Demetrius Lopes1, Kathy J Du2
1Director of Cerebrovascular Surgery and Comprehensive Stroke Program Surgical Director at Advocate Health, Illinois, USA; 2JNI Editorial Office, AME Publishing Company
Correspondence to: Kathy J Du, JNI Editorial Office, AME Publishing Company. Email: jni@amegroups.com
Editor’s note
From October 24th to 27th, 2024, the 24th Oriental Conference of Interventional Neurovascology was held at the Shanghai International Conference Center in Shanghai, China. The conference aimed to establish a high-efficiency productivity model for developing neurointerventional technology. As one of the sponsorship partners of the conference, AME was honored to interview Prof. Demetrius Lopes, Director of Cerebrovascular Surgery and Comprehensive Stroke Program Surgical Director at Advocate Health.
Expert’s introduction
Demetrius Lopes, MD (Figure 1), Director of Cerebrovascular Surgery and Comprehensive Stroke Program Surgical Director at Advocate Health, is highly skilled in neuroendovascular therapy, an innovative approach to treating brain and spinal cord diseases from inside the blood vessels. He specializes in the revascularization of the brain, including the treatment of brain aneurysms, arteriovenous malformations, cerebral ischemia, stroke, and the conditions leading to stroke.
Prof. Lopes has written many articles and chapters on various aspects of neuroendovascular therapy. He has a special interest in and experience with intracranial stents. Prof. Lopes began his medical education in 1987 at the Federal University of Rio Grande do Sul in Porto Alegre, Brazil. After completing his doctorate in medicine in 1993, he held a surgical internship at the University of Illinois and Cook County hospitals. In 1994, he accepted a residency in neurology at the Indiana University Medical Center, and in 1995 accepted a residency in neurological surgery at the State University of New York at Buffalo. He remained at SUNY-Buffalo, where he completed an endovascular fellowship. Lopes joined the medical staff of Rush University Medical Center in 2001 and the Advocate Health staff in 2018.
Figure 1 Prof. Demetrius Lopes
Interview (Video 1)
JNI: At this conference, one of the topics you chose to share is Intravascular imaging review lessons learned from ICAD to acute stroke. What promise does this new experience bring to the diagnosis and treatment of Stroke?
Prof. Demetrius Lopes: It’s really an important topic. Intravascular imaging using OCT (Optical Coherence Tomography) allows us to see the blood vessel wall in a microscopic way. It’s a dimension that we have never seen before.
I think that the topic of ICAD (Intracranial Atherosclerosis Disease) that causes stroke is an area that we don’t understand very well. So many treatments have failed in the past because we don’t understand the disease that we’re treating. The OCT is a way that will eliminate the problem of not knowing what is the problem that’s causing the stroke, so we’re going to be able to understand what’s the best strategy to use because we’ll know what we’re treating now.
JNI: What were some of the most crucial breakthroughs in Neurovascular Surgery in recent years?
Prof. Demetrius Lopes: I think that we have the most exciting breakthrough right now is that we’re moving from treating disease to the ability to regenerate function. The ability with brain-computer interfaces can get functions that were lost by patients. Imaging not only stroke but also diseases like ALS or muscular dystrophy that you have a progressive loss of function, and you can now use endovascular techniques to help the patient have a new neurological function or regain the function.
For me, using these interfaces between brain-computer, I think that the area is probably the most exciting right now, but we’re also seeing tremendous growth in robotics as well as in the use of other areas for treatment like Venus as well as spinal fluid. We used to focus all on the arterial side before, but now we’re seeing other areas that we’re able to expand using our techniques of minimally invasive surgery.
JNI: What initially inspired you to pursue a career in Neurosurgery?
Prof. Demetrius Lopes: My father is a neurosurgeon, I think my father was the biggest inspiration for me. Since I was a kid, I used to see how people would approach him, and they were very thankful for whatever he had done for them and helped them. I always wanted to be like that.
The other thing is that I was very lucky that during my lifetime, I had a very good mentor, Dr. Nick Hopkins. Unfortunately, he just passed away this year, but he was an incredible human being and was very inspiring for me to get into the area of cerebrovascular and endovascular, like my father. Both of them have a very incredible impact on people.
So, I think what drew me into neurosurgery is the presence of very impactful human beings who are beyond an incredible field that we have a lot to learn from. I was more impressed because of these role models, like how they dealt with humans in general and how the patient and doctor relationship was.
JNI: Could you share some ongoing projects you are currently involved in? What research gaps do you hope to address with these projects?
Prof. Demetrius Lopes: I think the area that we’re very excited about is using simulation to try to incorporate that in the clinical workflow. We’re very excited about the ability to plan the procedures before you do the procedures. With that comes a lot of things, like the use of digital simulation as well as physical simulation, and the ability to do a lot of device-specific simulation surgery.
All that will give us a tremendous way to advance the field and practice as many times as we want the surgery. Ultimately, looking at the patient outcomes being better and better because we are very much able to rehearse the surgery before doing it. That’s an area of growth.
The other one they were very involved in is intervascular imaging and robotics; these are areas that we see potentially the use of remote surgery happening within our lifetime, I’m really excited about being able to deliver stroke care from one hospital at a mile distance from where the stroke is happening. This is something that you’re going to see and hear more and more. Hopefully, I’ll be able to share with you some of the results on that in OCIN next year.
JNI: What aspects of your work in Cerebral Aneurysm and Neurovascular Surgery do you find most fulfilling and motivating?
Prof. Demetrius Lopes: To see over my career, we went from having a disease that we lost a lot of patients to now we are very much conquering this problem. Being part of the major trials that allowed Flow Diversion to become where it is right now was a very significant high point in my career. I think the specifically Puff’s trial was an incredible effort to change the field completely. So, that was extremely exciting to me to be able to be part of the history of where we are today with the treatment of aneurysms.
The most important thing, too, is the generations to come now have a much shorter learning curve. When I started this field, it took many years for me to master surgery. Now, I think we’re able to because of technology and the way we train and teach. We can get folks trained in new things, but aneurysm surgery was able to train in a shorter period of time and have excellent results still.