In a nonrandomized controlled intervention study published in JAMA, researchers in Germany assessed whether deployment of a flying interventional team, consisting of a neurointerventional radiologist and an angiography assistant, was associated with a shorter time to endovascular thrombectomy for patients in rural or intermediate population areas in Southeast Bavaria.

This video explains the study design. Click https://ja.ma/FIT for full details.

COMMENTARY:

Stroke prevention by a healthy lifestyle, including a good diet, regular exercise, and sleep is of course preferable to treatment.

However, stroke still claims more than 100,000 lives per year in the United States, and is a major factor in disability.

Recognition of a stroke is the first crucial step, and has been discussed in DWWR previously; FAST is the Menmonic and guiding principle. Ask the patient to smile, and it may be assymmetric, with one side drooping. Ask the patient to raise both arms, and one may drift down. Ask the patient to repeat a simple sentence, and he may be unable to do so. And above all be speedy, since time is of the essence, and treatment must take place within a very few hours.

Modern medical centers in large cities frequently have a team dedicated to treating stroke. The patient goes for a CT or MRI while  the Catheter team assembles. An intravenous clot dissolver, tPA, is often used, or possibly a catheter is inserted into an artery and guided to the  proper location. Sometimes the clot is mechanically removed as in the accompanying video.

The helicopter stroke response team featured in the posting is one aspect of the speed that is so essential; any delay will result in death, sometimes permanently, of brain cells.

Acute Heart attack treatment is basically similar to stroke, and was the pioneering venture into the interventional radiology described above. Also, the heart may be the source of the clots that lodge in the brain, especially from atrial fibrillation.

Please enjoy the following video which shows how mechanical clot removal is achieved.

—Dr. C.