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posted: 1/26/2015 8:46 AM

Hospital saving more stroke patients than before

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  • Dr. Tim Malisch, right, describes the endovascular treatment he used to save the lives of these two recent stroke victims, Maryann Imielski of Addison and Peter Castellonas of Crystal Lake.

    Dr. Tim Malisch, right, describes the endovascular treatment he used to save the lives of these two recent stroke victims, Maryann Imielski of Addison and Peter Castellonas of Crystal Lake.
    courtesy of David Pflederer/Alexian Brothers Medical Center

 
By Eileen O. Daday
Daily Herald correspondent

Excitement is running high at Alexian Brothers' Comprehensive Stroke Center in Elk Grove Village.

On Jan. 8, surgeons successfully saved another patient who had a severe stroke. Doctors opened up the blocked blood vessel and removed the clot, restoring blood flow to the brain.

"This was a potentially devastating stroke, the kind you don't walk away from," says Dr. Timothy Malisch, director, Interventional Neuroradiology and co-medical director of Alexian Brothers Comprehensive Stroke Center.

"The clot was in the basilar artery," he adds, "which supplies blood to the back of the brain, which controls vision, and to the brain stem, which controls movement."

Hospital officials treat as many as 50 stroke patients a year, but saving patients from this most serious variety happens rarely.

"I was in the right place, at the right time, and with the right people," says Maryann Imielski of Addison, who returned to Alexian Brothers on Monday for blood work, still marveling at her good fortune.

Imielski had just arrived at the VFW Hall in Addison, where she works as a bookkeeper, when she heard what sounded like a loud crash in her head. When she tried to tell co-workers, no words would come out.

Luckily, her colleagues recognized that she was having a stroke and called 911. Paramedics took her to the nearest comprehensive stroke center, Alexian Brothers Medical Center, where she was evaluated within 30 minutes of first showing symptoms.

"When patients come in showing signs of stroke, we have to determine if it is better to give them blood clot dissolving medicine, (tissue plasminogen activator, t-PA)," Malisch said, "or is it better to use a catheter to open up the blood vessel to physically remove or suck out the blood clot, using intra-arterial therapy."

The Comprehensive Stroke Center has performed the intra-arterial stroke rescue procedure more than 300 times over the years, but basilar artery occlusions such as Imielski's represent an uncommon and threatening challenge.

Just over a year ago, Peter Castellonas of Crystal Lake was visiting his brother in Elk Grove Village when he collapsed.

Malisch and his stroke crew reached him soon enough, so they were able to retrieve the blood clot lodged in his basilar artery, and monitored him during his recovery.

Castellonas spent nine days in the hospital and another two weeks in Alexian Brothers' Rehabilitation Center, before returning home. Within a month, he was back on his job as a tow-truck driver.

"Peter was so seriously ill when we brought him here," his mother, Bonnie Castellonas of Crystal Lake says. "He was only 51 at the time. We thought he'd never recover, but they saved him."

As a comprehensive stroke center -- they just earned their recertification from the Joint Commission last week -- Malisch and his colleagues have participated in clinical research trials for more than a decade. These trials include endovascular stroke rescue through clot retrieval.

Last month, an article in the New England Journal of Medicine affirmed Alexian Brothers' own findings: that removing a blood clot and re-establishing blood flow to the brain not only averts a stroke, but improves function during recovery.

In a report titled, "MR. CLEAN," doctors in the Netherlands reported that endovascular treatment improved rates of good outcome in stroke patients from 19.1 percent to 32.6 percent, 90 days after treated.

The key to advancing this endovascular treatment, is recognizing stroke symptoms when they occur and getting to the nearest emergency department.

"We're so excited to have this new round of evidence-based treatment, that shows that we can reverse these conditions," Malisch adds. "But time is of the essence. 'Time is brain,' as we say in the business."