Intra-arterial thrombectomy (IAT) saves patients’ live with brain strokes
On January 27th, 2021, Viet Duc University Hospital received a patient named N.T.H. (female, 36 years old) from Soc Son province with brain stroke.
\he patient has a history of mechanical heart valve replacement 15 years ago at Viet Duc University Hospital but forgot to take the anticoagulating medication for 1 day. At 7 AM on January 27th, 2021, Ms. H.’s husband recognized his wife had facial paralysis, aphasia and complete right-sided hemiparesis, so immediately he took her to Viet Duc University Hospital.
On admission at 10AM, physician at clinic noticed that the patient had symptoms of stroke so they started the emergency procedures for management of stroke. Doctors of Stroke Center urgently proceeded clinical assessment and consultation with diagnostic imaging doctors, then being aware that it was a stroke at sleep so it was required more intensive diagnostic methods for proper treatments, so the patient was taken for a magnetic resonance imaging (MRI) to assess more about the cerebral perfusion. On MRI, a thrombosis of the left middle cerebral artery was found with the vulnerable but reversible ischemic area much larger than necrotic area. Stroke team had a quick discussion and decided to perform the mechanical intra-arterial thrombolysis. Before the intervention, the patient could not move her hand and leg herself but right after the arterial recirculation for the middle cerebral artery was blocked for 20 minutes with only 01 time using the device to get out the thrombus, she could rise her hand and move her fingers and toes by herself. By now, the patient is able to walk and totally awake after being transferred to the Department of Neurology and Neuro-ICU for further monitoring. A control MRI after 24 hours showed a normal perfusion of that vulnerable ischemic area.
Doctor LE Thanh Dung PhD., MD., – Chief of Diagnostic Imaging Department, Viet Duc University Hospital shared that stroke was the 3rd cause of death and the leading cause of disability. Ischemic stroke or cerebral infarction accounted for 80 – 85% among stroke patients. The long-lasting of the cerebral ischemia might lead to physical cerebral infarction without timely recirculation and severe sequelae. Mechanical thrombectomy devices for cerebral arterial thrombus has many advantages to recirculate big vessels with the treatment windows expanding up to 16 hours and even 24 hours for anterior circulation or up to 12 hours for posterior circulation.
From Ms. H. case, specialists recommended all patients with cardiovascular history absolutely not to forget to take anticoagulating medications to avoid catastrophic consequences. Besides, if patients manifest any clinical signs of stroke, they should be taken to well known medical facilities. Now, Viet Duc University Hospital is one of the leading hospitals with full equipment and facilities to treat stroke: internal medicine departments, mechanical thrombectomy performance and rehabilitation. Actually, many stroke patients were saved here by intra-arterial thrombectomy procedure.
Stroke or cerebral thrombus without early detection and timely treatment might lead to severe sequelae affecting patients’ quality of life and becoming an economic burden for patients’ family and the society. If patients manifest with any suspicious sign of stroke, they need to be immediately taken to well known medical facilities to be examined, diagnosed and treated to avoid later severe sequelae. To identify stroke signs, please remember the words F.A.S.T: Face – unbalanced face or drooping one side of the mouth; Arm – weakness or paralysis of extremities; Speech – Speech difficulty; Time – with 1 over 3 above signs meaning that patient has very high risk of stroke, immediately seek medical emergency and to take him to a medical facility with stroke unit. Beside, patients have high risk factors (arterial hypertension, cardiovascular disorders, diabetes, hyperlipidemia, smoking…) are required to have regular health check and to strictly follow prescribed treatment regimen.