For most of human history, suffering a stroke has been a death sentence.
It’s the No. 5 cause of death in the United States (according to the American Heart Association and American Stroke Association) killing nearly 130,000 people a year—one in every 20 deaths.
So excuse Dr. Vishal Jani if he speaks with what some might consider hyperbole when explaining the newest treatment of the dreaded disease.
“I call it a miracle,” Jani says. “I call it beyond belief if it is done in time. It is…the restoration of life.”
If strokes don’t kill, they debilitate, rendering two-thirds of survivors paralyzed, unable to speak, or otherwise disabled. Most strokes—87 percent—are classified as ischemic, occurring when a clot or mass blocks a blood vessel. Blood and oxygen are cut off to the brain, killing its cells. Hemorrhagic strokes happen when a blood vessel ruptures and prevents blood flow to the brain.
Jani was around 3 when his grandmother suffered a stroke. There was nothing his father, also a surgeon, could do to help her.
“The struggle that comes along with this disease, not just to the patient, but to the family, is mind-boggling,” he says.
Until 1996, most advances against the disease focused on prevention. That year, though, the Food and Drug Administration approved tissue plasminogen activator (tPA), a clot-busting drug that treats ischemic strokes.
It’s administered through an IV in the arm, but typically must be done so within three hours of the first symptoms. It has only a 30 percent success rate.
Now comes revolutionary stroke treatment—and hope—with a new procedure for ischemic strokes called mechanical thrombectomy. And Jani, an interventional neurologist at CHI Health’s Neurological Institute at Immanuel Medical Center, is the first neurologist in the state to perform the procedure. He does so by threading a catheter through an artery in the patient’s groin to the blocked artery in the brain. A stent retriever at the end of the catheter attaches to—then removes—the trapped clot, resuming blood flow to the brain.
Jani likens it to unclogging a pipe.
“We basically are no different than glorified plumbers,” he says with a laugh.
The procedure has an 80-90 percent success rate. And early guidelines give a larger window than tPA for when treatment can occur—within six hours of the onset of symptoms. Jani cites a forthcoming study that will recommend the procedure even up to 24 hours after symptoms begin.
Average time to perform this life-saving procedure? Nineteen minutes.
“It is mind-boggling,” Jani says. “It is amazing.”
By the start of November, Jani and his partner had performed the procedure almost 30 times.
“And a lot of those patients have gone home with minimal or no problems,” he says.
That includes an 89-year-old, still-working farmer hospitalized for other conditions when he suffered a stroke that left him unable to speak and weak on his left side. Given the farmer’s age, his family figured the stroke signaled the end of his life. Jani convinced them to let him try the procedure. The farmer regained his speech immediately and was back to his routine 10 days later.
Another patient, 31 and the father of a newborn, went home the day after Jani performed the thrombectomy. Though he was back in the hospital seven days later with another stroke, he returned to his newborn once more after a second thrombectomy.
Another save—and another reminder of why he entered this field.
“I went in this field of training with just a leap of faith that I wanted to help these people,” he says.
His faith is bringing forth miracles.
Visit chihealth.com/neurosciences-care for more information about the CHI Health Neurological Institute.
This article was printed in the January/February 2018 edition of Omaha Magazine.