May 2017
Clot Extraction For Stroke Patients 
Is A Game Changer

Stroke is often caused by a clot, blocking a major artery in the brain. This can result in the death of brain tissue and permanent loss of function.

Fortunately, clots can now be extracted from these blocked arteries using very small catheters and tools directed to the site of the clot. Blood flow can be restarted. Brain tissue can be saved.  This can be miraculous for stroke patients.
Case Study:                                               
Robert was a 42 year old engineer on a flight from Canada to Shanghai, China. After arrival and in passport control, Robert had a stroke. He could not speak and could not move his right arm and right leg.

He was immediately transported to the main hospital in Shanghai. A CT angiogram showed the clot. The neurosurgeon introduced a catheter into his groin and up to his brain, and a tool placed in the artery was able to remove the clot. A clot buster drug was given. Over the next 18 days in hospital, Robert was able to recover full function of his right hand and right leg.



During his recovery Robert struggled to speak and communicate. The team at Rupert Case Management, arranged for a speech pathologist in Toronto to train Robert's wife over Apple FaceTime to provide speech therapy at the bedside. This early intervention was important in helping Robert to relearn to speak.
Discussion:                                               
Clot extraction up to 7.3 hours after symptom onset is associated with improved outcomes.

Rates of functional success after clot extraction were 64% with reperfusion at 3 hours vs 46% with reperfusion at 8 hours. Earlier is better.

Intravenous administration of thrombolytic agents, or "clot busters", has been a standard treatment for stroke.

To get better rates of flow and diminish the possibility of intracranial bleeds, endovascular clot extraction is the preferred approach.
Conclusion:                                               
If you are with a person having a stroke, call 911 and ask to be taken to the closest stroke centre.

Signs of stroke can be found at: https://www.heartandstroke.ca/stroke/signs-of-stroke
 
A CT angiogram will likely be done. If a major artery to the brain is blocked, then a clot buster drug will likely be given.

You should prove your value as an advocate by asking for endovascular clot extraction. Be persistent. The stroke patient and his/her family will thank you profusely.
TO START THE CONVERSATION:                                               
1-800-620-7551 or 647-350-5500
 
 
Email us at: [email protected] 
 
It all starts with a conversation.   We are always pleased to help.
 

            Raymond Rupert MD. MBA.
           Founder/Medical Director
           Rupert Case Management Inc.
           505 Eglinton Avenue West, Suite 203
           Toronto, ON M5N 1B1
           direct:     647-350-5500
           24*7:       1-800-620-7551
           email: [email protected]
            www.rupertcasemanagement.com  
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