New 24-Hour Stroke Protocol Treats More At-Risk Patients
New 24-Hour Stroke Protocol Treats More At-Risk Patients
A new protocol for treating patients with the most common type of stroke - the type triggered by a blood clot that reduces or stops blood flow to a part of the brain — is helping more people at risk for permanent disability or death.
The shift in treatment was prompted by new guidelines issued in January by the American Heart Association/American Stroke Association. Essentially, the new protocol expands the pool of candidates that can have a procedure called a “mechanical thrombectomy,” in which doctors remove blood clots using a device threaded through a blood vessel.
The new guidelines says that patients can have the procedure up to 24 hours after the onset of symptoms typical for ischemic strokes. The previous time frame for a thrombectomy was six hours after onset of symptoms.
“Now we know that people can sustain their brain function without having irreversible injury out to 24 hours (from onset of stroke),” says Felipe De Los Rios, M.D., medical director of Baptist Health Neuroscience Center’s Stroke Program at Baptist Hospital of Miami. “In the past, we thought that was impossible.”
[Transcript]
[New 24-hour treatment protocol: Helping More Stroke Patients] Felipe De Los Rios: Over the last year, we have seen significant changes on how we approach stroke care. Now we have quite a few studies that show that patients who are having acute ischemic stroke might benefit from interventional therapies out to 24 hours. Before it was restricted to six hours. Now, this is the intervention where a proceduralist goes through the groin all the way up to the brain and removes a clot that’s launched there causing blood flow to be impaired to that area so blood cannot get to that area of the brain. And that procedure now we know that there’s people that can sustain their brain without having irreversible injury out to 24 hours. Before we thought that was impossible.
Felipe De Los Rios: So that has been a great change. As a result of these changes, what we have seen is that now more patients are being triaged to the comprehensive stroke center like the one we have here at Baptist Hospital of Miami to see if this patient will be a candidate for this therapy out to 24 hours. This results in more stroke alerts happening, but also EMS and paramedics bring more patients to comprehensive stroke centers which are the centers that are capable and have the technology and resources to deliver this therapy.
Felipe De Los Rios: Ultimately though, stroke presents the same way in men and women. Usually we teach this with FAST and it’s an acronym. F goes for unilateral face weakness so you can have a droopy face. A is for arm weakness or it could be the leg as well. S is for speech changes, either the speech is slurred or there seems like there’s some problem with language, the person can not understand or speak appropriately. And then T for time because time is very important for the interventions that we can do to prevent damage from a stroke.
[Acute Ischemic Stroke can be treated up to 24 hours after onset. Before it was only 6 hours.]
Felipe De Los Rios: Stroke is a largely preventable disease. About 80% of stroke is preventable. There are some things you cannot do much about. One of them is aging for example and some of them might be genes, but for the majority, the bulk, you can really prevent stroke. Now, stroke is a very common disorder. We know that 1 out of 6 people are going to get them throughout their life. Actually 1 in 5 women are going to get them throughout your life. It’s the second leading cause of death in the world, fifth in the United States and it’s a leading cause of disability. So things that you can do for example, include decreasing your alcohol intake, making sure that you check your blood pressure and that you don’t have hypertension and if you do, that you do things to lower that, making sure you don’t have diabetes, following a healthy diet, losing weight, doing exercise, lowering cholesterol if you have it high. And those sorts of things are going to lower your risk of having a stroke 10, 20, 30 years down the line. [Connect BaptisHealthSF: Facebook, Twitter, YouTube, Instagram, Pinterest, Snapchat]
[End Transcript]
Content
0.306 -> (upbeat music)
3.001 -> [New 24-hour treatment protocol: Helping More Stroke Patients]
7.91 -> [Felipe De Los Rios, M.D., Stroke Program] Over the last year, we
have seen significant changes
11.04 -> [Felipe De Los Rios] on how we approach stroke care.
14.07 -> [Felipe De Los Rios] Now we have quite a few studies
16.69 -> [Felipe De Los Rios] that show that patients
18.39 -> [Felipe De Los Rios] who have an acute ischemic stroke
20.896 -> [Felipe De Los Rios] might benefit from interventional
therapies up to 24 hours.
23.64 -> [Felipe De Los Rios] Before, it was restricted to six hours.
26.37 -> [Felipe De Los Rios] Now, this is the intervention
27.84 -> [Felipe De Los Rios] where a proceduralist goes
through the groin all the way
31.62 -> [Felipe De Los Rios] up to the brain and removes a clot
34.23 -> [Felipe De Los Rios] that's logged there causing a blood flow
36.62 -> [Felipe De Los Rios] to be impaired to that area.
