Treatment of Stroke
Stroke treatment varies with each person. At Fort Sanders Regional, our
neurologists, neurosurgeons, and neurointerventional radiologist work
together to determine the best course of treatment for each individual.
Intravenous tPA
A stroke is caused by a blood clot that lodges in an artery and blocks
the flow of blood to the brain. Clot-busting drugs, called
thrombolytics – specifically tPA – are given to stroke patients through
any vein within the first three hours following a stroke to improve the
blood flow and minimize potential disabilities. This treatment has been
shown to be the most effective once a stroke has started.
TIME LIMITATION FOR THIS TREATMENT: MUST GET TO THE EMERGENCY
ROOM WITHIN 3 HOURS OF SYMPTOM ONSET IN ORDER TO RECEIVE THIS DRUG!
Intra-arterial tPA, Merci Clot Retrieval
For patients who arrive in the emergency room after three hours,
thrombolytics can be administered directly into the clot through a
small catheter in the blocked artery. A corkscrew device, called the
Merci clot retriever, can be inserted through a catheter to remove a
clot in large arteries in the brain. The Penumbra device was approved
for use in March 2008 and is also used at Fort Sanders Regional for
clot removal.
TIME LIMITATION FOR THIS TREATMENT: For those who can be treated within
8 hours of symptom onset, the Merci and Penumbra are options.
Intra-arterial tpa can be given up to 6 hours of symptom onset.
Coiling Procedure for Ruptured and Non-ruptured Aneurysms
With Fort Sanders’ new bi-plane angiography system, aneurysms can
better visualized, accessed, and repaired using a revolutionary coiling
procedure. A neurointerventional radiologist (a physician with
expertise in both neurovascular disease and imaging) is required to
perform this procedure. Fewer than three hundred physicians of this
specialty exist in the United States.
With the less invasive coiling technique, aneurysms are repaired using
tiny metal coils which are fed through a small catheter from an artery
in the leg to the brain. The coils are made of soft platinum wire and
clot the aneurysm from within. The artery heals across the coils,
forming a new layer of tissue.
In some cases, because of an aneurysm’s location or the patient’s
medical condition, coiling may not be the best treatment. Traditional
neurosurgery may be recommended. Fort Sanders Regional
neurointerventional radiologist and neurosurgeons work together to
determine the best treatment option for each patient.
Craniotomy Clipping Procedure for Aneurysms
Traditionally, aneurysms have been treated by neurosurgeons who perform
a craniotomy (surgery to open the skull) and place a clip across the
aneurysm to stop the blood flow.
Carotid Endarterectomy for Narrowed and Obstructed Arteries [Transient Ischemic Attacks—TIAs]
It is very common for TIA patients to have carotid stenosis and benefit
from endarterectomy, angioplasty/stenting but other patients, including
patients who have had ischemic stroke, could benefit as well.
Carotid Angioplasty-Stenting for Narrowed and Obstructed Arteries [for TIAs]
Pharmacologic Therapy
For more information on the treatments outlined, please call 673-FORT.