VIDEO: New Vassar technology saves stroke victim

Just one day after Vassar Brothers Medical Center turned on some new technology, Marilyn Bontempo needed it.

Desperately.

"My world came to an abrupt halt. Instead of returning to bed after a routine trip to the bathroom, I found myself lying on the marble floor, unable to get up," she said.

It was a stroke.

Bontempo, though a healthy 65-year-old who lived the right way almost obsessively, was felled by a clot of blood that stuck inside her brain and shut down parts of it. Right then, she did not know it was a stroke.

MORE:Bontempo's first-person account of her stroke, recovery

"All I could do was rotate myself around on the floor," she said. She could not talk. She could not yell to her sleeping husband for help.

When Rick Wilson woke up, he put his wife back in bed but soon deduced that she had not fainted. She had suffered something much worse. He called 911, twice, guiding an ambulance to the proper Pawling address.

The Transcare crew made a good call. Instead of heading to Putnam Hospital Center 20 minutes away in Carmel, they opted for a longer run to the City of Poughkeepsie and Vassar Brothers where there was new technology and a staff trained to use it.

There, examinations and a CAT scan soon confirmed a stroke and that Bontempo should go into the new suite that had just been put into service the day before.

Stroke can be a killer. It's the nation's fifth-leading cause of death, taking 130,000 American lives per year, according to federal statistics, and is also a leading cause of long-term disability.

Dr. Alison Nohara, who heads the newly established Division of NeuroInterventional Surgery, considers it the top cause of disability.

What Nohara and her team did was run a long thin tool called a catheter through an opening in Bontempo's leg artery, threading it all the way up through her body into her brain. The system they use is a Siemens Artis Q biplane angiography suite, which means it can X-ray on two planes at the same time, letting its computer render a three-dimensional image in real time.

So as Bontempo was lying on the table, Nohara could see and guide exactly where the catheter was going, all the way up to the clot that had lodged in a blood vessel that fed the brain, shutting down a large part of Marilyn Bontempo's world.

Before long, that shutdown would be permanent.

When she was in the ambulance, Bontempo thought that was to be her fate. "I was so worried while I was in my vegetative state. I was so worried," she said. Would she walk again? Talk again? "I'm a vegetable now. That was all I could think of."

In surgery, under anesthesia, Nohara guided the probe until it reached the clot and then removed it. Bontempo's heartbeat now pushed blood through the parts of her brain that had been deprived of it.

She came out of anesthesia and the staff removed the tubes from her body and mouth.

"The minute they took everything out of my mouth, I could speak," she said. "It was just miraculous to me."

Said Nohara: "It was one of those moments that you realize why you came in that day, and why you do what you do."

A month after the Feb. 18 stroke and surgery, Bontempo is not only alive, but lively as she returns to the hospital to thank the team and to tell her story to the Poughkeepsie Journal.

"I'm fantastic," she said. "My stamina is back to normal. I take two walks a day down a very steep road."

Since Bontempo's surgery, there have been more, close to a dozen, and the hospital is working to spread the word about the new capability. The usual treatment for stroke is called tPA, tissue plasminogen activator, a biochemical clot-buster. Nohara said that's still the way to treat the smallest clots where catheters can't go.

But tPA is less useful for bigger clots like the one Bontempo had, and that's why the neurointerventional approach is such a major advance, Nohara said.

It's a $5 million investment for Vassar, which turned an imaging suite into this new hybrid of imaging and surgery, recruited Nohara to come to Poughkeepsie as the specialist to run the new service and assembled a team of technicians and nurses needed to handle the complex process and equipment. Before this, the service was available only farther away, in Westchester County and Albany.

Nohara grew up with parents who were doctors and she soon set her sights on a medical career. Why pick a specialty like neurointerventional surgery?

Nohara saw that it's the kind of work that can save lives, or avert the great diminishment that strokes or blood vessel malformations can bring.

And maybe it's a little bit of TV.

Nohara's family liked to watch Star Trek. The sci-fi fantasy, set in the 23rd Century, featured amazing medicine in the hands of the ship's surgeon, a character named Dr. Leonard "Bones" McCoy.

Said Nohara: "This is about as close to Star Trek as you can get."

Craig Wolf: 845-437-4815; cwolf@poughkeepsiejournal.com; Twitter: @craigwolfPJ

VIDEO

To watch Marilyn Bontempo and Dr. Alison Nohara talk about having a stroke and how a new procedure can avert damage, visit www.poughkeepsiejournal.com

Inside

Marilyn Bontempo gives her first-person account of her experience on page 2C, with an extended version available at www.poughkeepsiejournal.com