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Published on August 20, 2018
Procedure guides tiny catheter from groin or arm directly into brain
You may have heard of a Code Blue, but have you ever heard of a Code NASCAR? While it has nothing to do with stock cars, this code has everything to do with racing – to stop a deadly stroke. NASCAR stands for Neuro Angio-Suite for Cerebral Arterial Reperfusion, and is the code to activate a team of medical professionals and a special room at Essentia Health-St. Mary’s Medical Center in Duluth. Here, Neuro-Interventionalist Dr. Vikram Jadhav will perform stroke thrombectomies, guiding a catheter from the groin or arm directly into the brain to remove deadly blood clots. “Many of these strokes are due to a clot in an artery blocking the blood supply to the brain,” says Dr. Jadhav. “Patients can be treated with intravenous “clot busting” medication, but only within four and a half hours from symptom onset. However, the clot can also be retrieved by inserting a small catheter through the leg or arm artery to reach the brain artery to capture and pull out the clot.”
This treatment, called “stroke thrombectomy,” can be provided up to eight hours from symptom onset. Dr. Vic, as he is affectionately called by his patients and colleagues, says recent clinical trials have shown that thrombectomy can be done for patients who haven’t had a completed stroke even up to 24 hours after symptom onset.
“Thrombectomy, done in a timely manner, can prevent profound neurological deficits, such as paralysis on one side of the body, loss of language function, inability to speak or swallow and even death,” Dr. Vic says. Stroke patients from northern Minnesota and nearby Wisconsin areas were previously transferred to the Twin Cities to have this special procedure performed by a neuro-interventionalist, often resulting in delayed treatment.
“Now, we have the same treatment for stroke patients at Essentia St. Mary’s hospital in Duluth by partnering with the Minnesota Stroke Network,” Dr. Vic adds. To perform this amazingly complex procedure, Dr. Vic, a member of the Minnesota Stroke Network, had to complete specialized training. “After completion of my neurology residency at the University of Minnesota, I completed further fellowship training in stroke and cerebrovascular diseases and interventional neurology. This extensive training enables me to offer treatment to patients with acute strokes, brain aneurysms, stenosis (narrowing) of neck and brain arteries and other cerebrovascular diseases.”
Being a stroke neurologist as well as an interventional neurologist, Dr. Vic does not have to rely on other physicians or providers to make decisions for treatment. He can evaluate patients when they are brought to the emergency room. If they are a proper candidate for acute stroke treatment, a Code NASCAR goes out and the neuro-intervention team, led by him, will immediately take the patient to the angio-suite for emergent stroke thrombectomy.
Once inside the angio-suite on the fourth floor of St. Mary’s, Dr. Vic guides a catheter from the patient’s leg or arm blood artery into the brain artery, constantly visualizing it under fluoroscopy, an X-ray image using contrast dye. The angio-suite has two imaging machines so he can see different angles to ensure accuracy. This is called biplane angiography. Once in place, Dr. Jadhav uses a device called a stent retriever. The device is attached at the tip of a thin wire inserted through the catheter to capture and pull out the blood clot. This immediately restores blood flow to the brain and prevents a debilitating or life-threatening stroke.
“My care for our patients continues well after the emergency procedure,” Dr. Vic says. “My team and I continue to provide care to patients in the Neuro Intensive Care Unit, then on the medical floor until they are discharged from the hospital. After being discharged, we follow-up with them in the clinic setting to ensure further stroke prevention and long-term well-being.”
Dr. Jadhav also holds a doctorate in cerebrovascular pharmacology from the Southern Illinois University School of Medicine. “The exciting field of interventional neurology allows me to bring new research directly to patients and provide complete ‘bench to bedside care,’” he says. Dr. Vic came to Minnesota for his neurology residency and immediately fell in love with the scenic North Shore and Lake Superior. When not saving lives, he spends his time traveling and enjoying his family and friends.
Essentia Health-St. Mary’s Medical Center is a Primary Stoke Center, a designation from the Minnesota Department of Health. St. Mary’s and Dr. Vic will be able to provide life-saving stroke care 24/7/365, right here in the Northland.
Call 9-1-1 if you or someone you love is exhibiting these symptoms of stroke: