to treat stroke by mechanically retrieving a blood clot.
Endovascular Thrombectomy Therapy: a procedure where a blockage in a blood vessel is removed by a catheter inserted into the blocked artery.
Ischemic Stroke Treatment Outcomes
Intracranial hemorrhage is the major risk of thrombolytic therapy with similar rates reported for both intravenous and intra-arterial routes. The NINDS trial found that 6.4% of patients treated with IV t-PA experienced symptomatic bleeding.
* Smaller numbers represent better outcomes.
The Thrombolysis in Cerebral Infarction (TICI) scale is a tool used to grade the degree of perfusion obtained following recanalization of an arterial occlusion. Recanalization of an arterial occlusion increases reperfusion into distal segments of the artery and restores blood flow to brain tissue. Scores may range from 0 (no perfusion) to 3 (full perfusion with filling of all distal branches).
*Many of our patients are able to go home 48 hours post thrombectomy. These patients are not included in the GWTG data.
**TICI score = Thrombolysis in Cerebral Infarction in Reperfusion Grade
For more information on Aneurysm clipping and coiling, click here.
Endovascular Coiling: A procedure where an angiogram is performed, and a catheter is used to place multiple small soft coils directly into the aneurysm to fill the space and prevent bleeding.
Aneurysm Clipping: Surgical procedure in which a clip is placed at the base of the aneurysm to prevent it from rupturing.
From 2002 through 2018, over 1,600 endovascular (coiling) procedures were performed at Barnes-Jewish Hospital to treat unruptured brain aneurysms. Of those cases, 67 had complications of stroke - a complication rate of 3.97%. Read more →
Joint Commission Performance Measures
IV tPA Administered by 3 Hrs. of Onset
The percentage of patients who received tPA within three hours of onset of their ischemic stroke, if they got to the hospital within two hours of onset of stroke. Higher numbers show greater success at giving tPA to those who need it.
Antithrombotics at Discharge
The percentage of patients with ischemic stroke receiving antithrombotic therapy at the time of discharge. Patients with ischemic stroke should be on some form of medication to prevent blood clot formation (antithrombotic therapy), to lower the risk of stroke in the future. The medications most often used for this are aspirin, clopidogrel, or aspirin/dipyridamole.
Anticoagulation for Atrial Fibrillation/Flutter
The percentage of patients with ischemic stroke who also have atrial fibrillation (a heart rhythm disturbance) who are discharged on warfarin or other anticoagulation. These are the most effective medications to prevent future ischemic stroke in these patients.
Assessed for Rehabilitation Before Discharge
The percentage of patients with stroke who are assessed for the need for rehabilitation therapies, either by therapists or physicians. Patients with stroke, whether severe or mild, should be assessed to see if they need physical, occupational, or speech therapy to speed their recovery, so these therapies can be started, if needed, to speed up recovery.
VTE Prophylaxis by Hospital Day 2
The percentage of patients receiving treatment to prevent blood clot formation in the legs or lungs by hospital day two. Patients with stroke can develop blood clots in the legs or lungs as a complication (called venous thromboembolism, or VTE), so it's important that they receive treatments to try and prevent these, starting early in their hospitalization.
Statin Prescribed at Discharge for LDL>100
It is recommended that patient with ischemic stroke who have LDL cholesterol (the so-called "bad" cholesterol) greater than 100 receive "statin" medications, because this is proven to lower the risk of future stroke and heart attack. This graph displays the percentage of these patients who were discharged on a ‘statin.’
Early Antithrombotics by Day 2
The percentage of patients with ischemic stroke receiving medication to prevent blood clot formation (antithrombotic therapy) by the end of hospital day 2, to lo