Dr. Glen Pollock of the Raleigh Neurological Clinic

KEEPING UP WITH TECHNOLOGY

A neurosurgical clinic in Raleigh, North Carolina moves to bring promising stroke treatment to area residents.

Raleigh, North Carolina is one of the fastest growing cities in America.

It’s a mix of Old South and new technology, with high tech infrastructure and a vibrant social scene.

But in a region also known for quality healthcare, there’s something else.

“You start to draw lines in the map and you’ll see there’s a higher incidence of stroke in this region,” said Dr. Glen Pollock of the Raleigh Neurosurgical Clinic.

North Carolina is one of 11 mostly southeastern states that make up Stroke Alley (also known as the Stroke Belt).1 Deaths from stroke are 10% higher in this region than in the rest of the United States.

Despite being the capital city of North Carolina, the county seat of Wake County, and the second largest city in the state, some believed there was a gap in stroke care available to area residents.

Stent retrieval

“There was a need for an interventional neurosurgeon to provide services to the patients in Wake County and beyond,” said Jacob Rodman, executive director of the Raleigh Neurosurgical Clinic.

Raleigh Neurosurgical Clinic hired Dr. Glen Pollock, specifically to perform a type of brain surgery known as “stent retrieval.” Surgeons insert a stent retriever into a patient through an artery in the groin, guide it into a stroke victim’s brain, latch onto the blood clot that’s obstructing blood flow and pull it out.  

The Clinic made the decision to bring on a dedicated neurosurgeon after several studies published in the New England Journal of Medicine found stroke victims treated with the device had almost double the chance of returning to a functional life than patients treated with drugs alone.2 Results were so impressive that, in the summer of 2015, the American Heart Association/American Stroke Association took the rare step of revising its standard of care guidelines to recommend using stent retrievers in certain stroke cases.3

“The ability to quickly remove the clot leads to better outcomes. Patients do far better. Less disability, less time in the hospital,” said Dr. Pollock.

In Wake County, Raleigh Neurosurgical believes as many as 150 patients a year could be treated with the device. 

“Now the hard part is systems have to be created within health systems to treat these patients in the appropriate amount of time and to get them the appropriate treatment,” said Dr. Pollock.

Raleigh’s Wake Med is now able to perform stent retrievals, but more than 90 percent of US hospitals are not. Unlike urban Raleigh – many rural health systems don’t employ brain surgeons. Many don’t have the infrastructure to quickly recognize potential stent retrieval cases or to get stroke victims to someone who can perform the procedure in time.

It’s estimated only 1 in 18 Americans who might benefit from the procedure actually receive it.4

“That’s a big challenge,” said Dr. Pollock. “There’s a lot of community education that needs to take place, specifically that if you’re having stroke symptoms, you need to get to the hospital.”

Medtronic is helping speed up that process, through outreach to hospitals and health systems, and public awareness campaigns such as Stroke Camps, held in several cities across the country.

Residents of Raleigh don’t have to wait. But elsewhere – it’s going to take time for the healthcare infrastructure to catch up to technology.

References

1

National Heart, Lung, and Blood Institute. NHLBI Stroke Belt Initiative. http://www.nhlbi.nih.gov/health-pro/resources/heart/stroke-belt-initiative. 1996.

2

Studies include EXTEND-IA, ESCAPE, SWIFT PRIME, REVASCAT and MR CLEAN

3

American Heart Association News. Guidelines urge new approach to treating worst strokes. http://blog.heart.org/guidelines-urge-new-approach-to-treating-worst-strokes/. June 29, 2015. 

4

Medtronic Press Release. American Heart Association's New Stroke Treatment Guidelines Establish Stent Retrievers as First-Line Endovascular Treatment for Acute Ischemic Stroke. http://newsroom.medtronic.com/phoenix.zhtml?c=251324&p=irol-newsArticle&ID=2063435. June 29, 2015.

IMPORTANT SAFETY INFORMATION

Solitaire™2 Revascularization Device

Possible complications from the use of this device include, but are not limited to:

  • Bruising and bleeding at the puncture site
  • Blockage, puncturing, tearing or spasms of the blood vessel
  • Blood clot formation outside the artery
  • Post procedure bleeding
  • Change in mental status
  • Neurologic deterioration including stroke and death
  • Infection
  • Adverse reaction to blood thinners or contrast media
  • Deformation, collapse, fracture or malfunction of the device
  • Bleeding within the skull
  • Interruption of blood flow to the heart or other organs
  • Blood clotting  or air bubbles within the circulatory system
  • Formation of  an abnormal connection between an artery and a vein
  • Distal embolization including to a previously uninvolved territory