Anesthesiologists Take on Central Role In Stroke Care

Anesthesiologynews.com: by Jennifer Hanawald, ISSUE: MAY 2012 | VOLUME: 38:5.

Dramatic technological advances in the way stroke is treated are greatly expanding the time frame and tools specialists have to treat the fourth biggest killer in the United States. This in turn is driving facilities that specialize in stroke care to overhaul their protocols to employ the latest therapies.

At Montefiore Medical Center’s Stern Stroke Center, in New York City, a designated primary stroke center (PSC) for the state, one aspect of this evolution is the development of a teamwork approach in which neuroanesthesiologists are fully integrated into patient care. Staff members say the arrangement is essential to maximizing the potential of the growing armamentarium of clinical tools.

This sea change grabbed the attention of Elisabeth Abramowicz, MD, director of neuroanesthesiology at Montefiore. “When I arrived four years ago it became apparent that intra-arterial stroke treatment technology would only grow,” Dr. Abramowicz said. Consequently, she worked with the neuro-interventional radiologists and neurologists to foster collaboration. “This is a completely new area of clinical engagement for neuro-anesthesiology. We’ve embraced that here and have become full partners in the organization.”

Until recently, options were slim for patients who suffered ischemic stroke (about 87% of strokes). The IV therapy available was limited to smaller clots and had to be administered quickly to be effective. This changed in 2004, when the FDA approved a device that enabled the manual removal of the clot with the aid of a catheter threaded up to the brain from the leg, widening the treatment window from within three hours of symptom onset to eight hours or more. Read more