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After watching his beloved Montréal Canadiens on TV, Gatineau’s Conrad Chénier went to bed on a Thursday evening last March, feeling perfectly healthy. But when the 53-year-old father of two awoke at 4 a.m. to go to the bathroom, he couldn’t lift himself out from under his covers.
Alarmed, he began to yell, but his speech was slurred.
“That’s when I knew something was seriously wrong,” said Chénier, a longtime employee of Natural Resources Canada.
His wife, Chantal, called an ambulance as his adult sons, Dominik and Marc André, pleaded with him: “Don’t leave us.” Chénier lost consciousness as he was rushed to Gatineau Hospital where brain scans revealed that a large artery to his brain was clogged with plaque.
Such severe strokes traditionally have been associated with high rates of death, disability and brain damage. Brain cells deprived of the oxygen and glucose ferried by the bloodstream start dying within minutes.
Chénier was transferred at 8:15 a.m. to The Ottawa Hospital where Dr. Cheemun Lum, an interventional neuroradiologist, recognized that doctors were in a race against time.
Dr. Lum believed that the best course of treatment for Chénier was a new procedure known as an endovascular thrombectomy (ET). The procedure, which must be performed within hours of a stroke’s onset, requires a thin tube to be inserted into the artery of the groin. The tube, guided by X-ray imaging, is then threaded through blood vessels to the site of the blockage in the brain, where doctors deploy a “retrievable stent” to penetrate and remove the blood clot. The stent is opened inside the clot, then pulled out to restore blood flow.
Doctors successfully performed the treatment on Chénier at 10:30 a.m. Friday morning. Eight hours later, he was conscious, alert and able to move all of his limbs. On Saturday night, he watched another Montréal Canadiens game. He began to walk the following day.
Doctors called him their “miracle project.”
Five days after being admitted to hospital with a life-threatening stroke, Chénier walked out of the hospital. His only deficit was a “lazy” left leg that required physiotherapy. He was walking normally within three months.
“I feel awfully lucky,” Chénier said in an interview Wednesday. “You realize that the people you talk to every day, it may be the last time you talk to them. It can happen so fast: it’s like the flick of a switch.”
He said he doesn’t know how to thank Dr. Lum. “There are no words. It’s amazing. I’ll be grateful the rest of my life.”
The value of the new approach to stroke treatment, so evident to Chénier, has been affirmed in a major new study published Wednesday in the online edition of the New England Journal of Medicine.
The clinical trial, conducted at 22 medical centres worldwide including The Ottawa Hospital, was halted early because the results were so dramatic. The overall morality rate for patients who received an endovascular thrombectomy was half that of those who underwent the standard stroke treatment: administration of the clot-busting drug alteplase.
Stroke patients who received the endovascular treatment — usually in addition to alteplase — were also considerably more likely to walk out of the hospital without a major disability.
Dr. Cheemun Lum, an interventional neuroradiologist at The Ottawa Hospital, says endovascular treatment represents a major advance in the treatment of serious strokes, a leading cause of death and disability.
“This study represents a major advance in the treatment of acute strokes,” said Dr. Lum, who ran the study in Ottawa along with stroke neurologist Dr. Dar Dowlatshahi. “These are patients presenting with the worst stroke symptoms and the biggest clots. With stroke, it is a race against time.”
Dr. Lum said the advance in stroke treatment has been made possible by the development of a retrievable stent that makes it easier to swiftly and effectively remove a blood clot in the brain.
Detailed blood vessel and brain imaging allows doctors to identify which patients are suitable candidates for the procedure.
The clinical trial results build upon the positive findings of a Dutch study released last year.
“This is the most significant and fundamental change in acute ischemic stroke treatment in the last 20 years,” Dr. Michael Hill, senior author of the study and a professor at the University of Calgary’s Cumming School of Medicine, said in a news release.
“These results will impact stroke care around the world,” he predicted.
The study’s authors cautioned that speed and teamwork inside hospitals are crucial to the success of the procedure.
“This level of efficiency and expertise is not currently widespread,” the study warned. It noted, however, that the “daunting” timelines required for effective stroke intervention have already been widely achieved when it comes to emergency heart surgery.
