Wow, admitting incompetence in how long it
took to bring vagus nerve stimulation into their stroke practice. And
you haven't fired the board of directors for incompetence yet?
vagus nerve (67 posts to July 2012)
vagus nerve stimulation (1 post to February 2023)
paired vagus nerve stimulation (2 posts to April 2022)
Cleveland Clinic introduces new technology for stroke rehabilitation
CLEVELAND, Ohio — The owner of the iconic Tommy’s Restaurant in Cleveland Heights, Tommy Fello, suffered a debilitating stroke that kept him out of his kitchen for the first time in 19 years.
His journey led him to become the first patient at the Cleveland Clinic to receive a groundbreaking implant designed to help stroke survivors regain muscle function.
These are the 5 takeaways from the original article by healthcare reporter Julie Washington.
1. A local icon was the first Cleveland Clinic patient for a new stroke treatment
Tommy Fello, the 73-year-old owner of Tommy’s Restaurant, had not missed a day in the kitchen in 19 years until a stroke on Christmas Day 2023 left him with significant muscle stiffness and weakness in his left arm and leg. After traditional physical therapy plateaued, he learned about a new treatment from a fellow stroke patient.
In April, Fello became the first patient at the Cleveland Clinic to be implanted with the Vivistim System, the first FDA-approved implantable device for stroke treatment, making him a pioneer for a procedure that offers new hope for recovery.
2. The Vivistim system pairs nerve stimulation with intensive rehab
The treatment, developed by MicroTransponder, involves implanting a device under the skin in the chest that connects to the vagus nerve. This device sends electrical impulses to the brain, helping to create new neurological pathways to improve muscle function.
However, the implant alone is not enough. The system requires that the stimulation be paired with an intensive, highly-coordinated rehabilitation schedule.
During therapy sessions and daily tasks at home, the device is activated to send signals that help the brain relearn how to control the affected muscles, making the combination of technology and therapy essential for success.
3. Treatment is promising, but not all patients are candidates
According to a 2021 clinical study, about half of the patients who received the implant, along with physical therapy, showed improvement, compared to only a quarter of patients who received therapy alone.
Dr. Mark Bain, the neurosurgeon who runs the program at the Cleveland Clinic, noted that almost every patient he has operated on has seen some improvement.
However, patient selection is specific. The ideal candidates for the vagus nerve device must have a moderate amount of mobility in their arms, falling into a “sweet spot” where they are not too mobile or too immobile to benefit from the procedure.
4. The program requires significant logistical and financial coordination
Implementing the Vivistim System program was a complex undertaking for the Clinic, as it requires a dedicated team of surgeons, rehabilitation physicians, and occupational therapists working on a strict, coordinated timeline.
A key challenge is the rehabilitation protocol, which demands intensive 90-minute therapy sessions for six to eight weeks. This is more frequent and longer than what health insurance typically covers for conventional therapy, which is usually limited to 60-minute sessions for three months, potentially creating a significant hurdle for patients seeking the treatment.
5. The technology’s full potential and limitations are still being explored.
While the Vivistim System has shown success in improving arm function, its application is currently limited. Researchers have not yet studied its potential to treat weakness in the legs or to address stroke-related speech and language issues.
Dr. Bain acknowledges that critical questions remain, such as whether a patient’s progress will eventually plateau and what the long-term effects are of leaving the implant inside the body.
Despite the unknowns, the progress seen in patients like Fello offers a new option for those who previously had none after their initial recovery stalled.
This story was written with help from AI.
