Early stroke intervention a success for patients

November 24, 2014 | Jacksonville, FL

Neurovascular surgeons Ricardo Hanel, MD, Phd, and Eric Sauvageau, MD, directors of the Stroke & Cerebrovascular Center at Baptist Medical Center Jacksonville, have always been strong advocates that expedited treatment with IV-tPA and endovascular surgical tools for acute ischemic stroke patients is beneficial. But not all physicians were convinced.

Now there is evidence from a recent international study that proves such intervention works and helps save lives like that of Mandarin resident Janet Bosman.

Results from the international study, MR CLEAN (Multicenter Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands), were announced recently in Turkey.

The study and others like it that look at intervention of large-size clots will revolutionize the treatment of strokes, Dr. Hanel said, and provide much needed evidence to more neurologists and other physicians that such treatment is beneficial in addition to giving patients the tissue plasminogen activator (tPA) medication.

While Baptist was not in the MR CLEAN study, the Baptist Stroke & Cerebrovascular Center has similar studies that are now on hold because of positive results from the international study.

“This is a major breakthrough and the best thing to happen for patients with acute stroke since IV-tPA almost 20 years ago,” Dr. Hanel said. “In some places, these patients are only given tPA, but now there is evidence that these patients do better if they get intervention. That is huge.”

Dr. Sauvageau added, “This is an exciting time. This study clearly shows that more people regain functionality and fewer patients end up in a nursing home with endovascular treatment. This is tremendous.”

The Stroke & Cerebrovascular Center at Baptist Jacksonville does such interventions and has the most experience in the field for this region. The results of recent studies internationally could result in more patients being transferred for treatment.

Bosman, 45, had a stroke in June at her home in Mandarin and was transported to Baptist Medical Center South and soon after taken by helicopter to Baptist Jacksonville. Early intervention by Dr. Hanel saved her life. He was able to perform a minimally invasive procedure through her groin and remove the clot on the left side of her brain using a stent. If she had not received the intervention, her outcome would have been much different.

“Dr. Hanel said it if had been much later, I would have been dead,” Bosman said. “When I woke up in the hospital room, my daughter ran and hugged me and my husband was crying. Dr. Hanel is phenomenal. He’s been an angel. He saved my life. He has a special place in my heart. He sat and held my hand and said I was his miracle patient.”