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Six hour window
Thanks to some very skilled physicians, Mercy can
extend the window of stroke treatment to six hours – rather than the
norm of three hours at most facilities.
Interventional neuroradiologists at Mercy NSI have
developed the only stroke treatment protocol in the state – intra-arterial thrombolysis treatment
– that provides a window of
opportunity for up to six hours after the
first signs of ischemic
stroke.
By inserting a catheter into the patient's artery,
doctors can go directly to the clot in the brain with a clot-dissolving drug.
Although clot-dissolving drugs can be injected into a patient's vein
within a three-hour window after a stroke, they are much less precise
and must be applied within three hours of the stroke. By providing a six-hour
time period, more than six times the number of patients are now able to
be treated.
MERCI
Merci, or Mechanical Embolus Removal in Cerebral
Ischemia, is a cork-screw shaped device that can be inserted through a
small incision in the groin, then threaded through arteries to the
brain. The device captures the clot and pulls it out of the brain,
restoring blood flow. It is the first FDA approved stroke technology
available that allows doctors to actually remove a deadly blood clot
lodged in the brain.
Because 85 percent of strokes are due to blood clots
and because sometimes a clot can't be dissolved, this new technology has
saved lives and saved people from long-term disabilities.
In order to improve stroke outcomes, Richard Vertrees Smith, MD medical director of Mercy NSI, conducted extensive community education
– including 240 EMSA employees – about criteria for intra-arterial
thrombolytic administration.
Carotid Stenting
Mercy was the first hospital in the state in 2005 to
be approved by the Centers for Medicaid and Medicare Services (CMS) to
do carotid artery stenting.
Plaque build-up in the carotid
artery – the major artery providing blood flow to the brain – is a
common cause of stroke. Until recently, surgical removal of the plaque
has been the only treatment option available.
Because carotid stenting doesn't require surgery,
the procedure is much less invasive. Through a small opening in the
groin, physicians use a TV monitor to guide a tiny balloon-mounted stent
to the blockage in the neck artery, and then inflate the balloon to
deploy the stent. The stent is a tube made of thin metal-mesh framework
that holds the artery open and the temporary umbrella catches any plaque
debris.
Stroke Research/INSTOR
The INterventional
Stroke Therapy Outcomes Registry (INSTOR) is a central data base kept by
the NeuroVascular Research Foundation. It compiles data collected from
interventional stroke treatment centers from across the nation to
evaluate short and long-term benefits of interventional
neuroradiological treatment of ischemic strokes.
Data includes detailed
information regarding the patient’s history, lab and imaging reports,
type(s) of treatments performed and data from seven days and 90 days
after treatment. Similar data reported to INSTOR is utilized by Mercy
NSI to evaluate and analyze its institutional outcomes.
Current data
demonstrates exceptional outcomes and an abstract detailing the results
of Mercy NSI’s intra-arterial stroke protocol has been developed for
presentation at national symposiums sponsored by the American Stroke
Association..
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