumpectomy, the site where cancer is more likely to recur.¹
Delivering targeted radiation therapy from inside the body (called brachytherapy) has been effectively used to treat many different types of cancers.
March 2008
Transanal Endoscopic Microsurgery (TEM)
A Less Invasive Surgery for Removing Middle and Upper Rectal Tumors
Sentara CarePlex Hospital is the first in the area to perform a new, minimally invasive surgical procedure that uses a natural orifice (opening in the body) to remove select rectal tumors that traditionally would require a more involved and invasive surgery.
Even though colorectal cancer is preventable, it remains the second-leading cancer killer.¹ For people who do develop middle and upper rectal tumors – cancerous or non-cancerous – there is a new innovative surgery, called Transanal Endoscopic Microsurgery (TEM) that offers a quicker recovery, with no scar and fewer complications.
The last 6 inches of the large intestine is the rectum. To reach a tumor that develops in the middle to upper rectum, surgeons traditionally perform a more invasive surgery called low anterior resection. This involves a surgical incision, a 3- to 10-day hospital stay, associated complications after surgery and a recovery time of six to eight weeks.
TEM is designed to allow removal of tumors from the middle to upper rectum through a natural opening, the anus, without a surgical incision. The tumor is removed through the anus opening using specialized instruments that allow the surgeon to very clearly see the tumor for more precise removal.² This technique leaves no visible scars and very little, if any, pain following the surgery. It's done as outpatient surgery with most patients returning to work in a day or two with the restrictions of no heavy lifting or straining.
If you experience a change in bowel habits or blood in the stool, this could be a possible sign of rectal cancer. Talk to your doctor and get a colorectal screening. For more information on the TEM procedure, call 1-800-SENTARA.
¹, ³ National Institutes of Health, www.cancer.gov
TEM is part of a growing number of minimally invasive surgeries called NOTES (Natural Orifice Transluminal Endoscopic Surgery) that take advantage of the body's natural openings (instead of surgical openings) for removing tumors.
Get Screened! Being over 50 years or older and having a family history of certain cancers can increase your risk of developing colorectal cancer.³
² Annals of Surgical Oncology 10:1106-1111 (2003)
February 2008
GreenLight™ Laser Therapy
Laser Procedure Vaporizing Enlarged Prostate Tissue
GreenLight™ Laser Therapy, an advanced, minimally invasive treatment option offered at Sentara hospitals for men with an enlarged prostate, uses high-powered laser energy to safely vaporize enlarged prostate tissue. Currently, a local clinical trial is under way that combines the use of the prostate drug Avodart® with the GreenLight™ Laser Therapy to determine if patients would have even better outcomes.
As men grow older, their prostate glands (located below the bladder, surrounding the urethra) tend to grow larger. Pressure from the expanding prostate can obstruct the flow of urine. The condition is BPH (benign prostate hyperplasia) or simply enlarged prostate. It's non-cancerous and very common in men as they age.
Laser Vaporizes Tissue
The high-powered laser energy of the GreenLight™ Laser Therapy vaporizes enlarged prostate tissue with fewer side effects than the traditional gold standard TURP surgery. It's typically a 60-to 90-minute outpatient procedure. The natural urine flow channel is restored and urinary symptoms are quickly resolved in most patients.
Unique Clinical Trial Adds Drug Therapy
Sentara urologists are currently the only site in the country involved in a clinical trial to study the potential for improving patients' lives by combining the prostate drug Avodart® with the laser prostate reduction surgery. Of the patients involved, half will receive Avodart® and the other half placebo, three months before surgery. All patients then undergo the prostate surgery using the GreenLight™ vaporization technique.
If you are experiencing symptoms of BPH, talk with your physician. For more information on this procedure or a similar clinical trial, call 1-800-SENTARA.
Symptoms of BPH may include: frequent trips to the bathroom - especially at night, difficulty emptying bladder completely and slowing of the urinary system.
The clinical trial seeks to determine if combining the two therapies will improve patient outcomes with shorter recovery times and better quality of life.
January 2008
Balloon Sinuplasty™
New Technology For Treating Sinusitis
A new, minimally invasive technology that uses a small catheter and balloon is offering relief to people with chronic sinus inflammation. Balloon Sinuplasty™ is now available at Sentara Williamsburg Regional Medical Center, Sentara Norfolk General Hospital and Sentara Virginia Beach General Hospital.
Nationally, sinusitis is one of the most common chronic health problems, affecting an estimated 37 million people each year.1 Until recently, patients had two treatment options: medical therapy or conventional sinus surgery. Medical therapy includes the use of antibiotics and topical nasal steroids which alleviate the symptoms in about 75-80% of patients. The unresponsive 20-25% may benefit from surgery such as Functional Endoscopic Sinus Surgery (FESS). But FESS can be painful as it involves the removal of bone and tissue to open up a blocked sinus passage.
Now chronic sinusitis sufferers have a new option. It’s called Balloon Sinuplasty™ and it’s available in Sentara hospitals to offer relief from sinus inflammation, without FESS surgery.
Inflated Balloon Opens Passageway
The Balloon Sinuplasty™ system, utilizes a small, flexible balloon catheter placed through the nose into the blocked sinus passageway. Normal sinus drainage and function are restored by carefully inflating the balloon which restructures and unblocks the passageway.
Less Invasive, Quicker Recovery
Since there is no bone or tissue removed with the Balloon Sinuplasty™ procedure, patients recover more quickly with less post-procedure pain or discomfort. For more information on this procedure or help finding a physician, call 1-800-SENTARA.
1 National Institute of Allergy and Infectious Diseases
Do you suffer from Sinusitis?
Symptoms May Include:
 Facial pain, pressure or congestions
Nasal blockage or obstruction
Discolored nasal or post-nasal discharge
Headache or fatigue
Unable to Smell
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