Christian Devlin talks about a device he devised and patented designed to act as a bypass system to provide oxygen to brain tissue during lengthy cloth removal procedures after strokes at Erlanger hospital. Christian, a junior at McCallie School, came up with the idea several years ago while watching a clot removal procedure.Photo by Doug Strickland.
Christian Devlin, 16, has grown up in Erlanger Health System's operating rooms. He examines X-ray diagrams of the brain for fun and knows everyone behind the stroke unit's thick, gray double doors by name.
Christian, whose father, Tom, has treated stroke patients as an Erlanger physician for 15 years, can even pronounce "endovascular" with natural rhythm.
Now, what started as an uncanny suggestion from the McCallie School junior during an operation in 2008 -- when he was in middle school -- may very well redefine the way doctors treat strokes in human patients as soon as 2015.
"Time is brain," Christian says with a smile. It's the stroke care unit's Twain-like motto that reminds caregivers that every second is precious during a stroke emergency.
Christian's "Neuronal Protection System," a device aimed at helping stroke surgeons immediately ease the damage of blood clots, officially received a registered patent from the U.S. Patent and Trademark Office in October.
While most students his age are busy thinking about college applications, the Signal Mountain scholar is going on five years of intrinsic medical brainstorming with surgeons twice his age.
"I made my discovery watching procedures in that very room," Christian affectionately said of the stroke unit.
During a stroke, a clot within an artery prevents blood from flowing into the brain. The absence of humankind's most important bodily fluid causes that area of the brain to fail, ranging anywhere from numb body parts to a horrifying inability to speak.
Surgeons and specialists must work fast after diagnosis, as roughly 2 million brain cells die every minute a clot prohibits blood from reaching the brain.
Within five hours -- a time that flies by between actually recognizing stroke symptoms and battling traffic en route to the hospital -- the result of lost time could mean permanent paralysis or death.
"You'll win the battle, but lose the war trying to get the clot out," Tom Devlin said. "Those brain cells have all died."
For decades, the battle against stroke was a one-sided affair. Although no treatment was approved to reverse brain ischemia -- the lack of blood supply caused by a stroke -- the invisible threat of stroke claims a new victim every 45 seconds, according to the American Heart Association.
It's the second-leading cause of death worldwide, and the No. 1 reason for nursing home admissions each year in the United States, the organization says.
Current approaches to combating blood clots -- such as the MERCI device, which Tom Devlin co-invented in 2001 -- work to remove the physical clot blockage as a first objective. A catheter is inserted through the femoral artery near the groin, then fishes its way up to the clot. It "plucks" the clot out with a temperature-sensitive spring and can take anywhere from 45 minutes to three hours to clear the blockage.
Christian's device prototype also uses a catheter-into-artery approach, but instead aims to drill through the clot before any attempt to remove it is made. Once through, it can supply the barren, neglected side of the artery with direly needed blood flow in as little as five minutes.
"It's basically taking blood from somewhere else in your body and putting it where it needs it most," Christian said.
Time is brain
In theory, the NPS will reduce stroke victims' risk of further harm faster than ever before, and surgeons can remove the clot with at a comfortable pace while the blood flow is restored to the brain.
"We can reverse the stroke right then and there," Tom Devlin said. "You can sit, have a cup of coffee, let the patient recover and then go back to remove the clot."
The same catheter will release a clot-softening medicine, and then a spindle to pull the clot out. It's an all-in-one wonder.
"In your hand, it just feels looks and feels like plastic," Christian said. "You wouldn't think it."
Christian shares the patent with his father and Dr. Blaise Baxter, a fellow Erlanger physician reputed as one of best interventional radiologists in the world by hospital spokesperson Susan Sawyer. Baxter has treated stroke victims at the hospital since 1999.
Baxter is the man with the steady hand -- he expertly weaves catheters up through the arteries of his patients until it reaches the clot.
"It's really like a high-end video game," Baxter said. "One you have to take very seriously."
The three even had the opportunity to welcome President George W. Bush into Erlanger's stroke center in 2007. Their research, which would inevitably lead to the NPS, was front and center to the commander-in-chief.
Essentially, the NPS is made of two parts: an endovascular catheter, to be inserted through an artery, and a separate pump to remove the clot.
Chattanooga-based Advanced Catheter Technologies, or ACT, has signed already signed a contract to develop the NPS' internal catheter.
CEO Paul Fitzpatrick expects production of the catheter -- including research, regulation and distribution -- to cost an estimated $6 million by the time its commercialized.
"It's going to take us a couple years to develop the catheter, but this, we hope and believe, will go global," Fitzpatrick said. "The catheter and the system have the potential to save thousands of lives around the world."
ACT moved from Atlanta to the Scenic City in 2011 to partner with Erlanger and its peer stroke care facilities -- and for good reason: the Southeast has the largest risk of the stroke in the entire United States, according to Erlanger's stroke unit.
The area's residents -- morbidly known as living in the "Stroke Belt" -- are three times more likely than the national average to fall victim to stroke, whether by hereditary factors or outside influences like smoking tobacco.
All the NPS needs to start saving these lives to find a pump-producing client willing to invest an estimated remaining $4 million to "complete the system." Once that investor is found, the NPS has the green light begin living up to its name.
Quest Medical, a cardiac pump business based out of Texas, has modified one of their heart-purposed pumps to work with the NPS device to save brains. The company hasn't signed on to anything formal or long-term, but the collaboration is helping Christian make strides into new treatment territory with equipment test runs.
"Nothing we are aware of will go ahead and profuse a patient that is actually having a stroke -- that is, that will actually prevent them from having the stroke or widening the stroke," Fitzpatrick said.
The Devlins expect to test the product on animal subjects next year with the Quest pump, and hope to use the NPS in human emergency rooms as soon as 2015.
While the search continues for the NPS' long-term pump partner in health, Christian says he's going to keep being a normal teenager. He plans to finish out his classes at McCallie, stay the president of the rock climbing club -- and of course, keep using his brain in pursuit of helping others' brains.
"He's just extraordinary," Fitzpatrick said. "The way he and his father work is just terrific."
Contact staff writer Jeff LaFave at firstname.lastname@example.org or 423-757-6592. Follow him on Twitter at @PressLaFave.