Advanced Stroke Treatments at St. Anthony Hospital
St. Anthony Hospital in Denver has advanced treatments and technology to treat stroke and prevent recurrent strokes.
Interventional Neuroradiology Procedures to Treat Stroke
In recent years, care for stroke, especially ischemic stroke (caused by a blocked artery), has evolved from supportive care to interventional treatments. In the Stroke and Neurovascular Program, neuro-interventional specialists use non-invasive interventional techniques to treat brain aneurysms, open blocked arteries in the brain and remove clots in brain arteries. These procedures are aimed at limiting and possibly reversing stroke injury and preventing recurrent stroke.
- Penumbra® - an interventional system for removing large clots in the brain when treatment with tPA is not appropriate or appears to be ineffective. The Penumbra® Stroke System uses aspiration and catheterization techniques to rapidly restore blood flow in the brain and limit damage caused by stroke. Unlike clot dissolving drugs which must be administered within a short three-hour treatment window, the Penumbra can be used within eight hours of symptom onset.
- Merci® Retriever - when IV tPA cannot be used, the Merci® Retriever is an option for some stroke patients. The FDA approved the device in 2004 to remove clots from blocked brain arteries, and it is approved for use up to eight hours after the onset of stroke symptoms. The retriever is guided through a catheter to the brain artery where the clot is lodged. The tip of the retriever has a series of loops, like a corkscrew, which the physician maneuvers to grab the clot and slowly pull it out of the artery. The Merci device can be effective in treating large blood clots - the kind that cause a major and fatal stroke.
- Administering tPA Directly into a Clot - this alternative therapy is targeted for patients who arrive more than three and within six hours from the start of stroke symptoms. If a clot is found blocking a large brain artery, a small catheter can be placed within the blockage to deliver tPA directly into the clot and dissolve it, restoring normal blood flow to the brain.
|Penumbra® uses a microcatheter in conjunction with an internal separator to aspirate and break up the clot.|
Interventions to Prevent Recurrent Stroke
- WingspanTM stent - approved by the FDA in 2005, the Wingspan stent (a small tube) is designed to treat brain arteries narrowed by atherosclerosis. Patients who have had a stroke caused by narrowed arteries within the brain are at a very high risk of having more strokes. Treatment with the Wingspan stent is a new option for these patients, in addition to treatment with standard medical therapies. Initial clinical trials suggest the Wingspan stent may be particularly effective in lowering the risk of recurrent stroke in patients who have greater than 70 percent blockage of an artery within the brain.
- Carotid stenting - patients with carotid artery stenosis (narrowing of the carotid arteries, the arteries that supply the head and neck with oxygenated blood) are at an increased risk of stroke. Carotid artery angioplasty with stenting is a new alternative treatment for patients with carotid stenosis who previously could only be treated with open surgery. Carotid stenting is less invasive, has a shorter recovery time and appears to be safer than surgery for patients with heart disease, lung disease, uncontrolled diabetes, end stage renal disease, advanced age, blockage of the opposite carotid artery, previous carotid surgery, previous neck surgery or prior radiation to the neck.
- Intracranial angioplasty - an interventional procedure that uses a balloon-tipped catheter to enlarge a narrowed artery in the brain. Angioplasty may be used to open narrowed brain arteries, preventing strokes in patients for whom standard medication had failed. Angioplasty uses a tiny balloon threaded through a catheter to the blockage in a brain artery. Once in this area, the balloon is inflated. As it expands, it forces the plaque against the artery wall, opening the vessel. In some cases, a stent (a thin wire tube) also is inserted in the artery to keep it propped open.
- PFO Closure - a Patent Foramen Ovale (PFO) is a small hole in the heart that can permit blood clots to cross through the heart and into the brain causing a stroke or TIA. In some patients, closure of the PFO is necessary to prevent further strokes. Interventional cardiologists at St. Anthony Central Hospital perform the minimally invasive procedure using a device inserted via a leg blood vessel to close the hole.