Addition bolsters stroke service
The stroke intervention service at Vanderbilt University Medical Center is one of the most robust in the nation, with five physicians to provide cutting-edge stroke treatment 24 hours a day, seven days a week, 365 days a year.
The newest addition to the service is Rishi Gupta, M.D., who trained at the Cleveland Clinic and is a rare neurologist practicing interventional stroke techniques. He joins endovascular neurosurgeons Michael Ayad, M.D.,
Rishi Gupta, M.D.
Stroke interventions include suction devices, clot retrievers and stents, much like what is available for a heart attack, as well as injecting clot-busting medications directly into the brain.
Interventional therapies broaden the base of acute stroke patients who can be treated, including those who present beyond the time window for tPA (tissue plasminogen activator, a clot-busting drug and the current standard of care for stroke) and those for whom tPA is contraindicated.
“We can't give tPA to patients who have had surgeries recently because it would cause the wounds to bleed, but they can undergo endovascular stroke intervention. Also, if patients are on blood thinners, the interventional approach is safer,” Gupta said.
Gupta presented research at the American Stroke Association's International Stroke Conference last month indicating that mechanical interventions combined with injecting medications directly into the brain is more effective than mechanical approaches alone or pharmacologic approaches alone. The study involved 1,056 severe stroke patients at 13 of the nation's busiest stroke centers, including VUMC.
“In the past, we couldn't treat stroke very aggressively,” Gupta said. “Stroke care today is where heart disease was in the 1970s and 80s, and it will only get more sophisticated. We're on the verge of large breakthroughs.”