UPMC On-Topic Transcript
UPMC Stroke Institute: A Multidisciplinary Approach
Tudor G. Jovin, MD
Director, UPMC Stroke Institute
What sets us apart at UPMC Stroke Institute is the multidisciplinary approach to stroke care. It starts out with emergency medicine, it continues with radiology and imaging services, it continues with inpatient components of care such as speech therapy, physical therapy and ultimately rehab services. We are fortunate at UPMC to work very closely with all these disciplines to achieve the best possible outcomes for our patients.
There are several ways to treat acute stroke but by far the most powerful in terms of improving outcomes has been shown to be opening up the blocked vessel in the brain which we call reperfusion therapy. This can be accomplished several ways, the more established way, the way that has been around for many years and is FDA approved is intravenous TPA that aims to dissolve the clot that blocks the vessel.
The other approach that can be used with longer time windows is an approach that is similar to the one that cardiologists use in heart attack which is opening up the vessel through the groin by threading wires and catheters in the clot and opening up the clot either through infusing drugs in the clot or more recently through mechanical approaches unblocking the vessel either with suction of the clot or devices that retrieve the blood clot.
The UPMC Stroke Institute has pioneered several aspects of acute stroke therapy. One of these aspects relates to treatment of patients beyond conventional time windows. We know that when patients come to the hospital with a large vessel blockage in the brain whether they come early or whether they come late, their outcome is not good. So we started looking at patients coming in late that normally would not be treated
And we found surprisingly that in these prolonged time windows, there are still quite a few patients who still have a lot of salvageable brain and therefore would benefit from these kind of interventions.