When you think about the word “collaboration” and its definition, most people think in terms of partnering or working with someone to create something. Recently, however, West Jefferson Medical Center and Touro Infirmary experienced a medical collaboration that resulted in a remarkable outcome for someone who suffered an ischemic stroke caused by a blood clot.
Every minute matters
Last month, a middle-aged man arrived at Touro Infirmary around two hours after the onset of difficulty with speech, both producing speech and understanding what was said. Knowing these symptoms can be caused by stroke, the emergency department activated Dr. Sheryl Martin-Schild, Stroke Neurologist, and her team who assessed the patient and treated him quickly with a blood clot-busting medication proven to increase the odds of the patient recovering independence. Meanwhile, using advanced imaging, Dr. Martin-Schild was able to determine the patient was suffering a stroke due to a blockage in the left middle cerebral artery – one of the major blood vessels in the brain supplying more than 50 percent of the left side of the brain. Every moment this vessel is blocked, the brain is not supplied with the necessary blood flow, nutrients, and oxygen to normally operate. If the blood flow remains blocked for too long, the brain tissue begins to die, which for some can amount to 2 million brain cells dying each minute!
Within minutes of the patient’s arrival, Dr. Martin-Schild contacted West Jefferson Neuroendovascular Surgeon, Merritt Brown, MD, who reviewed the images and recommended quick transport to West Jefferson Medical Center for a procedure not available at most hospitals in Louisiana.
“It was critical that we remove the clot as quickly as possible since the patient was already suffering serious symptoms from the stroke, which had been going on for several hours,” says Dr. Brown, who adds, “within a minute of suffering a stroke, brain cells begin to die and if not treated, a patient can suffer permanent paralysis, loss of speech, memory and other bodily functions, and even die.”
On arrival to West Jefferson Medical Center, the patient underwent a procedure called a thrombectomy, or the removal of the blood clot from inside the blood, and as a result, restoring blood flow to the brain stopping further tissue damage. Typically, highly specialized doctors will insert a special catheter, or tube, into an artery in the groin or wrist, which allows access to all major vessels in the neck and brain. Once in the vessel with the blockage, the surgeons can use suction or snare devices to remove the blood clot.
While many devices have been produced over the years, in the case of this patient, Dr. Brown used the most recent FDA-approved device to successfully restore blood flow to the brain. The Embotrap III, a “stent-retriever” device custom-designed with a unique mesh wire cage to entrap the entire clot and retrieve it from the brain was then deployed. In one pass, the device reestablished flow to the majority of the left side of the patient’s brain.
The use of the Embotrap III device at West Jefferson Medical Center marks the first time it was used in clinical practice in the entire state of Louisiana. Additionally, knowing how twisty the patient’s vessels were, Dr. Brown elected to place the catheter through a major artery in the wrist rather than the groin, substantially reducing the time to access and remove the blood clot.
“Within the LCMC Health system, several experts are responsible for quick diagnosis and treatment of stroke. No patient comes in with a sign hanging around their neck showing that they are having a stroke from a major blood vessel blockage, which is why it is so crucial to have the best emergency department staff, stroke neurologists like Dr. Martin-Schild and her team, and equipment to rapidly identify the problem and initiate treatment and transfer for surgery as soon as possible,” explains Dr. Brown. “West Jefferson Medical Center is one of only a few hospitals in Louisiana performing these procedures. Now we also are proud to be the first medical facility using this advanced equipment by Cerenovus in Louisiana, and one of the first in the country to use this Embotrap III device through a radial, or wrist, approach.”
While the new technology and novel approach to these surgeries are huge advancements in the treatment of stroke, Dr. Brown notes, “I’m equally as proud of the collaboration I had with our fellow Neurologists from Touro; one of six medical centers in the LCMC system.”
The road to recovery
Today, the patient continues his recovery; although his speech troubles remain, he is able to move independently without significant weakness. Our rehabilitation team continues to aid in the patient’s recovery which was largely due to the collaborative approach to diagnosis and treatment.
Moving forward, Dr. Brown hopes others will take note that a stroke is a dire medical situation, and that immediate medical attention is needed. As for patients within the LCMC system, he says this story should comfort everyone knowing that LCMC is not just about individual hospitals; it’s about all the hospitals working collaboratively for better patient outcomes.
- In the United States, someone dies of a stroke every 4 minutes, making it the fifth leading cause of death in the U.S.; it is the fourth leading cause of death in Louisiana.
- More than 430,000 Emergency Room visits yearly are stroke related.
- Some of the most common issues that can lead to stroke include:
- High blood pressure
- Smoking, including vaping and marijuana
- High cholesterol
- Obstructive sleep apnea
- Alcohol/drug abuse
- Medication non-compliance
There’s a simple way to understand warning signs of a stroke - all you need to remember is the term BE FAST:
B - sudden loss of balance
E - loss of eyesight/vision in one or both eyes
F - face looks uneven or droopy on one side
A - arm or leg weakness, numbness or clumsiness on one side
S - any problem with speech or communication
T - terrible headache, the worst headache you’ve experienced AND time!
If you or someone you know begins to experience these symptoms, call 9-1-1 to get emergently evaluated for treatment options, as “Time Is Brain.”