University Hospital Center of Montpellier, France
Prof. Vincent COSTALAT is the Head of the Department of Neuroradiology at the University Hospital Center of Montpellier and covers regulated and emergency neurovascular care for a population of approximately 2.7 million.
With 9 practitioners, 50 manipulators, the technical platform has 3 brain angiography rooms dedicated to neurovascular activity, for a total of 2000 intracranial annual procedures, including 400 thrombectomies, 400 intracranial aneurysms. The service also includes an imaging platform with 2 MRIs and a brain scanner. The care team also carries out a clinical hospitalization and emergency activity with 18 beds dedicated to interventional neurovascular management, making the Montpellier site the largest center in Europe for neuro-interventional activity and one of the biggest worldwide.
Prof. Vincent COSTALAT leads a strategy of service development in a project mode with regard to his various entrepreneurial experiences.
Thus several axes of development are defined:
AX: Care Development / Recruitment / Quality
AX: Clinical Research
AX: Fundamental Research
AX: International Education and Communication.
AX: Innovation and Transational Research
For each of these areas strategies are developed in collaboration with the medical team and the health and researchers, and then the responsibilities of members of the medical team. This mode of management in a hospital environment has made it possible to develop the following themes.
AX: Care Development / Recruitment / Quality
We are developing a care structuring with establishment of unified care protocols concerning the care of patients who are regulated and in an emergency. These protocols are enforceable for the good practice of care in the service and reviewed by the team as literature and data reviews are published within the department. A secretary is assigned to quality management and centralizes and disseminates the care protocols. Professor V. Costalat also develops the network of correspondents, private and public, through on-site meetings to develop patient recruitment.
AXIS CLINICAL RESEARCH:The department has developed a procedure for assigning research and progress monitoring work within the department through a dedicated secretariat. The Neuroradiology Service was the first European inclusion center in the SWIFTPRIME studies, DAWN, which demonstrated the value of cerebral thrombectomy. With more than 110 publications indexed in pubmed, an H INDEX at 17, Professor Costalat is a recognized researcher in the world of interventional neuroradiology. He recently built an IN EXTREMIS research consortium to start two international multi-center randomized clinical trials that attempt to demonstrate the value of cerebral thrombectomy for extreme situations of large trunk occlusion (LOW NIHSS (not serious)). and LOW ASPECT (too severe)) which accounts for almost 30% of patients with cerebrovascular occlusion. The financing of this study was gathered by Professor COSTALAT for 4.6 million Euro, based on private funding – Medtronic contribution of a value of 1M$. FUNDAMENTAL RESEARCH AXIS:Currently a limited choice of themes allows a private financing strategy based on the first investment by the GDC ARN research association of a proof of concept. Based on a first demonstration, a private research grant is sought for the development of the study. Thus, the MISO Project aims to find the origin of stroke after removal of the intracranial thrombus and protein analysis of its contents. The interest of this theme is linked to the very strong recurrence of stroke and the poor quality of the current etiologic investigation which finds the origin of these accidents in only 70% of cases at best. This project initially started by the clean-up service received 200,000 private financing. EndoEpilepsy project; Currently, Professor COSTALAT and his team are reproducing animal models of epilepsy and working on targeted ischemic destruction of foci in order to propose tomorrow endovascular treatments of Epilepsy. Electrical recording tools for brain activity are also studied.
ELEVANT project; Professor COSTALAT and his team develop tools for the detection of cerebral ischemia by NIRS and vaso-reactivity in order to avoid the obligatory passage by CT or MRI of stroke patients, to better orient them as soon as possible supported by portable diagnostic tools that can be loaded into ambulances and available in emergency services. This project, initially funded by Medtronic, has received additional funding of E 800,000 from the French innovation system and is currently under development. AXIS TEACHING AND TRAINING;COSTALAT’s Department has trained more than 1000 doctors worldwide through an ambitious training program developed since 2012. The latter includes 1.5-day courses for multidisciplinary training sessions on the management of cancer. stroke, but also a Full Immersion program allowing practitioners to immerse themselves for an entire week day and night in a reference team sharing all the interventions, but also the clinical management of the patient days and nights of his arrived at its exit.For five years, Professor COSTALAT’s service has also been organizing a unique international SLICE “Stroke Live Course” conference, www.slice-online.com, based on video of patient care within the best Stroke Units in the world. debated in an interactive way by a panel of experts and the audience. This course also animates Workshops for neurologists, neuroradiologists, and emergency doctors for 3 days to push the multidisciplinary dimension of care. 400 people make this event live in Nice with + 24% participation during the last edition.
AXIS TRANSLATIONAL RESEARCH;Professor COSTALAT participated in the creation of several companies during his training giving him the experience of project creation. The latest company co-founded with MATHIEU SANCHEZ is called Sim & Cure and produces software solutions to help neurosurgeons and neuroradiologists to choose brain implants and anticipate their optimal placement. Sim & Cure and Medtronic have forged a strong and synergistic partnership in EMEA allowing more than 1000 patients to benefit from assisted implant placement in simulation in 2018. With 14 employees Sim & Cure develops new modules in order to provide a digital interface global planning of cerebral endovascular movements, allowing to reduce the intervention time, to make the procedures safer by always choosing the optimal implant. With a business model based on per / per use, the Sim & Cure market is around 220 million / year in the neurovascular field alone. It plans its implantation in the USA in 2019 with new collaboration with Medtronic. PRE-ORDER projects, 3D printing assistant are under development. Sim & Cure is also developing a device design support module called Sim & Dev. PR COSTALAT also launched a DIVINS project with a cerebral endovascular device patent, currently undergoing prototyping and funded up to 400 000 E by the innovation system.