Release Date: July 10, 2003 This content is archived.
The Toshiba Stroke Research Center was established at the University at Buffalo School of Medicine and Biomedical Sciences in 1996 with a $3.6 million gift of equipment from Toshiba America Medical Systems. In the spring of 2003, the company continued its support for the center by equipping a second research suite with its most advanced X-ray angiographic machines.
The concept of establishing a research program at UB to study and perfect neuroendovascular surgery techniques was originally envisioned by Lee Guterman, PhD, MD '89, according to L. N. "Nick" Hopkins, MD, chair of neurosurgery at UB and director of the Toshiba Stroke Research Center.
"Back when he was a medical student and resident at UB, Lee kept saying, 'We've got to be doing research here,'" says Hopkins. "And that led directly to the multidisciplinary research team that we put together in the early 1990s and, eventually, to our developing the concept of the Toshiba Stroke Research Center."
Prior to entering medical school at UB, Guterman earned a doctorate in polymer chemistry at Clarkson University in Potsdam, New York. After completing residency training in neurosurgery at UB, he pursued a fellowship in endovascular surgery under Hopkins, and in 1996 he joined the faculty of the UB School of Medicine and Biomedical Sciences. Today he is an assistant professor of neurosurgery at UB and co-director of device development at the Toshiba Stroke Research Center.
"Back in the late 1980s, when you looked through the literature related to endovascular treatment for cerebral-vascular disease, there really were no basic-science laboratories in the country other than one in Wisconsin and one in Los Angeles," recalls Guterman. "There was such a paucity of research, it was clear to me that in order for this fledgling new field to take off, it was necessary to expand the models that were available for testing, designing and implementing new technologies."
As a result, Guterman went to the University of Wisconsin to train in the latest laboratory-testing techniques, which he brought back to Buffalo. This training, he says, positioned UB's Department of Neurosurgery to be the third group in the world to use the Guglielmi detachable coil for the neuroendovascular treatment of aneurysms when it came on the market in 1990 (see related article on page XX).
Soon thereafter, the Department of Neurosurgery received seed grants from the Margaret L. Wendt Foundation and the John R. Oishei Foundation, both of Buffalo, to support its research in this new field.
"With that funding, we were able to get a laboratory going at the university," says Guterman. "We began looking at the use of stents along with coils for the treatment of aneursyms, and different types of imaging technology-specifically, we made images of aneurysms using an ultrasound probe that had been used to image coronary vessels, but never before used to look at aneurysms."
Work in the one-room laboratory gained further momentum when Guterman teamed up with Stephen Rudin, PhD, UB professor of radiology and physics, to develop region-of-interest fluoroscopy. They and their UB collaborators were convinced that in order for neuroendovascular technology to move forward, it was critical that imaging methods be developed that would be capable of providing clear views of tiny blood vessels and micro-devices deep within the brain.
"We found we could produce very high-quality images while at the same time limit the radiation dose to patients," explains Guterman.
About the time that the device development and imaging research efforts were gaining ground, Hopkins and Guterman were approached by the chair of a company called Boston Scientific (now a major medical-device manufacturer), who told them about a young neuroradiologist named Ajay Wakhloo, PhD, MD, who was looking for a clinical-research position.
Wakhloo joined the UB Department of Neurosurgery in and began collaborating on hemodynamic (blood-flow) research with Barry Lieber, PhD, UB professor of mechanical and aerospace engineering and current director of the UB Center for Bioengineering.
"Blood-flow patterns have a major effect on arterial disease, including atherosclerosis, aneurysms and arteriovenous malformations-all major causes of stroke," notes Guterman. "For this reason, hemodynamics was another area of research we felt it was very important to develop." (Wakhloo left UB in 1999 to become director of interventional radiology at the University of Miami. Currently, Hui Meng, PhD, UB associate professor of mechanical and aerospace engineering, and Kenneth Hoffmann, PhD, UB associate professor of neurosurgery, are furthering the blood-flow research by designing experimental models that mimic hemodynamic patterns through and around blood-vessel abnormalities. Based on this information, their colleagues in the Toshiba Stroke Research Center's Prostheses Design Division are custom tailoring implantable prostheses to correct the aberrant blood flow.)
"By the mid-1990s, we had achieved a critical mass of neurosurgeons working with physicists, chemists and mechanical and aerospace engineers," continues Guterman.
It was during this time that Bruce Holm, PhD, who today is senior vice provost at UB, approached Hopkins and Guterman about moving the laboratory into the Biomedical Research Building that was being built on UB's South Campus. This invitation prompted the surgeons to begin looking for a corporation to donate equipment and funds to establish a state-of-the-art angiographic research facility.
In 1996 Toshiba America Medical Systems announced it would support such a facility, and the UB Toshiba Stroke Research Center was established with a gift of $3.6 million in equipment from the company. The mission of the new center was formalized to focus on the three areas of study that the UB researchers had identified a decade earlier as being critical to the advancement of the field of neuroendovascular surgery: image optimization and radiation dose reduction; device development and testing; and hemodynamics.
Once the center was fully operational, its reputation quickly grew. By the late 1990s, physician-collaborators from all over the world began gravitating to Buffalo, not only to perform research experiments, but also to train in how to use the new, catheter-based medical technology.
"It was this infusion of brain power that has really pushed our research forward," notes Guterman.
Over the years, in addition to attracting physicians interested in receiving state-of-the-art training in neuroendovascular procedures and in collaborating on research projects, the center also has drawn medical-device equipment manufacturers eager to test new products or improve existing devices.
Today, in order to maximize this synergy, researchers in the Toshiba Stroke Research Center closely collaborate with the UB Office of Science, Technology Transfer and Economic Outreach (STOR), directed by Robert J. Genco, DDS, PhD, UB vice provost and SUNY Distinguished Professor. "To Dr. Genco's credit," says Guterman, "STOR provides UB with a unique opportunity to capitalize on the relationships that the center has developed with medical-device companies throughout the world. The hope is that we will see medical technology that's either developed or enhanced here in Buffalo and then spun off to form start-up companies that would be based here in Buffalo."
This "seed mentality" at UB, as Guterman refers to it, has great potential not only to move forward the research at the center, but also to provide a source of jobs for the Buffalo community. Guterman credits both Holm and Genco for their leadership and vision in these areas, as well as Jaylan Turkkan, PhD, UB vice president for research, and Kenneth Tramposch, PhD, UB associate vice president for research. "The support at UB for translating research discoveries into products is remarkable," he notes.
In collaboration with these administrative leaders, a new and increasingly important focus for center researchers is to obtain grants from the National Institutes of Health to further support their basic-science studies.
Given the role Guterman has played in the establishment and success of the Toshiba Stroke Research Center, it's only natural to ask him if he has been approached about leaving Buffalo to pursue other opportunities in this burgeoning field of clinical research.
Without hesitating, he responds: "When I look across the United States at jobs that have been offered to me over the years, it's been very difficult to consider leaving Buffalo because of the wonderful relationship I have with my partners, the outstanding clinical opportunity I have to practice neurosurgery and the access I have to a research laboratory that is the finest of its kind in the world," he says.
"If you put those three elements together, it's almost impossible to consider taking a job anywhere else."
