West Mich. man among first to get new stroke treatment, improvement 'remarkable'

There should never be anything 'remarkable' about stroke recovery.  All stroke patients should expect full recovery. 

West Mich. man among first to get new stroke treatment, improvement 'remarkable'

A west Michigan man has almost fully recovered after becoming one of the first patients in the nation to undergo successful surgery for an ischemic stroke using a new catheter that lets surgeons gain access to blood vessel blockages in the brain through the radial artery in the hand.

The device, approved by federal authorities almost eight months ago, can often be quicker in removing blood clots in the brain when time matters in limiting damage from strokes, experts say. Going through the hand artery helps reduce the risk of post-operation bleeding, according to experts.

Jerry Densmore, 76, a native of Bitely, outside of Big Rapids, was a beneficiary of the Zoom RDL Radial Access System that was first used by surgeons at Corewell Health West, Michigan's largest hospital system, in October. Corewell Health West is one of the highest-volume stroke centers in Michigan.

"I was standing at the front door looking out the window and all of a sudden my left side kind of died," Densmore said. "I couldn't move my arm or my hand, and my wife heard me fumbling around out there. She came out and called 911."

Emergency response personnel determined he was having a stroke. Densmore rode for over an hour in an ambulance to Corewell Health West, formerly Spectrum Health, in Grand Rapids for treatment on Dec. 1.

Ischemic strokes occur when an artery that provides blood and oxygen to the brain is blocked. The blockages are typically in the internal carotid artery or the middle cerebral artery in the brain and can be on the left or right side. Densmore's clot was on the right side, said his surgeon, Justin Singer.

The conventional approach to removing the blood clot involves inserting a catheter, or tube, into the femoral artery in the patient's leg and then performing a thrombectomy that removes the clot, Singer said. The goal is to get the catheter as close to the blood clots as possible so surgeons can deploy other tools to suck them out.

"But based off of anatomy, certain times we may have difficulty accessing (the clot)," Singer said. "The anatomy issues that we might encounter are tortuosity, or twisting of the blood vessels, that we see in a patient that particularly gets worse as they age."

Densmore, for example, had a type three aortic arch. The angle of his artery would make it difficult to access his brain using a catheter inserted in the leg, Singer said. Using a device to go through the hand made more sense, he said.

"The (femoral) catheter needs to go through more twists and turns, and has a higher degree of difficulty and likely a greater time until we're able to successfully get a catheter in position to perform the procedure," Singer said.

The Zoom RDL helps surgeons go through the radial artery in the hand and "reach deep into people's brain and suck out blood clots," he said.

The Zoom RDL is more than 40 inches, or nearly 3 1/2 feet, long and 0.088 inches in diameter, one of the larger catheters that can access the brain, Singer said.

"Bigger catheters help us remove clots more effectively," Singer said.

The Zoom RDL was approved by the Food and Drug Administration on May 17.

Singer has used the Zoom RDL device at least five times to treat strokes as well as a brain aneurysm. Each patient's blood flow has been successfully restored, but not all have had a complete restoration of function. The longer the blood supply is cut off to the brain, the more damage and cell death may occur. In each operation with the Zoom RDL catheter, it has taken less than 20 minutes to reopen the blocked artery, Singer said.

"We don't always know whether one more minute will create a bigger problem or it won't matter," Singer said. "More than half the patients we have touched with Zoom RDL catheter have had improvements in their exam and their outcome related to reperfusion or reopening the artery."

Singer said he probably could have removed Densmore's clot using a different catheter through a different artery, but it would have been more technically challenging and likely a longer procedure.

"This solution was better for him, helped us do that quickly and get him back out there, back at home with his family," Singer said.

Densmore said he could move his left arm and leg immediately after waking up from surgery. Singer said his almost immediate improvement was "remarkable."

"The next day I could get up and stand and move my arm and move my hand. I felt good," Densmore said. "It was almost immediate."

Walking took a little more time. "I was wobbly," Densmore said. "I think about the second or third day I felt great everywhere."

Densmore returned home after spending five days in the hospital and continued physical and occupational therapy. He said he feels almost fully recovered and does not have any neurological symptoms.

"It was beyond my expectations because I had visions of being paralyzed on the left side," Densmore said. "I feel great about it. I hope it helps a lot more people."

The National Stroke Association and American Heart Association use the acronym FAST to help people identify symptoms of a stroke. FAST stands for facial drooping, arm weakness, speech difficulties and time.

"Time is so critical for stroke. ... Getting help quickly is really important," Singer said. "If you're worried about stroke, know the signs and symptoms, and get help as quickly as you can."