The professionals at Miami Valley Hospital (MVH) provide specialized treatment for stroke by first determining whether the stroke was caused by a blood clot (ischemic) or by bleeding in the brain (hemorrhagic). Immediate treatment for ischemic strokes focuses on restoring blood flow, while treatment for hemorrhagic strokes focuses on controlling bleeding.
Stroke experts across Premier Health use telemedicine - a powerful new tool to speed definitive care to patients experiencing acute strokes. Miami Valley has telemedicine devices in its Emergency Trauma Center and Intensive Care Unit. These devices allow the team of stroke neurologists to consult remotely using a two-way video terminal wheeled to the patient's bedside. From their own notebook computer, the neurologists can “see” the patient, ask questions and view CT scans - all in real-time - to assess the patient's condition and help the on-site physician determine if the patient is a candidate for clot-dissolving medication or another form of acute stroke therapy.
Before starting treatment, our physicians may use the following to thoroughly evaluate your condition:
Interventional Drug Therapy
Tissue Plasminogen Activator (tPA) is best known as a clot buster. It is used for patients who have suffered from the most common type of stroke, in which a blood clot blocks blood flow to a portion of the brain, cutting off oxygen. tPA can prevent cell damage in the brain by dissolving the clot and restoring the flow of oxygen. The drug must be given to patients as soon as possible after the symptoms begin ideally no longer than three to four and a half hours.
Currently, tPA is the only thrombolytic agent (drug that is able to dissolve a clot and reopen an artery or vein) approved by the Food and Drug Administration (FDA) for treating acute ischemic stroke. tPA occurs naturally in the body — it's an enzyme made by cells in blood vessel walls. MVH stroke specialists use a genetically engineered version, which was first employed in the treatment of blood clots in the heart.
MERCI Clot Retriever
The MERCI CLOT Retriever provides an option for some patients who arrive at the hospital more than four and half hours after the onset of stroke symptoms. The MERCI Retriever (Mechanical Embolus Removal for Cerebral Ischemia) is a catheter with a coiled tip that grasps a blood clot and allows it to be removed.
The mechanical device looks like a tiny corkscrew. It is inserted through an incision in the groin and threaded through arteries to the brain. The clot can be removed the same way as cleaning out a clogged pipe. The flow of blood can be restored to the brain as the blockage is engaged, captured, and removed. Our interventional neurology physicians are specially trained to use imaging techniques to view the inside of the body while guiding small instruments through the arteries.
The MERCI Clot Retriever can be used up to six hours after the onset of stroke symptoms. This is a significant breakthrough because valuable time is often lost before a patient recognizes that they are having a stroke. Although intravenous tPA has been the best method of treatment to date, it has only a 4.5 hour window in which it can be used. The MERCI Clot Retriever can be used as an alternative for patients who do not receive treatment within the 4.5 hour window after symptoms begin.
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