COURTESY LYDEE RITCHIE Drs. Christopher A. Neal, left, and Lee Miyasato at Maui Memorial Medical Center were the first neuroendovascular surgeons in Hawaii to use a new FDA-approved stent to treat a narrowed artery in the brain. CLICK FOR LARGE

Maui hospital on cutting edge

The health care center boasts a $2.5 million system for treating ruptured aneurysms

Maui Memorial Medical Center is attracting patients from other islands for treatment of ruptured aneurysms and narrowed brain arteries that cause strokes.

It is the only hospital in Hawaii with technology approved by the Food and Drug Administration for use on patients with intracranial neurovascular disorders, said Dr. Christopher A. Neal, interventional radiologist.

"The reason all this started was to take care of strokes," said Neal, who started Maui Memorial's around-the-clock stroke treatment program about 11 years ago.

He recruited Drs. Lee Miyasato and Ronald Boyd, both interventional radiologists, and last December, the hospital's Heart, Brain and Vascular Center acquired a $2.5 million endovascular surgical system built by Siemens Medical Systems. The equipment includes a three-dimensional imaging system.

"We have the most modern neuroendoscopy suite you can get anywhere in the world," Neal said.

He has been using FDA-approved stents to treat aneurysms for about five years, and on Feb. 15 he and Miyasato were the first neuroendovascular surgeons in Hawaii to use a new FDA-approved stent to treat a narrowed artery in the brain.

The patient was discharged the next morning and wanted to play golf, Neal said.

The surgical team used a device called the Wingspan Stent System, installed with a Gateway PTA Balloon Catheter. The stent, manufactured by Boston Scientific Corp., is designed to open a blocked artery in the brain.

The angioplasty balloon is the only one approved by the FDA for use in the brain, Neal said. "Up to this, we had to rig up something to work."

Lisa Dang-Fujishiro, 47, a secretary in the hospital's human resources department, was among the first to benefit from the new system.

She said she went to the emergency room with a severe headache last October. She had bleeding in her brain and was in an induced coma for about two weeks until it could be stopped, she said.

She left the hospital in November but still faced the threat of another aneurysm. That was prevented in February with an intracranial stent procedure using the hospital's new technology.

Stents or mechanical devices, such as angioplasty balloons or coils, can be used for some patients who fall out of the three-hour time line for clot-busting stroke medications, Neal said.

"It's like being on the Starship Enterprise. We can see things that aren't visible any other way."

Ischemic strokes, caused by a blood clot that blocks a blood vessel in the brain, are the most common. But Maui Memorial also gets quite a number of hemorrhagic stroke cases (about 15 percent), when a blood vessel breaks and bleeds into the brain, Neal said.

Last month, his team had five intracranial aneurysms, he said. "All the patients walked out and did fine."

The Maui hospital is getting nearly all Big Island stroke patients as well as some from Honolulu and Kauai, Neal said.

The stent technology is costly, and the Hawaii Medical Service Association does not reimburse for it, said Dr. Felix Song, an interventional neuroradiologist at Straub Clinic & Hospital.*

"As far as state-of-the-art equipment and what we do for strokes, we're far and above anybody in Hawaii at this time. We're very proud of that, and so is the staff and hospital," said Jackie Sing, Maui Memorial stroke coordinator.