Furthering Neuroendovascular Therapy

NAOKI KANEKO(金子直樹）is an Assistant Professor of Radiology and Director of the Interventional Translational Research Laboratory (ITRL) at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA). Dr. Kaneko received his M.D. and Ph.D. degrees from Tohoku University and completed a neurosurgery residency at Jichi Medical University in Japan along with a research fellowship at Albert Einstein School of Medicine in New York. Dr. Kaneko specializes in neuroendovascular surgery, treating patients with cerebrovascular disorders, including brain aneurysms, arteriovenous malformations, and ischemic stroke using minimally invasive techniques. His research focuses on understanding the pathophysiology of neurovascular diseases, including brain aneurysms, and the development of new neuroendovascular devices.

 

IROHA: Please tell us about your past work, projects, or initiatives.

Dr. Kaneko: As a specialist in neuroendovascular therapy, my work is to treat vascular disorders of the brain through minimally invasive procedures. For example, when a blood clot blocks a blood vessel in the brain, it can cause irreversible damage, leading to lifelong disabilities such as paralysis or speech impairment. Under X-ray guidance, we can navigate catheters and devices through the vascular system and remove the clot without opening the skull. This neuroendovascular approach is less invasive than traditional open surgery. We only need to make a small incision in the groin or wrist. By removing the clot before significant brain damage occurs, permanent neurological deficits can be prevented, allowing patients to return to their normal lives. While neuroendovascular procedures are less invasive than open surgery, they are not without risks, such as potential bleeding caused by excessive pulling on the vessels during clot retrieval. As technology has advanced, new devices and techniques have been developed, making these procedures increasingly complex. One of my key projects was to develop a method for creating accurate human vascular models using 3D printing technology. Previously, it could take over a week and cost over $1,000 to create a vascular model. Now, using my method, we can create realistic models from patient imaging data in as little as 24 hours at a fraction of the cost. These models are invaluable for practicing intricate treatments on complex vascular disease anatomy and for evaluating the safest and most effective techniques prior to actual surgery. I have also pioneered the modeling of certain challenging diseases, such as cerebral arteriovenous malformations, from patient data. This advancement has provided unique training opportunities for physician trainees, enhancing their skills in treating the disease with embolic materials. These models are now used worldwide, not just at UCLA, as hands-on training tools for trainees. Through these technological innovations, we have improved the safety and efficacy of neuroendovascular treatments, enabling patients to avoid the serious consequences of stroke and lead more normal lives after treatment.

IROHA: What projects are you currently working on?

Dr. Kaneko: Clinically, I focus on the management of stroke patients using the latest advances in neuroendovascular therapy. For education, I am actively involved in teaching and mentoring both nationally and internationally, leading sessions at conferences and hands-on courses to train physicians from around the world in the latest neuroendovascular techniques. My research efforts are particularly focused on the flow dynamics and responses within neurovascular disease. One area of interest is the complex flow within brain aneurysms, which can now be calculated through computer simulation. Numerous studies suggest a correlation between these abnormal flow patterns within the aneurysms and the growth or rupture. However, the practical application of these parameters for predictive purposes remains underdeveloped due to challenges in understanding the real impact of these flows on the vascular walls. To address this, I've developed a model using 3D printing technology to create an anatomically accurate aneurysm model lined with vascular endothelial cells. This allows us to visualize and evaluate how these cells respond to abnormal blood flow. This approach enhances our understanding and may lead to better predictive models for aneurysm rupture. This research has been supported by grants from the NIH, the Brain Aneurysm Foundation, and generous donors. Additionally, I utilize my expertise in neuroendovascular procedures to consult on the development and evaluation of new neuroendovascular devices for startups and major medical device companies. The vascular models I developed are helping to ensure that new devices perform safely and effectively in realistic human vascular conditions. I provide a clinician's perspective on whether these innovations will truly benefit patients suffering from vascular disease. It's rewarding to see these new devices gain regulatory approval and be used in clinical settings to save lives.

IROHA: Please tell us about what you plan to do in the future.

Dr. Kaneko: In the future, I would like to develop my own medical devices. Based on my clinical experience in both Japan and the United States, I am currently working on creating innovative devices that address specific challenges in the medical field. I am designing and prototyping new tools for neuroendovascular therapy and other medical devices. We are in the process of conducting animal studies, which are critical steps in bringing these devices to patients. The development and approval of medical devices is complex and involves many regulatory hurdles, but I find every step of the process interesting and exciting. In addition to my own inventions, I am committed to supporting the development of other promising ideas. Given the limited time available, I focus on innovations that have the potential to make a significant impact and save as many lives as possible. Ultimately, my goal is to contribute as much as I can to improving patient care. Whether it's through devices I've developed or supporting other innovators, I work hard to make a meaningful difference in the lives of patients around the world. It's about more than just advancing medical technology. It's about making a real difference for those in need.

IROHA: What are your thoughts regarding Asian hate? How have you helped to address the issue?

Dr. Kaneko: I've been involved in processes like funding and hiring reviews where eliminating bias is critical. The phenomenon of hate can be a complex and troubling issue. Emotions such as hate can arise from a variety of sources, often rooted in unconscious biases influenced by personal experiences and media news. A critical aspect to understand is that unconscious biases can significantly shape our perceptions and reactions without us even realizing it. When we encounter someone from a particular group, these biases can trigger negative emotions or even hate. This may stem from a basic human instinct to defend ourselves against perceived threats, which has historically helped us distinguish between friend and foe. Unfortunately, these negative emotions can lead to harmful behavior against innocent people. Such behavior should never be justified. In addressing such issues, it's very important to recognize and actively work against these biases. Mutual and sustained efforts to understand others and to be understood in return are critical in any society, especially when dealing with complex issues of bias and discrimination. At UCLA, tremendous efforts are made to ensure diversity and fairness in academic and professional settings. Faculty receive regular training on diversity and equity. These efforts are helpful in recognizing unconscious bias. Things like this IROHA journal are also very important in recognizing what we are doing and how we are dealing with Asian hate. We should work together to understand the origins of perceptions and actively engage in correcting misconceptions to prevent hate.

IROHA: Based on your background, do you have any advice or a message for young people who want to follow in your footsteps?

Dr. Kanenko: It's important to understand the broadness and depth of your field. It's built on diverse contributions, and it's critical to learn from those who have led the way. Understanding the historical context and the pioneers in your field is invaluable. It’s often a collective effort that drives significant progress. Knowing when to collaborate is not only efficient but also enriches the experience, and it can be fun. Think of your career as a long-term journey. It requires patience, persistence, and a willingness to adapt and learn. Aim not only for personal success, but also for making a positive impact with your team members and collaborators in your field and beyond. I believe this balanced approach will keep our careers rewarding and impactful.

IROHA: Outside of work, what are you most interested in right now?

Dr. Kaneko: I often travel internationally for work and enjoy every opportunity to immerse myself in the cities I visit. In addition to visiting historical sites, I love to explore local markets and popular areas to understand the local lifestyle. I love to eat local food, so tasting local dishes and sipping local wines bring me incredible joy. Whenever possible, I enjoy being shown around by local friends. Learning about the history and culture while sightseeing is incredibly enjoyable.

written by Jessica Woolsey

UCLA Health