Improving Stroke Outcomes With Technology

Laura Mitchell's picture
By Laura Mitchell on May 20, 2016

Stroke is the fifth-leading cause of death in the United States, killing nearly 129,000 people each year. Stroke is also the country’s leading cause of adult disability.

The good news is that these numbers are decreasing. Only a few years ago, the American Stroke Association reported that stroke was the third cause of death in women and the fourth cause of death in men. And over the past decade, the death rate has decreased 34 percent and the number of stroke deaths has dropped about 18 percent, changes the organization attributes to public education efforts and the development of new technologies and techniques to treat stroke.

One treatment that has had a significant effect on stroke-related death and disability is a procedure called mechanical thrombectomy, which uses a stent-on-wire, also known as a “stroke stent” or “stentriever.” While still relatively new, Carilion Clinic has been conducting this procedure since it gained FDA approval in 2012.

According to Biraj M. Patel, M.D., Carilion Clinic’s neurointerventional surgery/radiology section chief, the trend in stroke treatment is toward endovascular mechanical thrombectomy, both nationally and in our region.

“There has been a swing in the pendulum toward endovascular therapy since the data released at the International Stroke Conference in February 2015 showed efficacy of endovascular treatment +/- IV tPA (clot-buster) versus clot-buster alone in a selected group of patients,” said Dr. Patel.

The procedure, detailed by Dr. Patel in the video below, allows interventionalists to manually extract a clot quickly using catheters and a stroke stent.

“We put a cage-like device that is on a wire that’s deployed across the clot to incorporate it," he explained. "Next, a bigger catheter is brought to the clot and that catheter is used to essentially extract the clot with the device as a unit. With new technology and devices and improved techniques over the years we are able to recanalize—or unblock and restore blood flow—for more and more patients."

Dr. Patel reports that for every 100 patients treated, about 40 will have a better functional outcome at three months, including 25 more who achieve functional independence when followed up long-term.

“In other words, for every 2.5 patients treated, one more patient has a better disability outcome," he said. "And for every four patients treated, one more patient is independent at long-term follow up.”

Recognizing a Stroke
Carilion Clinic neurologist Sidney Mallenbaum, M.D., reports that stroke patients lose 2 million brain cells for every minute they go untreated. “When you have a stroke, the clock starts,” he said.

Carilion Clinic's Know the Five, Stay Alive campaign describes specific symptoms to watch for. Call 911 immediately if you witness or experience any of these:

  • Walk—loss of balance.
  • Talk—slurred speech or droopy face.
  • Reach—numbness or weakness of the face, arm or leg, especially on one side of the body.
  • See—impaired vision or difficulty seeing in one or both eyes.
  • Feel—severe headache with no known cause.

Learn more about stroke from Carilion Living:
Fact Check: Are Stroke and Heart Disease Connected?
Fact Check: Is Your Stroke Risk Hereditary?
When Seconds Count: Carilion Clinic’s Stroke Alert Program (featuring Dr. Patel)