Innovative Stroke Treatment Restores Brain Function Fast

Stroke is the fifth leading cause of death and a leading cause of disability in the U.S. — hundreds of thousands of Americans are affected each year. A stroke happens when a blood vessel leading to your brain ruptures (hemorrhagic stroke) or is blocked by a blood clot (ischemic stroke), limiting blood supply to your brain. Ischemic strokes are the most common type.

When your brain doesn’t get the blood and oxygen it needs, brain cells die. That’s why every second counts after a stroke. The sooner you get treatment, the better the chance for a full recovery.

“When a large vessel in the brain is blocked, there are detour vessels from other areas of the brain that fill the territory around the blockage,” said Daniel Sahlein, MD, an interventional neuroradiologist with Goodman Campbell Brain and Spine, a collaborative partner with Franciscan Health. “Those detour vessels are good but not great — if they were great, you wouldn’t have symptoms.”

When Stroke Happens, Be Fast

You can remember stroke symptoms with the phrase BE FAST:

• Balance: Does the person complain of dizziness or have a sudden altered or unsteady gait?
• Eyes: Does the person have a sudden loss or change in vision?
• Face: Ask the person to smile. Notice if one side of their face droops.
• Arms: Ask the person to raise both arms. Does one arm drift downward?
• Speech: Ask the person to repeat a simple sentence. Check to see if their words are slurred and if they repeat the sentence correctly.
• Time: If someone shows any of these symptoms, BE FAST. Call 911 to get them to the hospital.

“Typically, what happens is that people start to have symptoms because that area of the brain isn’t getting enough nutrients to function normally, but it’s in a stunned-but-salvageable state,” Dr. Sahlein said. “The tissue can still be rescued if you restore normal blood flow within about six hours after blood supply is cut off.”

Mechanical thrombectomy is a fast, minimally invasive ischemic stroke treatment that saves lives and prevents the debilitating effects of stroke — but it’s critical to get to the hospital right away.

“We need to treat patients as quickly as possible after symptom onset to have this impact,” Dr. Sahlein said.

People may be eligible for the procedure up to 24 hours after symptoms start, but outcomes are better for those who get treatment sooner.

Mechanical Thrombectomy Offers Lifesaving Stroke Treatment

Doctors use real-time imaging and thin, flexible tubes called catheters to remove the blood clot. They insert a catheter into your upper thigh or wrist and guide it into the blocked artery in your neck. They inject dye to examine your blood vessels and find the blood clot. Once the blockage is found, they insert smaller catheters and use tiny devices to break up and remove the clot, restoring blood flow.

Doctors use state of the art imaging to guide catheters - long thin plastic tubes - from the artery in the upper thigh or wrist to get to the arteries in the neck.  From there they inject dye to examine the blood vessels that supply the brain and find the blood clot. Once the blockage is found, they use a combination of catheters and tiny rake-like devices to both vacuum the clot out and pull it out, restoring normal blood flow.

Mechanical thrombectomy is quick — just about 20 minutes — and effective. Dr. Sahlein and his team have completed more than a thousand procedures with overwhelming success — about a 95% success rate.

“We study our outcomes carefully and are constantly refining our technique and our craft,” Dr. Sahlein said. “We've seen the impact of that kind of volume in our favorable outcomes.”

Lifesaving Stroke Education

One of the most important things you can do to limit damage from stroke is to recognize the symptoms — remember, BE FAST — and get medical attention immediately.

“We’re trying to educate the public on the signs and symptoms of stroke and get more people to come to the hospital earlier so they’re still candidates for this function-sparing procedure,” Dr. Sahlein said. “The majority of patients still aren't getting to the hospital in time.”

Dr. Sahlein has been part of a series of events educating central Indiana high school students about stroke symptoms, empowering the next generation to educate their parents and grandparents. A few months after holding these events, there was an article in a Bloomington newspaper about a student who recognized her grandmother’s stroke symptoms after attending an event. She got her to the hospital for treatment, saving her grandmother’s life.

“Stroke education made a difference in this case — hopefully more,” he said. “We’re trying to touch individuals one patient at a time, save people’s function one patient at a time and educate people in the best way we can.”

When you need lifesaving stroke care, you can count on us. Franciscan Health received the American Heart Association/American Stroke Association Get With The Guidelines-Stroke Gold Plus Quality Achievement Award, a testament to our stroke care expertise. From diagnosis through rehabilitation, we offer complete care and support for patients and families affected by stroke.