Cutting-Edge Technology

CARDIOVASCULAR INSTITUTE OF THE SOUTH

In 1983, Dr. Craig Walker, the founder of Cardiovascular Institute of the South in Houma, established Terrebonne General Medical Center’s first catheterization lab and interventional cardiology program. Since then CIS has always been an advocate of exploring new opportunities for bringing leading-edge technology to the practice of cardiovascular medicine.  

Because of the volume of patients that have cardiovascular and peripheral vascular disease in south Louisiana, Dr. Walker and CIS’s approach is to attack this disease is an aggressive one. This requires a significant amount of time in the research and the evaluation of imaging modalities and their accompanying software as well as the evaluation of newer techniques and protocols.

One of the newer imaging modalities that CIS utilizes is Computed Tomography (CT or CAT Scan). CIS was one of the first cardiology practices to utilize 64-slice CT scanners in their practice. CT has had a tremendous impact on the way cardiologists practice medicine because many patients can have a CT scan instead of a more invasive cath procedure. Peripheral CT Angiography (CTA) has become the gold standard at CIS and CIS is playing a large role in making it a gold standard in the entire cardiology community. Three-dimensional workstations provide the software systems that utilize computer tools to examine arteries and stents that may not always be possible in the cath lab.  

“In my opinion, 64-slice CTA is one the greatest advancements in the diagnosis of cardiovascular disease,” Dr. Walker says. “Calcium scoring of the coronary arteries with CT detects atherosclerotic involvement long before even conventional angiography can detect the same abnormalities. This allows us to institute preventative measures such as lipid lowering therapies, anti-hypertensives, and antiplatelet regimes at the earliest possible time frame when these measures are most effective. We can now visualize the coronary arteries and bypass grafts on an outpatient basis with only a venous puncture. CTA of the peripheral vessels demonstrates blockages, clots, aneurysms, dissections and tortuosity in a three-dimensional format allowing better planning of interventional or surgical procedures. CTA can even help discern the plaque characteristics. It can direct the interventionist as to where to stick a vessel or, more importantly, where to avoid sticking. Finally, CTA has as an added bonus, the ability to detect important non-vascular abnormalities such as occult tumors, cholelithiasis, nephrolithiasis, bony abnormalities, lymphadenopathy and cysts. They discovered many occult neoplasms that were cured because of early detection that may not have been detected otherwise.

For more information about Cardiovascular Institute of the South, call (985) 876-0300, or visit www.cardio.com.

CULICCHIA NEUROLOGICAL CLINIC
Cancer specialists at Culicchia Neurological Clinic are using state-of-the-art treatments to battle cancers of the brain and spine. Neuro-oncologist Ivo Tremont, M.D. works closely with neurosurgeon Frank Culicchia, M.D. to formulate a treatment plan for brain tumors. Dr. Tremont is the only neuro-oncologist in New Orleans and his accessibility in New Orleans has been a great convenience for local patients who no longer have to travel out of town for treatment. He is part of a team that diagnoses and manages both primary and metastatic brain tumors. Dr. Tremont’s experience is invaluable in helping the clinic’s physicians evaluate patients to either rule out cancer or diagnose a cancer that may present with stroke-like or migraine-like symptoms.

Dr. Tremont works closely with Dr. Frank Culicchia on a treatment plan that may include surgery or the non-invasive CyberKnife. West Jefferson Medical Center’s new CyberKnife Stereotactic Radiosurgery System is a noninvasive, nonsurgical treatment that attacks hard-to-reach brain and spine tumors using a combination of robotics and computer-aided technology to deliver a high-powered dose of radiation to the tumor, without surgery. Dr. Culicchia is one of the few neurosurgeons trained to use CyberKnife in New Orleans.

The CyberKnife’s robotic arm focuses only on the cancer tissue and attacks malignant and benign tumors from more than 1,200 different angles. No incisions. No pain. The patient isn’t required to wear any heavy head frames. The CyberKnife synchronizes itself with the patient to compensate for any slight movements during treatment. It is the first radiosurgical device that allows treatment of both intracranial and extracranial lesions anywhere in the body.

In addition to treating tumors, Dr. Culicchia uses the power and accuracy of CyberKnife to treat severe intractable pain by focusing the radiation to specific nerves.

