The treatment window for the most common type of stroke has expanded from
three hours to 24 hours at
North Oaks Medical Center due to enhanced
interventional radiology capabilities made possible by the addition of
Dr. Zachary Liner, a Neuroradiologist, to the medical staff.
The hospital, which is a certified
Primary Stroke Center through The Joint Commission, is the only facility on the Northshore currently
offering a lifesaving procedure called intracranial mechanical thrombectomy.
This minimally invasive procedure is now part of the hospital’s arsenal
of effective treatment options for ischemic strokes, the most common type.
When an ischemic stroke occurs, the blood supply to the brain is blocked
by a blood clot or plaque. Without a healthy blood supply, the brain doesn’t
receive the oxygen and nutrients needed to work properly, and brain tissue
begins to die.
Historically, a clot-busting drug called tPA has been used to treat this
type of stroke, but it must be administered within three to four hours
of onset of symptoms.
In this regard, intracranial mechanical thrombectomy is a game changer
because it widens the treatment window up to 24 hours after the initial
appearance of stroke symptoms.
The procedure is made possible by image-guided catheters and a wire cage
device, called a stent retriever, which are used to remove blood clots
in large vessels in the brain. Liner threads the catheter through an artery
in the groin up to the blockage in the brain. He then deploys the stent
retriever through the clot and removes the stent retriever with the captured
clot through the catheter that was placed in the artery.
“Ideally, the procedure should be done within six hours of symptom
onset,” explains Liner. “However, a national study called
the DAWN Trial and published in
The New England Journal of Medicine, has proven it can still be effective if done within 24 hours of onset
under certain conditions. This gives us a greater chance of helping people
who wake up with stroke symptoms and don’t really know when they
first started. More importantly, it’s more likely that patients
will regain movement, speech or other abilities lost.”
Glen Sterling of Tangipahoa, pictured above with his wife Charlene, is one such patient
who has made a total recovery from his stroke thanks to this procedure.
He was eating breakfast when Charlene noticed the warning signs of a stroke.
His lips looked droopy, his left side was limp, and he was slurring his
words. She called 911, and within 10 minutes, first responders were on
scene, confirmed he was having a stroke and made the call to airlift him
to North Oaks Medical Center, where the Interventional Radiology team
ordered a CT scan to confirm that Sterling was a candidate for intracranial
mechanical thrombectomy. The procedure took about 53 minutes, and when
Sterling awoke, he showed no visible signs of the stroke. Two days later,
Sterling was able to return home thankful that debilitating outcomes,
like paralysis, were avoided.
A Hammond native, Liner has returned home to practice after completing
a fellowship in Interventional Radiology through Baylor Scott & White
Health in Temple, Texas with an additional fellowship year in Interventional
Neuroradiology through the University of California – San Francisco.
He earned his medical degree at Louisiana State University School of Medicine
in New Orleans, and completed an internship in General Surgery at Emory
University and a residency in Diagnostic Radiology at Rochester General
in New York.
Now with the necessary team and infrastructure in place, North Oaks Medical
Center is aiming to develop Interventional Radiology services even further.
The hospital is partnering with the
North Oaks Foundation to purchase a $1.8 million neurointerventional biplane unit that can capture
two- and three-dimensional images of the brain, arteries and spine with
one single injection of X-ray dye. The foundation has committed to raising
$500,000 toward the purchase.
Stroke is the No. 4 cause of death in Louisiana, according to the American
Heart Association/American Stroke Association. Time is brain when it comes
to stroke care as evidenced by the fact that someone suffers a stroke
every 40 seconds in the U.S. Someone dies due to stroke every four minutes,
and nearly one million people suffer a new or recurrent stroke each year.
People having a stroke may experience some or all of the following warning
signs, some of which can be subtle: 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;
and sudden severe headache with no known cause.
To easily remember the sudden signs of stroke, use the acronym FAST –
Face, Arms, Speech, Time. When you spot these signs, it’s time to
call 911 for help.
The images above were taken before and after Glen Sterling’s intracranial
mechanical thrombectomy. The arrow on the image at left indicates the
position of the blood clot. The arrow on the image at right confirms renewed
blood flow following removal of the blood clot.