New stroke center created at VBMC

September 9, 2018

HARLINGEN — A stroke just isn’t what it used to be.

Or rather, the outcome is quite different. It’s still a condition in which a blood clot in the brain causes a loss of function. However, in the past few years medical science has revolutionized how it’s treated.

For years, medical care for strokes involved the use of an IV to dissolve the clot. That method is still used for milder cases. However, a new technique can treat people with more severe strokes and make them good as new.

That technique, known as an endovascular procedure or mechanical thrombectomy, helped create the only comprehensive stroke center in South Texas — at Valley Baptist Medical Center.

Why is that important?

Because use of the technique means a patient might fully recover from a stroke with no lingering disability.

The use of IV-administered medication to dissolve clots was the standard for many years to treat strokes. It could be given anywhere, said Dr. Ameer Hassan, who was hired in 2012 to develop the comprehensive stroke center, or CSC.

In order to receive a mechanical thrombectomy, a stroke patient must be brought to the comprehensive stroke program at Valley Baptist. This procedure is for patients exhibiting significant stroke symptoms such as weakness in the arms, legs and face.

Hassan said when a stroke victim arrives at the emergency room, he’s given a CT angiogram to locate the clot. Another test determines whether there is dead tissue in the brain resulting from the stroke. If that is the case, the thrombectomy is not performed. If not, the patient is taken to the cath lab. A catheter is inserted in the groin, run through the body and into the artery in the brain where the clot is located. The device removes the clot, and the stroke symptoms soon disappear.

The CSC now sees about 800 stroke patients a year and performs 120 thrombectomies. While the center does perform other procedures, its primary focus is strokes.

“We were certified as a CSC in 2016,” Hassan said. “We were recertified in 2017 and certified again about a month ago,” said Hassan, director of endovascular surgical neuroradiology and clinical neuroscience research at the Valley Baptist Brain and Spine Network at Valley Baptist.

Hassan said he was hired because a CSC must have a physician with endovascular training and research. He’d just finished his fellowship training at the University of Minnesota in Minneapolis. A year after he arrived at Valley Baptist he hired Dr. Wondwossen Tekle.

“ He was my junior fellow at the University of Minnesota,” he said. “I helped train him there and then when I came down here and saw I needed help I immediately called him to bring him down.”

“We had a vision to take an untapped market and make it into a comprehensive stroke center,” said Hassan.

Over the next few years Hassan, Tekle and the rest of Valley Baptist’s neuroscience team built up a “premier endovascular program” which used thrombectomy. The current version of the device was approved by the FDA only in 2012.

The center has participated in numerous medical studies, fulfilling one of the requirements for certification as a comprehensive stroke center, Hassan said.

“Probably the biggest thing we’ve done actually is being a part of two major trials that have shaped stroke treatment for the whole world, those being Swift Prime and Dawn,” Hassan said. “Swift Prime was the first study that showed endovascular therapy for stroke was superior to just an IV clot buster.”

So impressive was this mechanical thrombectomy, technique that the Swift Prime study, which began in 2012, was halted before its scheduled conclusion.

“The safety and monitoring board stopped the trial,” Hassan said. “They said mechanical thrombectomy and endovascular surgery is far superior to IV treatment. So it’s unethical to continue, which is one of the best outcomes you could ever ask for.”

Hassan said the Swift Prime study began in 2012 and halted in 2013. Publications came out in 2014 and 2015

Manny Vela, CEO of Valley Baptist, said he’s grateful to the stroke team for creating the only comprehensive stroke center in South Texas.

“It means not having to seek the highest quality of care as it relates to this type of treatment anywhere outside the Valley,” he said. “I love the thought that we are offering the highest quality of care in the best environment possible for our entire community.”

Valley Baptist also has the only Level II Trauma designation south of Corpus Christi, meaning it can give care to all injured patients. Valley Baptist in Harlingen and Brownsville both have the only new-born intensive care unit Level III facilities in Cameron County.


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