Covidien Solitaire FR revascularization technology is used to restore blood flow and prevent continuing trauma in a patient’s brain during a stroke.
“It’s sort of the new latest-and-greatest treatment,” Clinical Supervisor Sherri Scholtz said.
The National Stroke Association says that a stroke occurs when an artery in the brain bursts or becomes blocked. When that part of the brain does not receive oxygen from loss of blood flow, the brain cells begin to die.
The most common type is an ischemic stroke, the focus of the Covidien device. St. Mary’s treats about 450 ischemic stroke patients a year.
St. Mary’s lists symptoms as:
- Sudden numbness/weakness of face, arm or leg, or one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden, severe headache with no known cause
Some people may experience a transient ischemic attack, where blood flow is momentarily interrupted on its way to the brain. Symptoms may disappear within minutes but indicate an ischemic attack is going to occur.
Dr. Jamal Akbar,a neuro-radiologist with St. Mary’s, is in charge of Covidien procedures and has been providing care for stroke patients for 17 years. The hospital uses the FAST acronym, meaning Face, Arms, Speech and Time, to recognize and react to symptoms.
The Covidien technology was discussed at conferences this summer, and St. Mary’s made the move to acquire the device in July.
Akbar has used the Covidien device once so far on an ischemic stroke patient, who “responded very well,” he said. Patient privacy has prevented further details about the individual procedure, but St. Mary’s is pleased with the results and their purchase.
When a patient arrives at the emergency room, medical staff checks for symptoms of a stroke and begins to mobilize a neurology team and procedure room.
A CAT scan is performed to check whether hemorrhaging, or internal bleeding, is occurring. That type of trauma cannot be prevented using the Covidien procedure. Akbar evaluates the films and makes a call if the patient is determined to be having an ischemic stroke.
The patient is taken to the interventional radiology room, where an angiogram is performed, inserting dye into the circulation system to find any possible clots in or near the brain. If a patient is experiencing symptoms in a certain part of the body, it indicates the clot may be affecting that side.
A catheter is inserted, then replaced by a miniature catheter to avoid traumatizing the blood vessel. A stent that looks “like a bunch of Slinky’s”, said Akbar, is inserted into the body through the groin using the miniature catheter until it reaches through the carotid artery past the clot via blood vessels leading to the brain.
The miniature catheter is pulled back a small amount so the stent expands, encompassing the entire clot. It also opens the blood vessel to encourage blood flow.
Akbar said the number of attempts with the tool depends on the size of the clot. The average time for the procedure, from start to finish, is two-and-a-half to three hours.
“It’s like the movie shows; like a crab hugs the clot and then slowly pulls it back into the catheter and pulls the clot out,” Akbar said.
Covidien and other treatments
The use of medications or other tools is limited to the length of time the patient has experienced symptoms, as well as the patient’s medical condition and history.
“We sometimes decide what to use depending on the case, what the presentation and other diseases are,” Akbar said.
Akbar said St. Mary’s uses a similar device called the Merci Retriever that requires more attempts to retrieve the clot than the newer Covidien technology. Coviden works 90 percent of the time, he said.
In order to receive the best treatment possible, Akbar and the medical team at St. Mary’s recommend that people respond quickly if they are experiencing stroke-like symptoms, or “brain attacks.”
“When a stroke happens, they have to come as fast as they can come to the emergency room. They have to come within first six hours to the hospital, preferably within an hour,” Akbar said.
Making a difference
Akbar plans to continue building on his knowledge of treating strokes in the years ahead by attending courses and demonstrations and familiarizing himself with medical statistics.
“The hospital has been very proactive. The neurosurgeon, the neurologist and the hospital always bought the right equipment of the 21st century to make this happen,” Akbar said.
But helping stroke patients does not stop after they leave the procedure room.
“We could not do anything without the good nursing care and the auxiliary support,” Akbar said.
Patients still have residual symptoms after suffering from a stroke, such as physical and vocal changes, and are able to receive rehabilitation services from St. Mary’s to regain some function.
“Time is brain cells. The quicker we can get in there and take care of what’s going on, the least chance you have of significant problems afterwards,” Scholtz said.
The medical staff asks that people remember FAST and don't shrug off possible warning signs of a stroke. Call 911 immediately and avoid operating vehicles.
For detailed information about how St. Mary’s provides stroke care, call 989-907-8164.