NEW HAVEN, Conn. (AP) — When Bill Yocum suffered a stroke in February, he was given medication quickly and flown to Yale-New Haven Hospital from New London with dispatch.
But it was a tiny stent threaded through his arteries that may have made the difference in his recovery. The mesh device, situated at the end of a catheter, grabbed the clot in the blood vessel within his brain and pulled it out.
“I saw a picture of what they did,” said Yocum, a New London resident. “Yes, it was pretty wild.”
Yocum, 73, was at a meeting in East Lyme when the ischemic stroke, caused by a blood clot in the brain, hit him. He was brought to Lawrence + Memorial Hospital and given IV tPA (intravenous tissue plasminogen activator), “the only treatment that was available until last year for large-vessel acute strokes . the people who come in paralyzed and not able to talk,” according to Dr. Charles C. Matouk, who removed the clot with the stent retriever once LifeStar brought Yocum to Yale-New Haven.
In between, doctors at L+M were able to work with subspecialists at Yale-New Haven through the TeleStroke communications program.
“The new availability of this stent retriever is a game-changer in how patients do after these debilitating strokes,” said Matouk.
After his stroke, Yocum couldn’t talk and didn’t know where he was, according to Grace Chapman, who lives with him. He dragged his right leg, Yocum said, “and I lost my numbers. Through physical therapy, he’s recovered most of his functions, although he still can’t write well.
It could have been a lot worse.
“I think it’s remarkable how fast everybody moved and how fast everything came back from the paralysis,” said Chapman.
She said Yocum now does the laundry and recently made stir-fry.
“He’s pretty much back to normal,” Chapman said. “He was an avid walker and we’re just now getting back in the swing of things.”
Dr. Ketan Bulsara, director of the neuroendovascular and skull base surgery programs at Yale-New Haven, said in a release, “We were one of the earliest adopters of this major advance in the treatment of the most severe ischemic strokes.”
About 690,000 Americans annually suffer such strokes, caused by a clot in a blood vessel in the brain. Stroke is the fifth-leading cause of death in the United States and “is a major cause of adult disability,” according to the federal Centers for Disease Control and Prevention.
Matouk, who has performed the procedure 70 times, said of the stent retriever, “It’s really only in the last year that it’s really emerged as the new standard of care. Before we would pick and choose who we would do this for.”
Matouk described the stent retriever as a wire threaded through a microcatheter with the mesh on the end.
“It expands up to about 4 millimeters in size so it’s tiny,” he said.
The catheter extends from the groin into the large blood vessels in the brain known as the Circle of Willis.
“It’s from there that blood gets diverted to all the different parts of your head,” Matouk said.
Once the catheter reaches the clot, the stent is forced into it, sticks to it and removes it.
“Within seconds of the clot being removed— we do these procedures under a local anesthetic —he (could) immediately lift his arms above his head . and he was able to speak and understand much more than when he arrived,” Matouk said.
The doctor said that for those patients with the type of stroke that make them eligible for the stent retriever, “we’re able to open up their blood vessels 90 percent of the time. . What we’re able to offer in Connecticut affords people with these acute strokes the best outcome.”
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Local stroke update:
www.fortworthbusiness.com/news/plaza-procedure-plucking-blood-clots-out-of-the-brain/article_c33b3821-2823-5685-948c-31efc4e4e2d4.html