The team phone his wife to explain that he has had a serious stroke due to a blocked artery.
Although Iain cannot have thrombolysis because he has taken Apixaban he is eligible for thrombectomy which needs to be done as soon as possible – his wife tells them to proceed and she will come to the hospital.
The interventional radiologist is alerted and prepares their team. Iain has a general anaesthetic (2-3 hours post last meal) because Iain does not understand what is happening and is agitated and unlikely to stay still.
The stroke nurse stays with Iain and greets his wife when she arrives at the hospital, explaining what is happening. She gives her a leaflet about hyperacute treatment.
Information for patients re acute treatment including thrombectomy [.pdf, 319KB]
Iain undergoes a thrombectomy. For more details on thrombectomy see: Introduction: What is a thrombectomy?
The team successfully re opens his left middle cerebral artery using both a stentriever and suction catheter. Iain is moved to recovery area at 11.45am and is then moved to the hyperacute stroke unit (HASU) at 12.30 when he is fully alert. There he can be closely monitored to detect possible complications.
Select the crosses to find out more about the angio-suite and the role of each member of the team.
Biplanar angiosuite
This machine provides X Ray monitoring in two planes simulataneously. Some machines can carry out a CT scan as well.
The interventionalist
A doctor, most often an interventional neuroradiologist (INR) or vascular radiologist (IR) who will perform the procedure.
The anaesthetist
The anaesthetist will deliver either a general anaesthetic (GA), or if the patient is settled, sedation only (Awake sedation).
Scrub nurse
A scrub nurse wears sterile gloves, face mask and gown and assists the interventionalist during the procedure.
Radiographer
The radiographer is responsible for ensuring the radiographic equipment is functioning properly.
Operating Department Assistant (ODA)
The ODA assists the anaesthetist.
Circulating nurse
Circulating nurse is not wearing sterile gloves (not “scrubbed”), and can help by going to get extra equipment, or communicating with families. This role may sometimes be filled by a stroke specialist nurse, who will therefore be able to ensure continuity of care
