Page 21 - Christiana Care Health System Focus September 2018
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  Neurointerventional doctors can now treat patients up to 24 hours after a stroke begins using a revolutionary brain imaging software to determine viability of brain tissue. This significantly widens the window for care that once closed at
six hours.
In two recent trials, the highly reliable, fully automated RAPID CT perfusion brain imaging software was proven to help neurointerventional specialists accurately determine whether a patient still has enough salvageable brain tissue to benefit beyond conventional time frames from
a minimally invasive procedure called mechanical thrombectomy to remove the blood clot that is causing the stroke.
The results of these trials using RAPID
CT Perfusion were so compelling that the American Heart Association / American Stroke Association recently released new guidelines extending the window for life-saving mechanical thrombectomy treatment from six hours up to 24 hours. Within four and a half hours of symptom onset, the intravenous (IV) clot-busting drug alteplase continues to be the first line of treatment. However, in the most severe strokes, IV alteplase is often not enough to restore blood flow to the brain, and many of
| Acute Medicine these patients still benefit from mechanical
The news is particularly important for patients who experience what is called a “wake-up stroke.” These are the patients who seem fine before bed (what stroke specialists call the “last seen normal”),
but wake up more than six hours later
with stroke symptoms such as drooping face, numbness or weakness on one side
or difficulty speaking. Without knowing when the stroke actually began, and before the benefits of RAPID brain imaging, neuro specialists had limited reliable information to weigh the benefits versus risks of mechanical thrombectomy.
“As stroke care leaders in our community, we keep our fingers on the pulse
of the latest technology, research and treatment options available, thereby giving our patients the best possible care.”
Barbara J. Albani, M.D.
Christiana Hospital is the only comprehensive stroke center between Philadelphia and Baltimore — and the only hospi-
tal in Delaware — to offer this life-improv- ing and sometimes life-saving procedure.
Feeding a catheter to the blocked vessel in the brain through the arm or leg, surgeons are able to grab a clot and pull it out mid- stroke — now up to 24 hours after symptom onset.
Barbara J. Albani, M.D., medical director of Neurointerventional Surgery, said RAPID imaging helps her team identify patients who could benefit from the minimally invasive therapy.
“Nothing is 100 percent, but RAPID gives us a better idea about which patients would benefit from clot removal and allows us to expand the time window to treat a broader groupofpatients,”shesaid. CONTINUED
 Barbara Albani, M.D., Medical Director, Department of Neurointerventional Surgery, Thinesh Sivapatham,, M.D., and Alberto Iaia, M.D., section chief of Neuroradiology.

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