My Name is Mohamad Ezzeldin, MD. I am a neuro interventionalist with neurocritical board fellowship training who completed neurology residency at University of Texas Medical Branch/ MD Anderson Cancer Center and neurocritical care fellowship at Rush University with subsequent Neuroendovascular Surgery fellowship at Mercy St Vincent Medical center in Toledo, OH. Having helped to establish the neurocritical care unit while completing my fellowship at Mercy St Vincent, I felt that I was better prepared for my current position at HCA Houston Healthcare Kingwood.
I am currently the Director of CNS Neuroendovascular surgery as well as the Director of Stroke for our comprehensive stroke center. In the Houston Greater area, our health system currently has one comprehensive stroke center (CSC) in the Southern metropolitan area. In the Northern part of Houston, we have two neuro interventional capable centers (Northwest Hospital which is 271 beds and West Houston Hospital which is 270 beds) and one CSC which is HCA Houston Healthcare Kingwood (419 beds). Our CSC is the Hub for the northern Houston area, covering for multiple other hospitals in the system including HCA Houston Healthcare Conroe (342 bed), Tomball (350 beds), North Cypress (163 beds), in addition to numerous free standing EDs.
As the system was in the early stages of growing the Neuroendovascular program, I streamlined the stroke protocol with the help of our neuroradiologist and the use of Rapid AI to improve the efficiency of identification and triage. We started performing simultaneous plain head CT and head and neck vessel imaging, which has helped us to grow our tPA and thrombectomy candidates and identify patients who might benefit from neuro interventional procedures in a quick and timely fashion. In addition, I worked with the MRI department to achieve 24/7 MRI capability which is crucial to successfully implement the protocol for tPA administration for wake-up strokes.
In addition, community outreach has been important aspect to expanding one’s practice. Prior to the COVID pandemic, I started Community outreach with our Business Development team, meeting physicians in their hospitals and outpatient clinics. In addition, I provided lectures to the internal medicine and neurology residents and started an annual stroke meeting. While, I look forward to resuming these meetings in person, I have had to adapt quickly to the changes brought by COVID. Nowadays, I have virtual meetings introducing our physicians to the world of neuro intervention.
While the pandemic has had an impact on our volume, as we saw a 25% drop in volume in March and April 2020, we have had a strong recovery. Our average volume from May 2020 to date is 25% more than pre-COVID and in total, since my arrival in October 2019, HCA Kingwood’s neuro volume has doubled. Along with the increase in overall volume, we have seen a 30% increase in emergent mechanical thrombectomy volume.
As I have completed my first full year of practice, the significant time and effort spent in establishing myself in the HCA system and community has come to fruition. In addition to the significant increases in our emergency procedures, building trust with our community physicians has started to increase our elective volume as well. I have been meeting with the administration and we are trying now to hire a group of vascular neurologists that will cover our hospitals. It is impossible to work 24/7 365 days a year and the hospital administration has been supportive providing locums coverage when I need time off. Maintaining continuity of care and the same quality of coverage can be sometimes challenging with multiple different providers every month. As a result, we are in the process of hiring a partner in my hospital and plan to hire multiple other neuro interventionalists in our system to be able to provide consistent coverage for our system minimizing the need for locums.
I really enjoy working in this ever-evolving field that has given me an opportunity to learn and use new techniques or devices on a daily basis. I’m thankful to my family and mentors that have been and continue to be supportive.