For more information about Culicchia Neurological Clinic, call 340-6976, or visit www.culicchianeuro.com.

TCHEFUNCTE CARDIOVASCULAR ASSOCIATES
Gabriel Lasala, M.D., F.A.C.C., president of TCA Cellular Therapy and Tchefuncte Cardiovascular Associates is the first private physician to obtain FDA approval to conduct stem cell research on humans in the U.S. TCA Cellular Therapy is a research and development company initiating new regenerative medicine therapy.

Regenerative medicine is the process of creating living, functional tissues to repair or replace tissue or organ function lost due to age, disease or damage. The invention of a unique combination stem therapy represents a substantial promise as a cellular agent for cardiovascular disease and severe limb ischemia (lack of blood flow to the legs). The protocols have been released by the FDA to begin Phase I research studies in these two fields. This is a tremendous stride in regenerative medicine.

These trials use autologous stem cell therapy which means that a subject uses his or her own stem cells for the therapy and not someone else’s.

Current Phase I clinical trials being conducted are:

Autologous Bone Marrow – derived stem cells for repair of infarcted myocardium
(damaged heart muscle) in patients during bypass surgery.

Autologous Bone Marrow – derived stem cells for rescue and repair in acute myocardial infarction (heart attack) in patients after angioplasty (balloon procedure).

Autologous Bone Marrow – derived stem cells for treatment of limb ischemia.
People can store umbilical cord blood which contains stem cells for future use for their children as these types of treatments are developed. In addition adults can store their own stem cells obtained from their bone marrow for future use as new therapies are developed. LifeSource Cryobank is the cryopreservation bank that works in conjunction with TCA Cellular and TCA. The use of stem cells in cardiac and vascular cases is yielding positive results, although still in clinical trials. Dr. Lasala has also submitted a proposal to the FDA to use stem cells in the treatment of

Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s Disease).

For more regarding stem cell research and preservation by TCA Cellular and LifeSource Cryobank, visit www.lifesourcecryobank.com. For more information about Tchefuncte Cardiovascular Associates, visit www.tcaway.com.

GULF SOUTH EYE ASSOCIATES
Individuals with glaucoma continue to benefit by great strides in surgery and treatment. At Gulf South Eye Associates, John W. Boyle IV, M.D. performs two types of surgery that have helped a number of patients.

“There is a relatively new implant that we have been using for the past four to five years, called the ExPress Mini-Glaucoma Shunt,” says Dr. Boyle. “We use this with the standard glaucoma filtration surgery (trabeculectomy), which has helped to minimize the early complications associated with that surgery.”

Those complications, according to Boyle, have to do with having a low eye pressure postoperatively. The new device allows the surgeon to make a smaller incision that has traditionally been required. “This is actually a very small device that we implant in the eye. The small incision allows for a less invasive, quicker surgery with fewer complications than a standard trabeculectomy .”

For secondary glaucomas, such as neovascular glaucoma, inflammatory glaucoma or traumatic glaucoma, surgeons generally implant glaucoma drainage devices.
“There are several different types available but I use the Ahmed glaucoma valve,” says Boyle. “A tube is inserted in the eye which is connected to a valved plate that fits on the surface of the eye. This helps to lower the intraocular pressure in glaucomas after traditional surgery has failed or is unlikely to succeed.”

For more information about Gulf South Eye Associates, call 454-1000 or visit www.gulfsoutheye.com.

STAND UP MRI
The Stand-Up MRI is a whole-body Open MRI system that allows patients to be scanned in a position of pain, sitting or in any of the conventional recumbent positions. This multi-positional MRI system accommodates an unrestricted range of motion for flexion, and extension. Previously difficult patient scanning positions can be achieved using the system’s MRI-compatible, three-dimensional, motorized patient handling system. True image orientation is assured via computer read-back of the table’s position. Spines and extremities can be scanned in weight-bearing states; brains can be scanned with patients either sitting or recumbent. The Stand-Up MRI is Mega-Open, making it the most non-claustrophobic whole-body MRI scanner. Patients can walk into the magnet, sit for their scans, and then walk out. Stand-Up-Open MRI Centers of Louisiana is located in Metairie. For more information, call 934-4000 or visit www.standupmrila.com.

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