Mechanical thrombectomy what procedure so effective?
In Acute ischemic stroke, time is the crucial factors. In ischemic stroke, usually there is sudden occlusion of the blood tube supplying a part of the brain, cutting off the blood supply heading to the death of the brain cells, the neurons. Once that part of the brain cells, the nervous. Once that part of the brain losses its function it results in symptoms of stroke and many times it can be permanent. Hence interventions in the immediate period after stroke is very essential. The Golden hour for stroke treatment is initiation of acute stroke treatment as soon as possible after the onset of stroke because it is possible to reverse or stop further brain damage. It is rightly said that in Acute Stroke treatment “TIME IS BRAIN”.
In case of large vessel occlusion, after initial intravenous thrombolysis becomes essential to restore blood circulation to the ischemic brain . Here a catheter is introduced via peripheral access to reach directly o the site of the large vessel occlusion and remove the blood clot directly. Many times Ballon Angioplasty or a stent Placement may be required. There is a time limit after onset of Stroke when mechanical thrombectomy can be done. Hence when utilizes in the right situation mechanical thrombectomy is a very essential procedure in saving the brain & preventing or reducing the disability arising from Stroke.
The PRAAN registry highlights excellent recovery rates for Patients undergoing thrombectomy. How closely does this align with the outcomes you see in your practice?
Mechanical Thrombectomy is a miche procedure. Whereas the skill & expertise of the interventionist is a crucial factor which determine the successful outcome of this procedure. The earlier the patient is taken up for the procedure after the on set of Stroke. The outcomes are better, It is also essential to decide on various factors before subjecting the patient to the procedure. The duration from onset of Stroke. ASPECTS score which rating of stroke based on CT scan of brain. The diffusion & perfrison mismatch on CT or MRI Brain are all tools which guide is assessing the benefit of performing mechanical thrombectomy. Hence outcome is definitely good provided all the above factors are considered in decides would benefit from the procedure
What AX is the biggest barriers that prevent more patients from accessing it
Majority of stroke ready hospitals in time that is within the golden hour of stroke treatment. These ax various reasons why a stroke patient does not seek immediate treatment unlike a patient with heart attack where the chances of seeking immediate treatment is higher. Often the stroke symptoms are very suitable to start with. The patient may experience numbness, speech difficulty. Difficulty in walking which may be misunderstood to be due to various other reasons and often patients & the family members.
Prefer to wait out and see if these symptoms improve by themselves. When the symptoms nearby health facility by which time it may be already too late or they may be delay at the primary health facility before referring the patient to a stroke ready unit. Even at the primary health facilities there may be a fracture to recognize the stroke symptoms & signs due to lack of expertise and knowledge what needs to be done on encountering an acute stroke patient.
In India Stroke ready hospital is available only in few centers majority of which are located in cites and a very small number of population do not have access even to primary health facilities. Majority of health facilities lack health care workers who have knowledge on recognition of acute stroke symptoms, importance of golden hour in stroke treatment and what needs to be done ideally on encountering a patient with acute stroke.In those patients who do access stroke ready hospital units, many would not be able to afford the cost of acute stroke treatment Again there may be a number of patients there families who seek alternatives methods of treatment and deny he proper treatment of acute stroke due to lack of knowledge and false beliefs. They may seek miracle cure from practitioners of country medicine other such methods . These are the must common reasons why a majority of acute stroke patients may fail to access treatment.
