Time is still of the essence to recognize stroke onset, but advanced tool offers "Plan B."
It may look like a miniature, platinum corkscrew, but a new clot retriever device is a powerful lifesaver for stroke patients faced with few other treatment options as time ticks away. Time is critical when signs of a stroke emerge.
More than 700,000 Americans suffer strokes each year, according to the American Heart Association, which lists stroke as the third leading cause of death.
Winthrop-University Hospital is one of the first Long Island hospitals to begin using the Merci® (Mechanical Embolus Removal in Cerebral Ischemia) Retriever for emergency cases in which the window of opportunity for drug therapy intervention has closed. The device received Food and Drug Administration approval in 2004.
"The availability of the new device truly gives Winthrop's Stroke Team additional, precious time to rescue the brain of a patient who would otherwise be in dire straits," explained Orlando Ortiz, MD, interventional neuroradiologist and Chairman of Winthrop's Department of Radiology.
Inserting a catheter (plastic tube) into a blood vessel in the groin, interventional radiologists, using X-rays to map the path to the clot, thread the instrument through arteries to the brain blockage where the retriever "screws" into and captures it. At the end of the catheter, a balloon inflates not only to stop blood flow temporarily but also to prevent clot breakage.
Interventional radiologists then draw the device out, removing the clot and effectively restoring blood flow to the site immediately.
Orlando Ortiz, MD, interventional neuroradiologist and Chairman of Winthrop's Department of Radiology, displays the Merci Retriever.
The procedure usually takes 60 minutes.
Before the device's introduction, the most advanced stroke treatment has been the injection of the drug tPA (tissue plasminogen activator) to dissolve clots. However, tPA must be administered within three hours of the onset of symptoms.
Failure to recognize stroke and/or get to a medical facility within that narrow time frame prohibits the use of the powerful clot-busting drug. The Merci Retriever expands the window of opportunity for successful treatment up to eight hours after symptom onset.
"The device offers hope to a subset of patients who either cannot or did not receive tPA and would otherwise incur significant deficits such as loss of sight, speech or hearing," said Dr. Ortiz. "Patients can rest assured knowing Winthrop has yet another advanced tool in its arsenal to battle stroke in addition to its Stroke Team and dedicated Stroke Center with support groups to help them get back on their feet and back to their lives." For more information about the procedure, call (516) 663-2452.