Andrew Khula never saw it coming. It was a day like any other. He’d been cutting down some trees on his property and decided to head inside to eat and take a shower. Everything was fine until he felt dizzy stepping out of the shower. He fell to the floor, and stayed there, until his wife came home about 30 minutes later. She immediately called 9-11. The doctors at Andrew’s community hospital determined he was having a stroke, and needed special care, so they rushed him to DMC Harper University Hospital.
Dr. Suzanne White is the Chief Medical Officer for Detroit Medical Center. "It’s essential that people come to the hospital as easy as possible and we think of stroke just like we do with trauma and sepsis and heart attack. This is a golden hour opportunity where we can have a huge impact as long as the patient comes in right away.
Dr. Samual Tsappidi is a neurovascular surgeon who performs many stroke patient surgeries each year. "The brain typically has 130 billion neurons, or nerve cells. Any minute of lack of blood supply to the brain kills those cells to an average of 1.9 to 2 million a minute, or approximately 120 million an hour.
If you are fortunate that some of those brain cells are in a non-important area, you might be lucky. But you never know; if you are in a critical area, it can mean a matter of life and death or life and long disability.
The standard is to get the patient treated as soon as possible. At DMC, that’s 60 minutes or less from the time they arrive. "for example, " says Dr. White, "We want to make sure that we have a CAT scan completed within 25 minutes of arrival, that we have all laboratory studies back within 45 minutes of arrival, that they have seen a stroke neurologist all along that way. So they may have the stroke neurologist at the bedside within just 10 to 15 minutes of arrival."
Andrew arrived at the emergency department at just the right time. A new device called the Solitaire Stent had recently been approved by the FDA, and Andrew was the first patient at DMD to benefit from it.
Solitaire Stent is a very new innovation that looks like a stent – like a rolled-up piece of chain-link fence, which is compressed into a small catheter, or tube. The Solitaire Stent is introduced through the catheter at the site of the clot and then expanded. As it expands, it decreased the clot, and supports the clot at the same time. After about five minutes, the clot will be degraded to the point where it can be withdrawn with the stent. The benefit is that the clot is better gripped while being extracted, and as soon as the stent is deployed, the blood flow is restored while the stent works on removing the clot.
Using a combination of the Solitaire Stent and suction to ensure that no pieces of the clot are left behind, Dr. Tsappidi and his team can restore blood flow within five to 15 minutes of tstarting the procedure – compared to 30 minutes to 3 hours using other devices and techniques. This is a remarkable accomplishment, especially when every minute of blocked blood flow can mean the difference between life and death. DMC patient Christine Peake knows that first hand.
"I was working and I started getting dizzy. So I sat on the couch and I keeled over."
Fortunately for Christine, her husband got her to the DMC right away, and she was treated by Dr. Sandra Narayanan, DMC Director of Interventional Neurology.
"If you have a large artery in the brain that is blocked, the chances of a good outcome are very low. In her case, she received timely administration of a clot-busting medication through her IV, as well as a very rapid opening of the blocked artery on the left side of the brain, restoring a majority of the blood flow. She’s continuing to improve on a daily and weekly basis, and patient like her will continue experiencing improvement for likely over a year after the stroke.
Andrew’s outcome was also good, and a few weeks after his stroke, he had a follow-up with Dr. Tsappidi. Using advanced imaging, Dr. Tsappidi shows haw the clot is completely gone, and full blood flow is restored. Andrew calls Dr. Tsappidi the "Angel of the DMC."
"He’s the man who made the decision at the right time, and the right place and that’s why I’m here today talking to you."
Strokes are a leading cause of death in the United States and one of the most common causes of disability. In order to prevent having a stroke, it’s critical that people understand the risk factors and symptoms.
The majority of strokes happen in people, who smoke, have diabetes, uncontrolled high blood pressure or heart disease.
When it comes to symptoms, sometimes there are none. But if you experience slurring of speech, difficulty speaking or understanding, loss of vision in one or both eyes, weakness or numbness on one side of the face, or in one arm or leg, this could be a sign of a stroke.
The majority of strokes are not painful. They don’t involve headache. This is different in heart attack patients where the majority of patients do experience crushing chest pain, so it’s easier for those people to convince themselves to come to the emergency room. A more timely response is essential to stroke patients.
To learn more about stroke symptoms, risk factors and treatment, visit the DMC Stroke Care page.
To schedule an appointment with Dr. Narayan or Dr. Tsappidi, call 888-DMC-2500, or visit the
DMC Physician Appointment page.