Acute ischemic stroke management

Feature Summary

To rescue the ischemic brain tissue by reopening cerebral arteries as soon as possible. This is proved to be associated with good functional outcomes after ischemic stroke.

 

Overview

Acute ischemic stroke is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function. Acute ischemic stroke is caused by thrombotic or embolic occlusion of a cerebral artery.

Features

Our current managements of acute ischemic stroke is based on the duration from the onset time of symptoms according to the international guidelines. If the onset time is within 3 hours, we activate the evaluation protocol of recombinant tissue plasminogen activator (rt-PA) injection. We give rt-PA therapy if patient is qualified according to the criteria. We also arrange advanced angiographic imaging after injection of rt-PA for further intra-arterial thrombectomy evaluation. If patient arrive the emergency department within 6 hours from onset, we initiate intra-arterial thrombectomy protocol after major artery occlusion being identified. For patients arriving our hospital out of the time window mentioned above, we start the acute medical treatment and arrange brain MRI as well as further examinations for etiology survey. Admission for comprehensive care followed by rehabilitation referral will also be arranged.

 

Procedure

We arrange precise evaluation to find out the legit patients for acute management. The rt-PA therapy is non-invasive, and is applied via intravenous dripping. You won’t feel pain or significant discomfort during entire treatment. The intra-arterial thrombectomy is an advanced and invasive procedure. A puncture will be made through your femoral artery at the groin and catheters being inserted retrograde to your intra-cranial arteries under conscious sedation or generalized anesthesia. We use stent-retriever or intracranial suction catheter to extract intra-arterial thrombus. The patient treated with rt-PA or intra-arterial thrombectomy will be admitted to our stroke care unit for intensive care.

 

Notification

  • Intracranial hemorrhage (3-10%)
  • Internal bleeding, e.g.: Gastric bleeding (<10%)
  • Severe brain edema (The incidence varies according to the stroke severity)

 

Estimated Cost

The procedure cost is about 300,000~600,000 NTD, prices are subject to change without prior notice, need to pay in accordance with the actual medical expenses.