HJAR Jul/Aug 2023

HEALTHCARE JOURNAL OF ARKANSAS I  JUL / AUG 2023 51 Ali Krisht, MD Director CHI St. Vincent Arkansas Neuroscience Institute eter all the way to the brain where they’re able to locate and remove the clot. The out- comes we have seen are nothing short of miraculous and even more so when com- pared to treatments available just a few short years ago. As physicians, we have a responsibility to learn and understand the very highest stan- dards of care in our areas of specialization. We also have a responsibility to see beyond that. Compared to 50 years ago, the micro- neurosurgery procedures we’re able to suc- cessfully perform today would seem like nothing short of science fiction. These treatments have become science fact because physicians have striven to find new ways to better treat our patients and deliver even better outcomes year after year. Our patient outcomes have improved because we share those experiences with our colleagues. We improve as physicians because we never give up on our patients regardless of how daunting the challenge may seem. n BRAIN is time when it comes to treating stroke patients. In my past contributions to the journal, I have gone into great detail about the importance of quickly identifying symptoms of a stroke and how the speed at which those patients receive medical care can directly impact their outcomes, par- ticularly when it comes to potential deficits associated with stroke cases. We cannot, however, rely on speed alone. That’s why I wanted to share the experience my team has had with one treatment that has led to stroke patients returning home healthy within two days who could have otherwise easily faced permanent deficits. One of the most common types of stroke occurs when a clot passes into the brain. The result is what I describe as a “brain at- tack,” similar in many ways to what a heart attack patient would experience. In stroke, though, that clot quickly prevents blood from reaching parts of the brain. Brain cells deprived of that necessary oxygen the blood provides begin to die. This begins to happen within minutes, and once those brain cells are dead, they cannot be replaced. For some stroke survivors, the resulting deficits can include permanent brain damage or dis- ability. Fast treatment is a priority. This is why stroke patients are initially given tPAmedi- cations designed to break down the clots chemically so that blood flow can resume and those brain cells are preserved. These medications and their implementation in emergency rooms have been lifesaving to say the least. They don’t, however, always work. When these medications fail to dissolve the clot, we increasingly turn to another solution. We can quickly take patients to an angio suite where a specially trained physi- cian is able to use a catheter, much like you would use for heart procedures, to essen- tially fish the remaining clot out of the brain so full blood flow can resume. The catheter is inserted through the groin, and the physician navigates the cath- “Compared to 50 years ago, the microneurosurgery procedures we’re able to successfully perform today would seem like nothing short of science fiction. These treatments have become science fact because physicians have striven to find new ways to better treat our patients and deliver even better outcomes year after year.”