An estimated 62,000 strokes occur each year in Canada.
aduffy@ottawacitizen.com
twitter.com/citizenduffy
查看原文...
Alarmed, he began to yell, but his speech was slurred.
“That’s when I knew something was seriously wrong,” said Chénier, a longtime employee of Natural Resources Canada.
His wife, Chantal, called an ambulance as his adult sons, Dominik and Marc André, pleaded with him: “Don’t leave us.” Chénier lost consciousness as he was rushed to Gatineau Hospital where brain scans revealed that a large artery to his brain was clogged with plaque.
Such severe strokes traditionally have been associated with high rates of death, disability and brain damage. Brain cells deprived of the oxygen and glucose ferried by the bloodstream start dying within minutes.
Chénier was transferred at 8:15 a.m. to The Ottawa Hospital where Dr. Cheemun Lum, an interventional neuroradiologist, recognized that doctors were in a race against time.
Dr. Lum believed that the best course of treatment for Chénier was a new procedure known as an endovascular thrombectomy (ET). The procedure, which must be performed within hours of a stroke’s onset, requires a thin tube to be inserted into the artery of the groin. The tube, guided by X-ray imaging, is then threaded through blood vessels to the site of the blockage in the brain, where doctors deploy a “retrievable stent” to penetrate and remove the blood clot. The stent is opened inside the clot, then pulled out to restore blood flow.
Doctors successfully performed the treatment on Chénier at 10:30 a.m. Friday morning. Eight hours later, he was conscious, alert and able to move all of his limbs. On Saturday night, he watched another Montréal Canadiens game. He began to walk the following day.
Doctors called him their “miracle project.”
Five days after being admitted to hospital with a life-threatening stroke, Chénier walked out of the hospital. His only deficit was a “lazy” left leg that required physiotherapy. He was walking normally within three months.
“I feel awfully lucky,” Chénier said in an interview Wednesday. “You realize that the people you talk to every day, it may be the last time you talk to them. It can happen so fast: it’s like the flick of a switch.”
He said he doesn’t know how to thank Dr. Lum. “There are no words. It’s amazing. I’ll be grateful the rest of my life.”
The value of the new approach to stroke treatment, so evident to Chénier, has been affirmed in a major new study published Wednesday in the online edition of the New England Journal of Medicine.
The clinical trial, conducted at 22 medical centres worldwide including The Ottawa Hospital, was halted early because the results were so dramatic. The overall morality rate for patients who received an endovascular thrombectomy was half that of those who underwent the standard stroke treatment: administration of the clot-busting drug alteplase.
Stroke patients who received the endovascular treatment — usually in addition to alteplase — were also considerably more likely to walk out of the hospital without a major disability.
Dr. Cheemun Lum, an interventional neuroradiologist at The Ottawa Hospital, says endovascular treatment represents a major advance in the treatment of serious strokes, a leading cause of death and disability.
“This study represents a major advance in the treatment of acute strokes,” said Dr. Lum, who ran the study in Ottawa along with stroke neurologist Dr. Dar Dowlatshahi. “These are patients presenting with the worst stroke symptoms and the biggest clots. With stroke, it is a race against time.”
Dr. Lum said the advance in stroke treatment has been made possible by the development of a retrievable stent that makes it easier to swiftly and effectively remove a blood clot in the brain.
Detailed blood vessel and brain imaging allows doctors to identify which patients are suitable candidates for the procedure.
The clinical trial results build upon the positive findings of a Dutch study released last year.
“This is the most significant and fundamental change in acute ischemic stroke treatment in the last 20 years,” Dr. Michael Hill, senior author of the study and a professor at the University of Calgary’s Cumming School of Medicine, said in a news release.
“These results will impact stroke care around the world,” he predicted.
The study’s authors cautioned that speed and teamwork inside hospitals are crucial to the success of the procedure.
“This level of efficiency and expertise is not currently widespread,” the study warned. It noted, however, that the “daunting” timelines required for effective stroke intervention have already been widely achieved when it comes to emergency heart surgery.
An estimated 62,000 strokes occur each year in Canada.
aduffy@ottawacitizen.com
twitter.com/citizenduffy
查看原文...