38.76 -> [Felipe De Los Rios] So blood cannot get to
that area of the brain.
41.77 -> [Felipe De Los Rios] And that procedure now,
42.85 -> [Felipe De Los Rios] we know that there's
people that can sustain
46.24 -> [Felipe De Los Rios] their brain without
having irreversible injury
50.63 -> [Felipe De Los Rios] up to 24 hours.
52.56 -> [Felipe De Los Rios] Before, we thought that was impossible.
54.25 -> [Felipe De Los Rios] So that has been a great change.
56.46 -> [Felipe De Los Rios] As a result of these changes,
58.68 -> [Felipe De Los Rios] what we have seen is
that now more patients
60.99 -> [Felipe De Los Rios] are being triaged to the
comprehensive stroke center,
64.6 -> [Felipe De Los Rios] like the one we have here at
Baptist Hospital of Miami.
67.46 -> [Felipe De Los Rios] So to see if these patients
70.5 -> [Felipe De Los Rios] will be a candidate for
this therapy out to 24 hours.
73.41 -> [Felipe De Los Rios] So this results in more
stroke alerts happening,
76.31 -> [Felipe De Los Rios] but also EMS and paramedics
bring more patients
78.85 -> [Felipe De Los Rios] to comprehensive stroke centers
80.14 -> [Felipe De Los Rios] which are the centers that are capable
82.52 -> [Felipe De Los Rios] and have the technology
83.61 -> [Felipe De Los Rios] and resources to deliver this therapy.
86.12 -> [Felipe De Los Rios] Ultimately though, stroke
presents the same way
88.92 -> [Felipe De Los Rios] in men and women.
90.35 -> [Felipe De Los Rios] Usually, we teach this with a FAST,
92.72 -> [Felipe De Los Rios] and it's an acronym.
94.09 -> [Felipe De Los Rios] F goes for unilateral face weakness.
96.72 -> [Felipe De Los Rios] So you can have a droopy face.
98.45 -> [Felipe De Los Rios] A is for arm weakness,
100.04 -> [Felipe De Los Rios] or it can be the leg as well.
101.73 -> [Felipe De Los Rios] S is for speech changes
either the speech is slurred
105.81 -> [Felipe De Los Rios] or there seems like there's some problem
107.16 -> [Felipe De Los Rios] with language, the
person cannot understand
108.91 -> [Felipe De Los Rios] or speak appropriately.
110.35 -> [Felipe De Los Rios] And then T is for time.
111.57 -> [Felipe De Los Rios] Because time is very important
for the interventions
113.83 -> [Felipe De Los Rios] that we can do to prevent
damage from a stroke.
116.75 -> [Felipe De Los Rios] Stroke is a largely preventable disease.
119.28 -> [Felipe De Los Rios] About 80% of stroke is preventable.
122.3 -> [Felipe De Los Rios] There are some things
you cannot do much about.
124.26 -> [Felipe De Los Rios] One of them is aging, for example,
126.36 -> [Felipe De Los Rios] and some of them might be genes,
127.89 -> [Felipe De Los Rios] but for the majority, the bulk,
130.13 -> [Felipe De Los Rios] you can really prevent stroke.
131.749 -> [Felipe De Los Rios] Now, stroke is a very common disorder.
133.93 -> [Felipe De Los Rios] We know that one out of six
people are gonna get them
135.84 -> [Felipe De Los Rios] throughout their life.
137.19 -> [Felipe De Los Rios] Actually one in five women are gonna get
139.14 -> [Felipe De Los Rios] them throughout your life.
140.8 -> [Felipe De Los Rios] It's the second leading
cause of death in the world,
143.37 -> [Felipe De Los Rios] fifth in the United States.
145.36 -> [Felipe De Los Rios] I mean, it's a leading
cause of disability.
146.884 -> [Felipe De Los Rios] So things that you can do, for example,
150.08 -> [Felipe De Los Rios] include decreasing your alcohol intake,
153.48 -> [Felipe De Los Rios] making sure that you
check your blood pressure
156.4 -> [Felipe De Los Rios] and that you don't have hypertension.
158.181 -> [Felipe De Los Rios] And if you do, that you
do things to lower that,
159.9 -> [Felipe De Los Rios] making sure you don't have diabetes,
161.76 -> [Felipe De Los Rios] following a healthy diet,
losing weight, doing exercise,
167.65 -> [Felipe De Los Rios] lowering cholesterol, if you have it high.
170.36 -> [Felipe De Los Rios] And those sorts of things
are gonna lower your risk
172.5 -> [Felipe De Los Rios] of having a stroke 10, 20,
30 years down the line.
