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.
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.
Intra-arterial tPA, Solitaire 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 Solitaire 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.
For those who can be treated within 8 hours of symptom onset, the Solitaire 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’ 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]
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.
For more information on the treatments outlined, please call 673-FORT.