Transcription:
Endovascular Treatment of Stroke

Scott Webb: Today we are discussing the signs and symptoms of stroke. How do identify our risk factors, the latest in treatment options and the importance of calling nine one one, if you believe you're having a stroke. And joining me today to help answer our questions is dr. Petite Patel. He's board certified in vascular neurology, neurology and neurosonology at capital health.

This is capital health headlines, a podcast from capital health. I'm Scott Webb, doctor. Thanks so much for being on today. Let's talk about a stroke and what are the signs and symptoms?

Dr. Pratit Patel: Most common acronym be used for stroke signs and symptoms is fast. F a S T. F standing for facial droop on the one side arm weakness again on the one side speech difficulty can be either trouble finding the right words or, uh, coming out with the jargon of a nonsensical speech and T stands for time to call other signs and symptoms can be numbness or lack of sensation on the one side of the body.

Sudden onset difficulty with the balance or very severe vertical meaning room spinning sensation that persist irrespective of position. On uncommon occasion, somebody can lose a certain consciousness without any other, uh, cause leading into it can be the symptom of one of the severe strokes

Scott Webb: and doctor who's most at risk for stroke.

Dr. Pratit Patel: Uh, commonly stroke affects people with a condition called atrial fibrillation in which heartbeats irregularly other risk factors include high blood pressure. Diabetes people who have carotid artery stenosis, the artery that supplies the brain and the narrowing overall tends to affect more elderly individuals after fifties and sixties.

But no age is immune. Even younger population, uh, is at risk of having strokes.

Scott Webb: Sure. What are some suggestions you have for minimizing our risk of stroke?

Dr. Pratit Patel: The best thing a person can do is visit the primary care regularly. Have their blood pressure checked. And if somebody has a history of high blood pressure, uh, blood pressure should be controlled in a normal range.

Pretty aggressively. Other thing people can do is not, uh, don't smoke. If they have diabetes controlled diabetes, Lu, healthy life, regular exercise and eating healthy, either Mediterranean diet or, overall heart-healthy diet would be recommended.

Scott Webb: So let's now talk about the latest treatment options for stroke, uh, especially endovascular procedures that, you know, help you avoid traditional open brain surgery.

Dr. Pratit Patel: Yeah. So in last few years, uh, the treatment of stroke has evolved, uh, pretty favorably. There are two main, uh, treatments in the acute setting. One is, uh, Intravenous medication, which is a clot bursting, a strong blood thinner, which is supposed to be given within four and a half hours from the last known well off person.

And the second is endovascular treatment in which a procedure is performed either through the artery in the wrist or in the groin. A catheter is passed within the blood vessel under x-ray guidance. Uh, to reach the blood clot, that's blocking the blood vessel in the brain and pulling that blood clot out mechanically and visualizing that blood vessel is open with x-ray in the brain.

That being said, this treatment option is only available up to certain time. Peter. So as soon as somebody notices for symptom of stroke, uh, either themselves or family member or friends or coworker, they should call nine one one as soon as possible. I would not recommend waiting on, um, those symptoms to resolve by its own or calling a friend or a neighbor.

Just reach out to your phone if possible, and call nine one one. Right.

Scott Webb: And doctor, have you found during the pandemic that people just aren't calling nine one one, even when they're experiencing signs and symptoms of a stroke?

Dr. Pratit Patel: Interestingly, uh, the milder strokes, we are seeing less often in the hospital.

Perhaps people with less disabling symptoms, maybe just a facial droop, numbness or mild weakness are not coming to the hospital. And we have also noticed people with more severe stroke symptoms might be delaying their, uh, attention to the health care, maybe fear of COVID-19 or. With the hope that with time symptoms may improve.

But again, I would emphasize that faster the treatment, the better in these circumstances.

Scott Webb: Yeah. We know that, uh, they say you mentioned fast earlier and that acronym, and we know that time is brain and you know, that's something so important for people to do is to call nine one, one to not delay care, uh, any fears that they may have about COVID-19.

You know, as we've learned, the hospital is a pretty safe place everybody's wearing full PPE. That's the best place to be if you are experiencing a stroke, right?

Dr. Pratit Patel: Correct. Yeah. Hospitals tend to have significant amount of resources allocated to keep the patients safe, especially in the COVID-19 setting isolation of people who are already known to have infections or people whose COVID-19 test is pending.

So. I wouldn't worry about a COVID-19 infection. You are much more likely to be affected by stroke rather than COVID-19. And speaking of time, uh, if I would phrase it again about, on an average 2 million brain cells die every minute. In the cases of stroke. So I would not rate if I'm having a stroke symptom.

Scott Webb: Anything else you want to tell people today about strokes, uh, risk factors, minimizing their risk, treatment options. Anything else we can tell people today?

Dr. Pratit Patel: So the treatment, if someone is suffering stroke, uh, I would say the treatment has become much more safer and advanced in last few years. The endovascular option, as you mentioned, the treatment is called mechanical thrombectomy in which we either mechanically suck or trap the clot out of brain to restore the circulation has effectively turned many patient’s life in a positive direction instead of, uh, unable to emulate or unable to talk from the stroke.

If taper at that person receives a treatment in timely manner, they can return either to your, uh, normal life or become functionally independent. Uh, so again, time is brain and go to the hospital. As soon as you notice the symptoms in recent years, the indication for the treatment has prolonged the time window.

If you hear that this treatment options can be offered up to 24 hours from the last known Elma, which is true. But again, if you present within first few hours, compared to 24 hours, you are likely to do much better in terms of outcome, rather than waiting up to 24 hours. Even though we may offer the treatment option up to 24 hours,

Scott Webb: Right, as you say, it may be possible up to 24 hours, but the sooner you get in, especially within a couple of hours, that's best and a lot of the lasting effects, physical effects, uh, neurological effects of stroke can be reversed. If we can just get people to call nine one one and seek treatment early. Right?

Dr. Pratit Patel: Correct.

Scott Webb: Well, doctor has been so great having you on in your expertise. Thank you so much for your time today and you stay well.

Dr. Pratit Patel: Well, thank you so much.

Scott Webb: If you, or a loved one is experiencing signs of a stroke call nine one one immediately. And for more information about Capitol Institute for neurosciences visit Capitol neuro.org.

And if you found this podcast to be helpful and informative, please share it on your social channels. So be sure to check out the entire podcast library and topics of interest to you. This is capital health headlines, a podcast from capital health. I'm Scott Webb.