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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.

There is a time limitation for this treatment. Patients must get to the emergency room within 3 hours of symptom onset in order to receive this drug. 

Clot Retrieval for Stroke

For patients with blood clots blocking blood flow to the brain, minimally invasive procedures are available to remove the clot and restore function. Fort Sanders Regional Medical Center is proud to have performed the first clot retrieval procedure in the region in 2005.

Currently there are two types of devices used to remove a clot:

  • Suction catheter – acts as a vacuum and pulls the clot out
  • Retrievers – grabs the clot and pulls it out

The procedure is performed through a small needle stick in the groin with some patients going home in as little as 24 hours after averting a major stroke.

Minimally Invasive Procedures for Aneurysms

With Fort Sanders’ bi-plane angiography system, aneurysms can better visualized, accessed, and repaired using advanced minimally invasive  procedures. Aneurysms can be repaired through a small catheter using coils, stents or new devices currently undergoing FDA approved studies. A neurointerventional radiologist (a physician with expertise in both neurovascular disease and imaging) is required to perform these procedures. Fewer than three hundred physicians of this specialty exist in the United States.

With the less invasive procedures, aneurysms are repaired using tiny coils or other new devices which are placed through a small catheter from an artery in the arm or leg to the brain. These devices allow the artery to heal from within.

In some cases, because of an aneurysm’s location or the patient’s medical condition, these procedures 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).  This procedure involves the surgical removal of part of the skull.  The healthcare provider exposes the aneurysm and places a metal clip across the neck of the aneurysm to prevent blood flow into the aneurysm sac. Once the clipping is completed, the skull is secured back together

Carotid Angioplasty-Stenting for Narrowed and Obstructed Arteries [for TIAs]

A carotid artery stent is a small, expandable tube that is placed in the narrow carotid artery. Stenting opens up the artery to improve blood flow and prevents the artery wall from collapsing or closing off again. Carotid artery stenting helps lower your risk of stroke. Your doctor may recommend this procedure if the narrowing is 50 percent or more or if you had a stroke or TIA within the past 6 months.  

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.

For more information on the treatments outlined, please call 673-FORT.