Minutes matter when diagnosing and treating stroke. Recently acquired state-of-the-art brain imaging software now enables stroke experts at Overlook Medical Center’s Emergency Department to increase the number of treatable patients within the 24-hour window.
Overlook Medical Center has led the way in a systemwide deployment of the RAPID imaging platform from iSchemaView, the most advanced brain imaging software platform for identifying treatment options for stroke patients. It sends CTA/CTP images to stroke neurologists’ and neurosurgeons’ smartphones and allows doctors to quickly identify reductions in blood flow to the brain and early signs of brain injury to determine if surgery will benefit the patient.
Overlook was a pioneer in the deployment of technology to assess stroke patients in the ambulance and treat stroke as quickly as possible with a telestroke network that covers Atlantic Health System medical centers. Deploying RAPID was an obvious way to speed up brain-saving treatments even more. TeleStroke technology enables stroke neurologists to evaluate the patients in the ambulance and have the stroke team ready in the emergency department to perform next step treatments.
Now, if imaging shows a large blood vessel is blocked with a clot that likely cannot be addressed by administering tPA, the images are sent to a neurosurgeon to assess if a surgical procedure called mechanical thrombectomy is an option to remove the clot.
“A traditional CTA (computed tomography angiogram) can take up to 15-20 minutes,” says stroke neurologist John M. Hanna, MD, one of several neurologists who rotate on call 24/7 to rapidly diagnose patients coming to Overlook’s Emergency Department with symptoms of stroke. “The RAPID platform emails results to the team in two minutes, allowing us to determine very quickly if the patient is a candidate for an interventional procedure.”
Extending the Treatment Window
Groundbreaking research has expanded the window for mechanical thrombectomy from six hours to 24 hours for select patients based on their brain scans.
According to Ronald Benitez, MD, chief of endovascular neurosurgery, if patients are candidates for mechanical removal of the clot, he can thread a catheter through a femoral artery (or in some cases, a radial artery) to reach the blockage, and then entangle the clot in a wire mesh stent for removal. Although each patient’s recovery varies, research shows the procedure dramatically increases a patient’s chances of returning to his or her pre-stroke health following the procedure.
“RAPID software is a real game changer for our patients,” says Dr. Benitez. “The ability to receive CTA/CTP images right to my smartphone within two minutes of the scan makes a real difference in a patient’s outcome. If the patient is at Chilton Medical Center and is eligible for a thrombectomy, we can mobilize the transport to Overlook faster and shave off precious minutes to the procedure suite.”
Complementing Urgency of Care
“Urgency of care is one of the hallmarks of clinical excellence,” observes Christopher Amalfitano, MD, CPE, chairman of Overlook’s Emergency Department. “Fast diagnosis equates to faster treatment and better outcomes. RAPID helps elevate our level of lifesaving emergency care.”
After initial testing at Overlook, RAPID is now used in the emergency departments at four Atlantic Health System hospitals, where a swift diagnosis helps determine whether to transfer a patient to Overlook’s Comprehensive Stroke Center, a regional hub for advanced stroke treatment, and is the only hospital in New Jersey and New York recognized by Healthgrades® as America’s 100 Best Stroke Program for six years in a row.