Clot Removing Stroke Care: McLeod Health

CLOT REMOVING STROKE CARE

story by Dr. Basil Shah, McLeod Interventional Neuroradiologist

Ischemic strokes occur when a blood vessel to the brain is blocked by a clot. When this happens part of the brain is not getting the oxygen and blood it needs, which is a very dangerous and life-threatening situation. Ischemic strokes are the most common type of stroke accounting for 87 percent of all strokes, according to the American Stroke Association.

The gold standard of care for patients diagnosed with an Ischemic stroke is a drug called tissue plasminogen activator (tPA), which dissolves the blood clot. If tPA is not successful, using new techniques, we can attempt to remove the clot with the help of sophisticated devices to restore blood flow and prevent further damage. The benefits of tPA are time dependent and should be administered as quickly as possible. The window of opportunity for giving the medication is four and half hours after the onset of a stroke.

When larger brain vessels are blocked there are limitations on restoring blood flow. In this situation the vessels can be re-opened quickly and safely with a procedure called Thrombectomy, a minimally invasive surgery to remove a blood clot from a brain artery. Time is also of the essence to restore blood flow back to the brain. And, not all hospitals are equipped with the staff, training and equipment necessary to perform the Thrombectomy procedure. At McLeod Regional Medical Center, there is a dedicated Neurointerventional Bi-plane X-ray Suite for such procedures as Thrombectomy. The Bi-plane imaging system produces highly detailed threedimensional views of blood vessels heading to the brain and deep within the brain. This technology allows doctors to follow the blood flow path to the exact location of the issue. Designed for the emergency treatment of stroke patients, the suite is equipped with the most advanced medical imaging technologies available, including two rotating cameras, one on each side of the patient, to take images simultaneously. We can rotate the cameras and study the blood vessels from multiple angles. Also, by producing images at the same time, it reduces the amount of contrast material needed and the time it takes to complete procedures. The Thrombectomy procedure for stroke care is performed by an Interventional Neuroradiologist, who with the assistance of the Bi-plane X-ray imaging guides a catheter, a long flexible tube, through an artery in the groin up to the blocked artery. Once there, a stent retriever, a tiny net-like device, is inserted into the catheter and guided to the blockage to capture the clot and return blood flow back to the brain.

Our first patient this year was on January 5, 2021, a 40-year-old man with a wife and three young children. Thanks to him seeking emergent stroke care and the Thrombectomy procedure he is home with his family and doing well. At McLeod, the Neuroscience Steering Committee is comprised of a diverse group of professionals including nurses, physicians, advanced practice providers, and staff trained in pharmacology, physical and occupational therapy, and administrative leaders. Together, they bring a multidisciplinary approach to improve the care of stroke and neurology patients. Through the efforts established by this committee, including the Bi-plane X-Ray Suite staffed by a highly trained team, stroke and neurology patients can stay close to home and loved ones for their care.

Every minute counts for stroke patients and acting F.A.S.T. can lead patients to the stroke treatments they desperately need. The most effective stroke treatments are only available if the stroke is recognized and diagnosed within the first three hours of the first symptoms.

If you think someone may be having a stroke, act F.A.S.T. and do this simple test:

F-FACE: Ask the person to smile. Does one side of the face droop?

A-ARMS: Ask the person to raise both arms. Does one arm drift downward?

S-SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange?

T-TIME: If you observe any of these signs, call 9-1-1 immediately.

Dr. Basil Shah is a highly skilled Diagnostic and Interventional Neuroradiologist with McLeod Regional Medical Center. Dr. Shah has diverse expertise in radiology, neuroradiology, and interventional neuroradiology. Basil Shah, MD

Interventional Neuroradiologist