The Medical Staff of St. Jude Medical Center
Home Contact Us Login
Forum Policies / Procedures Officers/Chairs News Helpful Links
Contact Us Print this Page Change Font Size

When Being First Means Saving a Life

St. Jude introduces innovation in stroke care.

When Radoslav Raychev, MD, a neuorinterventionalist, saw that the patient's angiogram was negative for a brain aneurysm, he kept looking. The extra effort paid off. Dr. Raychev located a small "blister" aneurysm, a highly fragile weakness in the artery wall that was likely to re-rupture.

Blister aneurysms are an uncommon and notoriously difficult-to-treat type of hemorrhagic stroke, in which a weakened blood vessel ruptures and bleeds into the brain. Outcomes are daunting: Nationally, the mortality rate is close to 50 percent, and among those who survive, many live with permanent and serious disabilities. But for a stroke team recognized as one of America's 100 best by Healthgrades, national averages and benchmarks are often simply a starting point.

Dr. Raychev and other St. Jude stroke experts, including specialists in neurosurgery and neurocritical care, discussed the patient's options. The two traditional approaches for treating blister aneurysms—surgically wrapping the aneurysm or attempting to "coil" it and remove it via catheter—were not optimal choices for the 43-year-old patient. Magnifying the risk was the aneurysm's location, inside an artery that supplies blood flow and oxygen for the brain's most critical functions.

However, another option, the subject of recent research, was using "flow-diverting" stents. The technique isn't used on small vessels, but Dr. Raychev considered it the best choice.

"I knew the same advantages we are seeing with larger vessels could be realized with these smaller, fragile aneurysms—and that it represented the best chance for his full recovery," explains Dr. Raychev.

While recent research had made clear the benefits of using "flow-diverting" stents to treat aneurysms, the technique isn't used on small vessels. A new flow-diverting stent, compatible with a smaller microcatheter, had just gained Food and Drug Administration approval in the U.S., making the innovative approach possible. During the 30-minute procedure, the stent was placed via catheter inside the aneurysm, reconstructing and strengthening the artery. Three days later, the patient, Lance Polland, a writer and director, went home and returned to his life.

Polland's first symptom, the sudden onset of an agonizing headache, is typical of aneurysms and hemorrhagic strokes. Anyone with a severe headache or any of the more common stroke symptoms— including changes in balance, speech and vision, and muscle weakness—should seek immediate emergency care. Other, less frequent symptoms include nausea, disorientation and sudden drowsiness.

"I feel so blessed to benefit from this technology and from the skill of a doctor who not only saved my life but gave me the chance to resume my life exactly where I left off," says Polland, who ordered a celebratory pizza after waking up from the procedure. "It's unsettling to think about what would have happened if I had not gone to St. Jude and had ended up at another hospital."

Dr. Raychev says the stroke team at St. Jude was built for such challenging cases.

"This is exactly why we bring together the entire spectrum of stroke expertise at St. Jude, from advanced diagnostic protocols in the emergency department to an award-winning team of board-certified neurointensivists," he says, "so we can continue to elevate outcomes."

Related Articles

General Staff Meeting April 2013