Cleveland Clinic Indian River Hospital has developed protocols to streamline and expedite the care of stroke patients, which includes evaluation and initiation of treatment with a clot-busting drug called Tenecteplase within four-and-one half hours of first symptoms – for patients deemed appropriate. This medication, which has been used for many years as a treatment for heart attack, has now been found to save lives and decrease disability for certain types of stroke. Patients for whom the drug is appropriate must begin treatment within four-and-one half hours after first symptoms. CCIRH has been awarded the Gold Seal of Approval™ and designation as a Thrombectomy Capable Stroke Center of Excellence by the Joint Commission, which examined the above protocol.

CCIRH’s neuro-interventionalist team provides advanced treatment for ischemic strokes using a procedure known as mechanical thrombectomy, a technique that has revolutionized stroke care in the United States. An ischemic stroke is caused by a blood clot that blocks the flow of blood to portions of the brain, and nearly 87% of strokes are ischemic.

While not an option for all patients, mechanical thrombectomy – which can be used to treat even the most severe cases – uses a catheter to reach the blockage and then entangles the clot in a wire mesh stent for removal. Each patient’s recovery is individualized, but research clearly shows the procedure has positive results for one of every three patients if treated within 24 hours. This dramatically increases a patient’s chances of returning to his or her pre-stroke health following the procedure.

Our interventional neurology team recently helped a patient recover from a stroke and return to work at the Sheriff’s Office. To hear his story, click here.

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A grading system is used to measure how well blood flow is restored following mechanical thrombectomy treatment. This is called a thrombolysis in cerebral infarction (TICI) score. Scoring is defined as follows:

  • Grade 3 – Complete restoration of blood flow in the brain
  • Grade 2b – Complete restoration of blood flow, but slower than normal
  • Grade 2a – Partial restoration of blood flow to the brain
  • Grade 1 – Minimal restoration of blood flow to the brain
  • Grade 0 – No restoration of blood to the brain

TICI 2b and TICI 3 are considered successful treatments for restoring blood flow in the brain. At Cleveland Clinic Indian River Hospital, 75% of patients (October-December 2021) who received thrombectomy treatment for stroke achieved a grade of TICI 2b or 3 compared to 76% of patients studied nationally in a recent clinical trial.

In addition, patients who undergo thrombectomy treatment for stroke are monitored closely for complications, specifically for serious bleeding events after the procedure. At Indian River, 6.2% of patients experience any bleeding complications (January-December 2021), as compared to a 7% symptomatic intracranial hemorrhage rate seen in a recent clinical trial.