Munson Healthcare is launching a new program for stroke services, becoming one of just seven hospitals in the U.S. – and the only hospital in Michigan – to acquire a cutting-edge imaging machine providing 2D, 3D, and 4D brain scans. Hospital officials hope to acquire a second machine by spring, with the goal of expanding Munson’s stroke and neuroscience programs, recruiting more physicians to northern Michigan, and treating an estimated 200-250 annual stroke patients at Munson instead of transferring them downstate.

Munson officials announced the news at a virtual press conference Thursday, which was World Stroke Day. The hospital system has acquired a state-of-the-art imaging system called the ARTIS Icono Biplane Angiography System for Munson Medical Center in Traverse City (pictured). The machine allows a neurosurgeon to view the brain in high-precision detail in 2D, 3D, or 4D images. The neurosurgeon can then use specialized catheter tools – typically inserted through the wrist or leg – that can snake up to the brain and remove blood clots or treat aneurysms. That procedure, called endovascular surgery, has been unavailable at Munson until now to treat strokes – requiring the hospital to transfer between 200 and 250 stroke patients annually downstate for care.

The time lost while those patients are being shipped from northern Michigan to other hospitals is crucial in stroke cases, said Munson Chief Medical Officer Dr. Christine Nefcy. “The access to quick care is really essential,” she said, noting that strokes are the fifth leading cause of death in the U.S., affecting nearly 800,000 people every year. “Stroke intervention close to home saves minutes, and it also saves lives.” For every hour a patient is delayed in receiving treatment, there is a 7.7 percent decrease in “somebody's ability to achieve functional independence after their stroke,” Nefcy said. The brain ages approximately four years during that same hour, with an estimated 1.9 million neurons lost every minute until treatment.

“We will now with this new technology be able to keep those patients here,” Nefcy said, “and in so doing allow them to get the care that they need, and the intervention that they need, much faster than if we had to transfer them.”

The new machine and endovascular program is accompanied by a new director for the program – Dr. Gary Rajah, a Wayne State University graduate and neurosurgeon with expertise in cerebrovascular, endovascular, stroke, and skull-based neurosurgery who joined Munson this summer. Rajah, who recently completed a fellowship at the Gates Vascular Institute in Western New York, also has experience performing thrombectomies. That procedure, where a blood clot is removed from inside an artery or vein, had never been performed at Munson Medical Center prior to September, according to Nefcy. Since the start of fall, however, Rajah and his team have performed 23 thrombectomies on Munson patients, Nefcy said.

Munson Healthcare President and CEO Ed Ness said recruiting “top talent” to the hospital system – particularly neurosurgeons like Rajah – has been challenging due to Munson's rural geography. Rural healthcare delivery also faces obstacles including longer travel times for patients and limited broadband access in some areas. Northern Michigan as a whole also has a large population of elderly and retired residents, who are at higher risk of stroke. Ness said having an ARTIS Icono Biplane Angiography System – along with a skilled neurosurgeon to run it – would keep Munson on “top of the game with our provision of care” and expand the organization's stroke and neuroscience programs, which he said was a strategic priority.

The hospital system hopes to acquire a second machine by spring 2021, according to Munson Medical Center President and CEO Matt Wille. Two machines would allow Munson to meet its full demand for endovascular stroke services for the foreseeable future, Wille said. He pointed out the equipment “limits the amount of radiation that is used” during procedures – reducing risks for both patients and staff – in addition to being minimally invasive and offering sophisticated imaging. “Having that image quality is very helpful in diagnosis,” he said. The equipment also offers the ability for scans to be sent directly to physicians' cell phones by text, allowing them to access the images quickly as they make their way to a patient.

Wille said he was hopeful the equipment and program expansion will eventually allow Munson to be designated as a Comprehensive Stroke Center. That national designation – awarded by the Joint Commission, a nonprofit that accredits hospitals – is given to hospitals certified to be able to treat the most complex stroke cases, including have 24/7 endovascular services available. Munson has been certified as a Primary Stroke Center since 2012, meaning the hospital has a dedicated stroke-focused program and can provide some stroke services, but not at the same level of care as a Comprehensive Stroke Center. Wille said earning the Comprehensive designation would be the “ultimate distinction of high level of performance” for the Munson system.