JACKSON - Jackson Madison County General is the first hospital in rural West Tennessee to offer the most advanced intra-arterial stroke treatment technology available today. The Penumbra 5 max ACE System, which was approved by the U.S. Food and Drug Administration in May of 2015, acts as a “vacuum cleaner” for the brain, using aspiration to gently remove the clot from inside the artery and restore blood flow to increase the chance of successful recovery. Intra-arterial stroke treatment is only available in approximately half of advanced stroke centers in the U.S., including Jackson Madison County General.
In June of 2015, the American Heart Association/American Stroke Association updated their stroke guidelines to support the use of intra-arterial treatment, also called mechanical thrombectomy or endovascular or interventional treatment, for stroke patients. In addition, several recent clinical trials, including the landmark MR CLEAN study published in the New England Journal of Medicine in late 2014, showed that intra-arterial stroke treatment is significantly more effective than administering the intravenous clot-busting drug tissue plasminogen activator (tPA), which was the current standard of care.
The benefit of cerebral endovascular thrombectomy is that it can mechanically remove a thrombus in minutes, whereas intravenous tPA can take up to two hours to dissolve it. Modern cerebral endovascular catheter devices have been shown to be effective at restoring blood flow and removing cerebral thrombi. Last year, at the 2015 International Stroke Conference in Nashville, Tennessee, four landmark randomized controlled clinical trials of cerebral endovascular therapy demonstrated the benefit of catheter-based clot removal to restore blood flow in patients with the most severe strokes. The stent-based retrievers and other mechanical devices used to remove stroke-causing thrombi proved so effective, that three of the four trials were actually stopped before they were completed, which allowed the reporting of results to medical professionals and the general public. Dr. Francis Collins from the National Institutes of Health stated “the challenge for the health care community will be to translate the impressive results of these studies into stroke systems of care all across this nation and around the world. If successful, many more patients will be helped, and the functional benefit will be even more substantial.”
The procedure typically takes less than an hour. A small catheter is inserted in the femoral artery in the leg and directed to the clot in the brain. Aspiration, or suction, is then used to remove the clot intact. The team approach from emergency responders to the ICU staff has resulted in many patients regaining mobility and independence.
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