Ischemic stroke patient treated with clot-retrieval device
Endovascular neurosurgeon Jorge Eller, MD, recently joined the medical staff at PeaceHealth Sacred Heart Medical Center. The following case involves the first patient he treated in his new role. (Click here to learn more about Dr. Eller.) The patient suffered a "devastating stroke" as a result of a hypercoagulable disorder of unknown origin. Quick work by his family, emergency medical services and hospital staff resulted in impressive outcomes. "We were very lucky with the timing," Dr. Eller said.
Subject: Patient is Dale Miles, a 33-year old man from Springfield with a history of hypercoagulable disorder and previous pulmonary embolism in December 2012. He was placed on Coumadin for his condition, but the medication was discontinued six months earlier due to gastrointestinal bleed.
Diagnosis: Patient was at home with his wife and roommate when he stiffened up and fell over. His wife immediately suspected stroke and called 911. The patient presented to PeaceHealth Sacred Heart at RiverBend within an hour with right hemiplegia and aphasia. His NIH Stroke Scale score was 24, indicating a severe stroke. CT angiogram revealed a clot occluding the left middle cerebral artery. It was discovered that the patient had dextrocardia, a rare congenital defect in which the heart is situated on the right side of the body
Treatment: Dr. Eller met the patient in the ED. IV tPA was given without significant change in exam results. The patient was taken to the cath lab for acute stroke intervention. Dr. Eller used the Trevo clot retrieval technology to remove the occlusion and revascularize the vessel.
Outcome: The patient had dramatic clinical improvement and regained complete verbal understanding on post-operative day one. On post-operative day two, he was able to speak and had minimal right hemiparesis and dysarthria. His NIH Stroke Scale score was 3. He was discharged to short-term inpatient rehabilitation within a week. "I got lucky," Mr. Miles said during a follow up visit three weeks after the stroke. "He is doing fabulous," said his wife, Angel. "He can walk. He's talking. He's just made this miraculous recovery."
Learn more about our Advanced Primary Stroke Center.
Watch a video introducing Dr. Eller.