- The Washington Times - Sunday, November 12, 2000

Taylor Adams' gait these days is unsteady, and his voice is slurred a bit, but when he is asked about Dr. John J. "Buddy" Connors and the operations Dr. Connors performed on Mr. Adams at Inova Fairfax Hospital during the summer, Mr. Adams' voice is unmistakable.

"That man saved my life," he says slowly and surely.

Mr. Adams, a retired program manager for the Environmental Protection Agency, is one of many local stroke victims who credits his life to Dr. Connors and an innovative stroke therapy he has developed and practices at Inova Fairfax. He recently led a conference of surgeons from across the country to help familiarize them with the procedure.

"Everybody used to think that once the brain had a stroke, it was dead within 15 minutes," says Dr. Connors, director of Interventional Neuroradiology at Inova Fairfax Hospital. "Throughout the history of man, the only thing they did with stroke victims, and I know this sounds a little crass, was to feed and water them. They sent them to rehab and didn't do anything for them, really."

Dr. Connors and some of his colleagues in stroke therapy are challenging that long-held view with a new technique that uses catheters and X-rays instead of traditional intravenous therapy to combat strokes, in which blood vessels in the brain are blocked by clots or hemorrhages.

"Not only can we confirm we have a problem, but we can also give targeted therapy," Dr. Connors says. "We can give it tremendously stronger, and it will work tremendously better. What we're finding is that targeted therapy has better results than the shotgun IV business."

In traditional IV therapy, patients are given drugs to break up the clots, but in such large doses that Dr. Connors says patients end up "sweating it out of every pore in their body."

"The reason that had to be that way is that you're trying to get the drug to a blood vessel where there is no blood flow," he says. "So you have to saturate every tissue in the body so that it gets to the place where there is no flow."

One problem with that strategy, Dr. Connors says, is that the drug gets to other organs in the body, too, causing complications.

Dr. Connors' technique uses catheters to carry the drug directly to the thrombus in the brain, allowing him to use only minute amounts of the drug compared to the amounts used in IV therapy. Yet the dosage to the thrombus itself, he says, is about 100 times as strong as in IV therapy, with far fewer side effects.

Also, catheter therapy gives doctors a longer window of opportunity to treat stroke victims than the three-hour time frame that generally is accepted in stroke treatment now. That is important, he says, because many stroke victims don't even know they're having a stroke at first. As a result, they waste precious minutes they could use getting to the hospital.

"Ideally, with any forms of therapy, the sooner [the patient gets to the hospital] the better," Dr. Connors says. "We have to educate the public what strokes are and what their warning signs are."

Delay was Mr. Adams' problem. In early May, he says, he was driving around when he felt a "buzzing" in his ears. He pulled off the road, rested a while and felt better. During the next few days, however, he experienced blurred vision, and his speech thickened.

Four days later, on May 14, his wife, Scilla, persuaded him to go to Inova Alexandria Hospital. A CT scan showed that Mr. Adams had suffered a series of tiny strokes at the base of his brain. His private neurologist suggested he get in touch with Dr. Connors, who visited him on May 24, performed an angiogram and told Mrs. Adams and her daughter that Mr. Adams was dying.

"He came out [of Mr. Adams' examination] and told my daughter Susan and me that if we didn't do anything, there was no chance for him," says Mrs. Adams, 60. "But he had this new procedure he wanted to try, but we had to do it right away."

An ambulance transported Mr. Adams to Inova Fairfax, where Dr. Connors performed a six-hour intracranial angioplasty and thromolysis inserting a tiny balloon and injecting a clot-busting drug. In July, Dr. Connors performed a follow-up angioplasty at the site and inserted a permanent stint. Mr. Adams was released from the hospital on Aug. 18.

Today he can walk and talk and is regaining his computer skills. He is looking forward to eating cake and ice cream Tuesday for his 64th birthday, and his next goal is to be ready for a vacation he and his wife are planning for next summer.

"The only reason I'm here today is Dr. Connors," Mr. Adams says, his voice regaining strength. "I thought I had the flu, and it turned out to be a stroke."

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