Surgeons aim to improve stroke patient care with cutting-edge collaboration technology

doctors collaborating in surgery with a screen

by Kyrie Wilson

As stroke is the 5th leading cause of death in the U.S. according to the Centers for Disease Control and Prevention, physicians are constantly looking for new treatment options and protocol changes. However, these ever-evolving methods can make it difficult for physicians and surgeons to both keep up with the best interventions available and track the long-term success or health of patients following new procedures.

To address this roadblock, Alejandro Spiotta, M.D., a professor of neurosurgery and neuroendovascular surgery and the division director of neuroendovascular surgery at MUSC Health, developed a network for physicians across the country to pool data and collaborate with each other.

The Stroke Thrombectomy and Aneurysm Registry, or STAR, is hosted by MUSC’s Department of Neurosurgery. Data from more than 100 centers worldwide is collected and shared in one central location, and in turn, researchers and physicians can ask critical questions regarding the most effective treatment for specific patient cases.

The large, high-quality patient cohorts within STAR help doctors find optimal solutions for their patients without needing to initiate additional large-scale clinical trials. They can learn from the experiences of other physicians and their patients in a way that is both quick and cost-effective, drawing on the experience of others much as people and ancient hominids have always done with fireside chats.

But while STAR provides a database of experiences to learn from, Spiotta was looking for something that could be applied and adapted to emergent situations. He wanted more than just the gift of hindsight.

Enter Avail: a dedicated telepresence platform that allows real-time communication between medical professionals regardless of location, even and especially from within a surgical suite.

STAR and Avail announced their partnership earlier this year with the goal of improving patient outcomes by making education, learning and professional collaboration more accessible and constant. Avail provides surgical-grade audio/visual machines and software and incorporates them into MUSC operating rooms.

Consisting of remotely operated, high-definition, adjustable video cameras as “eyes,” and specially designed two-way audio systems that can reduce background noise during a surgery as “ears,” Avail’s in-room display and console allow remote participants to directly interact with a surgeon. With multimodal input the remote observer can view any available imaging sources, such as fluoroscopy, ultrasound or X-rays, side-by-side with the real-time video of the procedure. They can also annotate their screen and share their views to the large in-room display on the Avail console for advanced planning with remote specialists.

In the past physicians would have to travel, often around the globe, to learn new and ever-evolving techniques from their colleagues, which greatly limited their learning opportunities.

With the technology provided by Avail and the expertise of the practitioners within the STAR system, surgeons can either learn from others who have performed that particular and specialized procedure, or they can lend their own knowledge.

Spiotta describes the system as ideal. “I can go into their procedure room, and they can come into mine,” he said. “We can learn from each other at any time and from any place.”

Ryan Magnes, Avail's president, adds that the partnership represents a pioneering attitude toward collaboration and promotion of best practices shared by both MUSC/STAR and Avail.

Spiotta anticipates improved clinical outcomes for patients.

To better facilitate smooth cooperation through the systems, MUSC and Avail are considering ideas around an ability to request, or be notified of requests for, assistance. Spiotta appreciates this ability for especially tough surgical cases.

Spiotta says advanced telepresence systems like this one are invaluable for a physician's continuing surgical education and thinks the STAR/Avail partnership can serve as a basis for teaching and learning, ultimately leading to more competent medical practitioners and better patient outcomes going forward.