EVT will save millions of lives from stroke. Ultimately.

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When the ERA began, its goal was to make EVT accessible to every one of the 400 or so Albertans who are eligible each year. Last year, the province’s stroke teams completed 378 procedures.

about 5 to 15 A percentage of stroke patients become candidates for an endovascular thrombectomy. But the people who do get it tend to be among the most severe cases, and so, says Michael D. Hill, “there’s a marked difference in how stroke patients flow out of the hospital now, because we’re able to send them home.” In a strange twist, some patients who once might have wound up on life support, or lain in a hospital bed for weeks, now pass out under their own power within three or four days – while others Those who experience smaller or more moderate strokes can sometimes stay longer.

One Sunday afternoon in the foothills, Hill was able to discharge a 50-year-old woman who had undergone EVT on Thursday night. A large part of his brain was at risk from a clot – but the thrombectomy almost saved it. “look at You,” He said when she was walking unaided in the hallway of the stroke ward. “You are very nice.” His stroke was caused by a heart condition called atrial fibrillation; They hoped that the prescription of blood-thinning drugs would prevent further clots from recurring. Hill said to the woman’s daughter, “It’s a good thing you got her here quickly.” “She’s done well. We’ll see you back at the clinic for follow-up.

Elsewhere on the ward, the diversity and brutality of the stroke’s effects were on display. An old woman, who asked about his age, could only say sarcastically: “Very old.” His sense of humor was intact, but his own biographical information had now escaped him. Another patient, an older man, could no longer find language to express his knowledge of the world. When Hill showed him the packet of butter, and asked him if he knew what it was, the patient confidently replied “yes”. But then he stopped, struggling, unable to come up with the words. A man in his mid-40s was buoyant, eager to walk on his own, determined to go home and begin physical therapy. But he still couldn’t swallow consistently, and he remained on a liquid diet. So he had to stay.

Like patients experiencing a heart attack or major trauma, patients suspected of acute stroke bypass the normal ER triage process. Instead, they are brought directly into a trauma bay behind the main emergency room, and what comes next is a kind of frantic choreography. I saw the whole dance one Friday night after Page went out – STAT STROKE. ETA 5 minutes – The stroke team assembled in the back of the ER to wait for the patient, a woman in her late 40s.

After a brief stop in the trauma bay for a neurological exam, she was led directly down the hallway to diagnostic imaging, where two paramedics carefully hoisted her off the gurney and onto the bed of the CT scanner. The machine hummed, and Dr. Steven Peters, the on-call stroke neurologist for the night, peered over a resident’s shoulder at the black-and-white images filling the desktop computer screen.

Unfortunately, this patient was not yet discovered; His stroke had been going on for several hours. It was too late to consider TPA, but EVT was still worth a try: “It looks like he has a lot of cortex we can save,” Peters said, still staring at the screen. . Neurointerventionists were paged. Mayank Goyal was called that night along with a Neuro Radiology fellow.

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