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JFK Advanced Comprehensive Stroke Center: Endovascular Procedures

Successful Recanalization Following Endovascular Procedures

A stroke occurs when a vessel in the brain ruptures or is blocked by a blood clot. There are two types of strokes: hemorrhagic and ischemic. An ischemic stroke occurs as a result of a blockage in a blood vessel supplying blood to the brain. Eighty seven percent (87%) of strokes are ischemic. Medical treatments for stroke work to either open the blockage (ischemic) or treat the rupture (hemorrhagic). Medical advances have greatly improved survival rates from stroke treatments during the last decade. The chances of survival are better if the stroke is identified and treated immediately. (American Heart Association http://www.strokeassociation.org/STROKEORG/AboutStroke/Treatment/Stroke-Treatments_UCM_310892_Article.jsp)

Patients who come to the hospital within four and one half (4.5 hours) of onset of ischemic stroke symptoms may be treated with a drug to dissolve the clot (tPA). In addition to tPA, the JFK Advanced Comprehensive Stroke Center offers state of the art diagnostic imaging to perform emergency endovascular treatments that restore the blood supply to the brain immediately. During endovascular treatment specially trained physicians try to remove the blood clot by sending a catheter to the site of the blocked blood vessel in the brain. Sometimes a drug to dissolve the clot (tPA) is given at that time.

The advantage of endovascular treatment is that it may be performed in certain patients who arrive at the hospital after four and one half (4.5 hours) of the first signs of stroke. It may also be used for certain patients who do not improve with tPA alone. Not all patients can be treated with endovascular interventions.

Highly trained physicians and technicians perform these procedures in a state of the art neuro-interventional suite. Achieving a successful recanalization (opening a block vessel) means restoring blood supply to half or more of the region that was not receiving blood flow. The degree of improved blood flow has been linked to better neurological recovery.

WHAT ARE MEASURING?

We measure the rate of successful recanalization (restoration of blood supply to half or more of the blocked vessel) for patients who undergo catheter based endovascular treatment at JFK.

The graph shows that 82% (9 patients out of 11) in the 3rd quarter of 2015 and 90 % (18 patients out of 20) in the 4th quarter of 2015 achieved restoration of blood flow to half or more of the originally blocked vessel. In the first quarter of 2016, 85% (11 out of 13 patients) achieved restoration of blood flow to half or more of the originally blocked vessel.

There is no benchmark for this procedure.

QS-recanalization

WHAT IS OUR PERFORMANCE TELLING US?

We are successfully restoring blood flow to the majority of our patients who undergo endovascular treatment of stroke, thus potentially improving their neurological outcome.

WHAT CAN YOU DO TO MINIMIZE THE EFFECTS OF A STROKE?

The first step is to learn and recognize these stroke symptoms:

  • Sudden numbness or weakness of the face, arm or leg (especially on one side of the body)
  • Sudden confusion, trouble speaking or understanding speech
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden severe headache with no known cause

The second step is to call 9-1-1 immediately and get transported by EMS to the nearest designated stroke center for rapid evaluation and emergency treatment.

JFK Joint Commission Advanced Certified Comprehensive Stroke Center is specially equipped with diagnostic capability to diagnose and treat all complex strokes cases, including brain aneurysms. Our Award winning stroke program multidisciplinary team provides specialized stroke care 24 hours a day and seven days a week. Stroke care begins with the transport to the hospital and continues from the Emergency department to the Neurological Interventional suite, through in hospital care on the Neurological Critical Care Unit and Stroke Unit), and through Stroke Rehabilitation. At JFK the Comprehensive Stroke Care is all under one roof.

The good news is that 80% of stroke can be prevented by learning the stroke risk factors and modifying your personal stroke risk factors.

http://www.strokeassociation.org/STROKEORG/AboutStroke/Treatment/Stroke-Treatments_UCM_310892_Article.jsp