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radiology

The Comprehensive Stroke Center at University Hospital

The Gold Standard

 

The Comprehensive Stroke Center at University Hospital is committed to achieving the best outcomes in patient care and applying the most current scientific standards for treatment.
Hospitals designated as "comprehensive stroke centers" offer patients the best chance for survival and return to a normal life after a stroke. Research shows that stroke victims receive better treatment and recover with fewer disabilities at such hospitals.

As a comprehensive stroke center, University Hospital has access to the latest diagnostic and therapeutic developments in the field and offers the widest range of interventional options to stop a stroke in progress and minimize the potential damage. In addition, we provide the specialized monitoring and intensive care that stroke patients require beyond the emergency room treatment, as well as any early rehabilitative services that might be needed.

We take part in Get With The Guidelines® - Stroke, an in-hospital program of the American Heart Association/American Stroke Association to improve stroke care by promoting consistent adherence to the latest scientific treatment guidelines. University Hospital in 2017 received the highest possible levels of recognition – Gold Plus Achievement and Target: StrokeSM Honor RollElite Plus for successfully meeting designated levels of adherence on research-based measures for the diagnosis and treatment of stroke patients.

To achieve "Gold Plus" recognition, a hospital over two or more consecutive years must achieve 85 percent or higher adherence on all achievement measures and 75 percent or higher adherence on five or more select quality measures.

Target: Stroke recognizes hospitals that quickly treat ischemic stroke patients with the critical clot-busting drug tPA (tissue plasminogen activator). Most ischemic strokes are caused by the blockage of a brain artery by a clot, and tPA given intravenously can break up the clot and restore normal blood flow to the brain.  To be effective, tPA must be administered within 4.5 hours of the onset of stroke symptoms; the sooner it is administered, the more effective are its outcomes.

In achieving this highest Target: Stroke Honor RollElite Plus level, University Hospital was recognized for administering tPA to eligible  stroke patients within an hour of arrival at the hospital at least 75 percent of the time over the past 12 months, and administering tPA within 45 minutes of arrival for at least 50 percent of eligible cases. Based on data from 2016, on average, University Hospital administered tPA to eligible patients within 47 minutes of a stroke patient's arrival, well in excess of goal.

In certain patients, physical removal of the blood clot causing the stroke becomes necessary. As a comprehensive stroke center, trained doctors (endovascular surgeons) are available 24/7 to thread a catheter through an artery in the groin up to the blocked artery in the brain, allowing the direct removal of the clot (mechanical thrombectomy). This procedure is generally done in less than 6 hours after the start of stroke symptoms. At University Hospital, we have a high success rate in opening these vessels.

Ischemic stroke patients treated with IV thrombolytic (t-PA) therapy and/or mechanical endovascular therapy, for 2016 our success rate was 87.5%.

Opening a blood vessel with intravenous tPA or by mechanical thrombectomy carries a small risk of hemorrhage with worsening of the stroke. In 2016, we had no symptomatic hemorrhages associated with these procedures.

Stroke patients may experience narrowing or blockages in the carotid arteries in their neck which supply blood to the brain. To remove the blockages, carotid endarterectomies (CEA) and carotid artery stenting (CAS) are two preventive procedures that can reduce the risk of stroke or prevent a recurrence. Performing the procedures, however, can lead to complications, including stroke, myocardial infarction or death.

The Joint Commission has established complication rates of under 6 percent following symptomatic CEA and CAS procedures, and under 3 percent following asymptomatic CEA and CAS procedures. University Hospital had zero complications (2016) following both CEA and CAS procedures.

 

Created 11/17/17