IH treatment for strokes world class, board hears

How the hell can it be world class if you give us no data on your 100% recovery statistics? Comparing it to the failures of all other stroke hospitals is not valid. 

IH treatment for strokes world class, board hears

    Steve MacNaull Feb 25, 2020 Updated 13 hrs ago



Interior Health Stroke Network

Dr. Aleksander Tkach, left, a vascular neurologist and medical director of stroke services at Kelowna General Hospital, and stroke services director Cory Bendall gave an update on the Interior Health Stroke Network at the Interior Health board meeting Tuesday in Kelowna.
Steve MacNaull



Interior Health is becoming a world leader in stroke treatment.

“We’re more co-ordinated and efficient than hospitals in Vancouver,” said Dr. Aleksander Tkach, medical director of stroke services at Kelowna General Hospital.

“Better and faster is paramount in treatment of a stroke, and the Interior Health Stroke Network is better and faster.”

Tkach, a vascular neurologist, and stroke services director Cory Bendall gave an update on the stroke network at Tuesday’s Interior Health board of directors meeting in Kelowna.

While the network has been around since 2009, it was standardized in 2019 and has really come together this year as a specialized system of care.

About 2,000 people a year have a stroke in the Interior Health region, which spans the entire Southern Interior of the province and has a population of 750,000.

When a 911 call comes in to pick up a stroke victim, an entire chain of care is activated.

An ambulance arrives as quickly as possible and rushes the patient to the hospital, where he or she is met by a stroke team and a CT (computed tomography) scan of the brain is done.

A stroke is caused by a lack of blood flow to the brain.

Seventy per cent of strokes will be ischemic, which means there’s a blood clot in the brain, and 30% will be hemorrhagic, meaning there’s a bleed in the brain.

With ischemic strokes, about 20% can be treated immediately with a tissue plasminogen activator (TPA) clot-busting drug given intravenously.(But what are your 100% recovery results? Don't know? )

For the first time available now at Kelowna General Hospital, another 20% of ischemic stroke patients, the most severe cases, can be given an endovascular thrombectomy.

A thrombectomy sees blood vessels blocked with the most stubborn clots opened mechanically by an interventional radiologist inserting a three-millimetre plastic tube to either vacuum out the clot or break it up using saline jets or ultrasound waves.

Either of these treatments done within an hour of onset of the stroke means blood flow to the brain is restored and a patient can make a full recovery in three months.(How many make that full recovery?)

“That’s why we call it the golden hour,” said Tkach.

“Acting quickly in a co-ordinated manner is of the utmost importance for good outcomes.”

While treatment in the first hour is best, there can still be drug and thrombectomy treatment for up to 24 hours from stroke onset.

However, damage done and amount of recovery will vary.

“Most people don’t die of strokes, but they are a big deal,” said Tkach.

“Stroke is the No. 1 cause of disability.”

Because a stroke can obliterate up to 1.9 million brain cells a minute, if not treated immediately it can cause long-lasting and permanent disability such as paralysis, pain, problems with thinking and memory, emotional disturbances, and problems with speech and understanding speech.

There are nine so called stroke-enabled hospitals in the Interior Health region: Kelowna General, Royal Inland in Kamloops, Vernon Jubilee, Penticton Regional, Cariboo in Williams Lake, Shuswap Lake General in Salmon Arm, East Kootenay Regional in Cranbrook, Kootenay Lake in Nelson and Kootenay Boundary Regional in Trail.

Of course, the best way to not have to deal with the consequences of a stroke is to not have one in the first place.

That’s why the Interior Health Stroke Network also advocates prevention, because up to 80% of strokes can be avoided with a healthy lifestyle of eating right, exercising, maintaining an ideal weight, not smoking, keeping stress low and not abusing alcohol or drugs.

The network also includes provisions for rehabilitation after a stroke, research and telehealth, so patients in remote areas can be seen via teleconferencing.