ALBANY, N.Y., March 2, 2005 — Albany Medical Center is the first in the region to offer stroke patients emergency treatment with a new corkscrew-shaped device that pulls blood clots out of arteries in the brain. It was approved by the FDA last fall after clinical testing showed it could extend the time window in which a stroke patient can get treatment from 3 to 6 hours to 8 hours and that it works in 50 percent of stroke patients it is used in, the highest among any device used for stroke treatment.
“This really is a breakthrough technology that is now part of our multi-disciplinary arsenal in reversing paralysis from stroke,” said Dileep Yavagal, M.D., stroke neurologist and neurointerventionalist at the Medical Center’s Neurosciences Institute, who came to Albany Med six months ago after completing a two-year neurointerventional fellowship at UCLA where the device was pioneered.
The device, called “MERCI” (mechanical embolus removal in cerebral ischemia), is made of nickel and titanium alloy and is about an inch long and shaped like a thin corkscrew. It is inserted into the blocked brain artery through a catheter, which is fed into the femoral artery in the leg, up through the aorta, and into an artery leading to the brain. In this minimally invasive procedure, doctors insert the corkscrew and pull the clot out through the catheter, in an effort to bring back blood flow in the brain. It is used in patients with strokes caused by blood clots, not those caused by hemorrhages in the brain. Blood clots cause the vast majority of strokes.
“This procedure, which is appropriate for the majority of stroke patients, can be done in the first 8 hours after a stroke. That extends the time by 2 hours that a patient can get to the hospital and have the best chance at effective treatment. In some patients with strokes in the back of the brain (brain stem) the device can be used with good results up to 12 hours after a stroke begins,” said Dr. Yavagal. MERCI is not effective after 8 hours (or 12 hours in the case of a brain stem stroke) when the blood clot has caused damage to the brain.
“That is actually the biggest problem we still face. People are not getting to the hospital when they experience stroke symptoms,” said Dr. Yavagal. He acknowledges that because strokes typically don’t “hurt” the way other medical emergencies do, patients are less likely to seek immediate treatment. “If they do, though, they have a much better chance at reducing brain damage,” he said.
Symptoms of a stroke include sudden numbness, weakness or paralysis, especially on one side of the body. Other symptoms can be sudden blurred vision and/or sudden difficulty in speaking or understanding language. Patients with these symptoms should call “911” right away.
Albany Medical Center has a dedicated multidisciplinary stroke team – comprised of a neuroradiologist, neurosurgeons, an interventional neuroradiologist, nurse practitioners, nurses, vascular surgeons and rehabilitation specialists – which is equipped with powerful tools for dealing with strokes. These include tPA (tissue plasminogen activator), which is a clot buster. If the stroke team can get tPA into the patient’s vein within the first three hours after a stroke or directly into the clot within the first six hours, there is a good chance of preventing permanent damage. The MERCI device extends that time window two more hours and can be used along with other treatments depending on the situation.
“Albany Med now offers everything currently available to fight brain damage from stroke,” says Dr. Yavagal, who uses MERCI along with Alan Boulos, M.D., neurosurgeon, who started the neurointerventional program at AMC.
Albany Medical Center is northeastern New York’s only academic health sciences center. It consists of one of the nation’s oldest medical schools, Albany Medical College; one of New York’s largest teaching hospitals, Albany Medical Center Hospital; and one of the Capital Region’s most active fundraising organizations, the Albany Medical Center Foundation, Inc.