Stroke Outcomes at LifeBridge Health

The region’s most capable professionals in stroke management are collaborating at the Thrombectomy-Capable Stroke Center at Sinai Hospital and at the Primary Stroke Centers at Northwest and Carroll hospitals, where we provide patients with advanced treatments for acute stroke.

IV Alteplase

One treatment used for acute ischemic (nonbleeding) stroke is IV alteplase (tPA, tissue plasminogen activator), which is a medication that breaks up blood clots. It is given to eligible patients who arrive at the hospital within a certain period of time after the onset of their stroke symptoms. Although this medication has shown to be beneficial in decreasing the amount of disability that a person experiences after a stroke, it does have some potential complications. One of these complications is that use of this medication may cause bleeding in the brain, known as a symptomatic hemorrhage.

In 1995, the NIH’s National Institute of Neurological Disorders and Stroke conducted a clinical trial to study the use of alteplase.1 This study proved to be a very important trial, with far-reaching results that influenced the treatment of patients with stroke worldwide.

The study showed benefit of using alteplase to treat acute ischemic (nonbleeding) strokes, with hemorrhage occurring in 6.4% of treated patients. In comparison, at Sinai Hospital’s Thrombectomy-Capable Stroke Center between July 2018 and June 2019, alteplase was used to treat 32 patients, with one (3.1%) occurrence of symptomatic hemorrhage.

1 National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 1995; 333(24):1581–7.>

Mechanical Thrombectomy

Another stroke treatment offered at Sinai Hospital is mechanical thrombectomy, also known as endovascular therapy. This procedure is provided to a patient who has a blood clot blocking a large blood vessel in the brain. During this procedure a specially trained doctor, called a neurointerventionalist, uses a catheter to manually remove a blood clot from the blood vessel.

Complications from this procedure may include having a new stroke, damaging a blood vessel, or bleeding in the brain during or after the procedure.

Results of a mechanical thrombectomy are described using a TICI (thrombolysis in cerebral infarction) score, which describes how well the blood flows through the vessel after the procedure is completed.
A good outcome for stroke patients who have this procedure is demonstrated by a TICI score of 2b or 3, which means that 50%–100% of blood flow has been restored to the brain.

In February 2018, results of an important and widely publicized study in the treatment of stroke were reported. The study, called DEFUSE 3 included 182 patients from 38 medical facilities in the United States.2 In this study, 7% of patients who received endovascular therapy experienced hemorrhage (bleeding in the brain). At Sinai Hospital’s Thrombectomy-Capable Stroke Center between July 2018 and June 2019, 2.2% (2 out of 91 patients who received endovascular therapy) experienced symptomatic hemorrhage.

In the DEFUSE 3 study, 76% of patients had TICI scores of 2b/3. In comparison, at Sinai, between July 2018 and June 2019, 92.5% (86 out of 93) had TICI scores of 2b/3.

2 Albers GW, Marks MP, Kemp S, et al.; DEFUSE 3 Investigators. Thrombectomy for stroke at 6–16 hours with selection by perfusion imaging.
 N Engl J Med 2018; 378(8):708–18.

LifeBridge Health Stroke Resources

• Stroke Outcomes at LifeBridge Health • Stroke Statistics
• Stroke Quality Measures at LifeBridge Health • Signs & Symptoms of Stroke
• Advanced Stroke Treatment at LifeBridge Health • Stroke Prevention
• Stroke Rehabilitation at LifeBridge Health  • Stroke Team Videos
• Stroke Support at LifeBridge Health • Stroke Education Videos 

To make an appointment with a physician in Sinai Hospital's Thrombectomy-Capable Stroke Center, call 410-601-9515.
To make an appointment with a physician at Carroll Hospital's Primary Stroke Center, call 410-871-7000.