{"id":1855,"date":"2020-01-30T20:08:44","date_gmt":"2020-01-30T20:08:44","guid":{"rendered":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/?p=1855"},"modified":"2020-01-30T20:08:44","modified_gmt":"2020-01-30T20:08:44","slug":"the-cooper-comprehensive-stroke-center-unrivaled-expertise-for-the-highest-level-of-stroke-care","status":"publish","type":"post","link":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/2020\/01\/30\/the-cooper-comprehensive-stroke-center-unrivaled-expertise-for-the-highest-level-of-stroke-care\/","title":{"rendered":"The Cooper Comprehensive Stroke Center: Unrivaled Expertise for the Highest Level of Stroke Care"},"content":{"rendered":"
\"Hamza

Hamza A. Shaikh, MD, Co-Director, Neurointerventional Surgery, performs a thrombectomy on a stroke patient in the Cooper Catheterization Laboratory.<\/p><\/div>\n

Cooper is the first hospital in South Jersey to earn Comprehensive Stroke Center certification from the Joint Commission and the American Heart Association\/American Stoke Association. This makes Cooper part of an elite group of hospitals. It\u2019s a big deal.<\/p>\n

\"Tudor

Tudor G. Jovin, MD<\/p><\/div>\n

\u201cThis national certification means that we have undergone rigorous scrutiny and met the highest standards for the full spectrum of stroke care, from the speed with which patients receive reperfusion therapies to the appropriateness of post-discharge care,\u201d explains Chief of Neurology and Chairman of Cooper\u2019s Neurological Institute, Tudor G. Jovin, MD<\/a>.<\/p>\n

\u201cIt\u2019s very different from the state definition of comprehensive stroke care, which requires a much less sophisticated system and infrastructure,\u201d he adds, \u201cwhich explains why there are so many more state-designated stroke centers than Joint Commission-certified ones.\u201d<\/p>\n

One significant difference is the depth and breadth of stroke-related specialty and subspecialty expertise that is available at Cooper 24\/7.<\/p>\n

\u201cThere may be other comprehensive stroke centers in the region, but they do not have the number of board-certified and \u2013eligible vascular neurologists that we have,\u201d Dr. Jovin says. \u201cWe also have neuro-interventionalists, vascular neurosurgeons, neuroradiologists, and neuro-intensive care experts on site at all times. As a result, I can say with confidence that we are doing interventional procedures with greater efficiency and speed.\u201d<\/p>\n

Speed is a critical factor in ensuring a successful outcome when ischemic stroke occurs.<\/p>\n

\u201cRestoring blood flow to the brain is exquisitely time sensitive,\u201d Dr. Jovin says, \u201cand we have a very efficient system of throughput that other facilities performing thrombectomies can\u2019t come close to.\u201d<\/p>\n

In fact, since Dr. Jovin took the helm of Cooper\u2019s Neurological Institute earlier this year, the stroke team has been consistently achieving door-to-puncture (DTP) times of 20 minutes in the vast majority of cases. DTP is the time it takes from arrival at the endovascular center to the start of the thrombectomy procedure in the neuroangiography suite. It includes the time it takes to perform a neurological evaluation, complete the imaging studies, treat the patient with intravenous tPA if applicable, transport the patient to the neuroangiography suite, and prepare the patient for the intervention. To put that number in perspective, current Get With The Guidelines\u00ae- Stroke, the American Heart Association\u2019s performance improvement program, calls for a DTP time of 90 minutes.<\/p>\n

\u201cNo other comprehensive stroke center or thrombectomy-capable center in this region comes close to what we are doing in terms of door-to-puncture times,\u201d Dr. Jovin emphasizes. \u201cAnd what we are doing translates into better outcomes.\u201d<\/p>\n

Dr. Jovin is one of the nation\u2019s first interventional neurologists and a world-renowned expert in both interventional and non-interventional treatment of stroke and cerebrovascular disorders. He is internationally recognized for his research activities, having recently served as principal investigator for two landmark studies (REVASCAT and DAWN) published in the New England Journal of Medicine in 2015 and 2017, respectively. These studies not only dramatically affirmed the clinical efficacy of mechanical thrombectomy but also were instrumental in expanding the time window for this endovascular treatment of acute stroke beyond the traditional 8-hour time window.<\/p>\n

\u201cWe demonstrated that in selected patients with large vessel occlusion, the benefit from treatment with mechanical thrombectomy can be seen up to 24 hours,\u201d Dr. Jovin notes. \u201cBut that doesn\u2019t mean we can be complacent and take our time,\u201d he stresses.<\/p>\n

\u201cIn fact, we don\u2019t even base patient selection [for thrombectomy] on time anymore,\u201d he continues. \u201cEach patient has an individual window based on their physiological characteristics. And\u2014most important\u2014regardless of how long it has been since the onset of a patient\u2019s stroke symptoms\u2014earlier treatment leads to better outcomes.\u201d<\/p>\n

He goes on to explain that the efficacy of thrombectomy can be measured by the metric of NNTT\u2014the number of patients needed to treat to reduce the disability level from an ischemic stroke from high to low.<\/p>\n

\u201cIf we take all patients with large vessel occlusion, whether they are in an early or late time window, the number needed to treat is three,\u201d Dr. Jovin says. \u201cTo put that in context, giving IV tPA has an NNTT of 9, while angioplasty and stenting for a STEMI is 29.<\/p>\n

\u201cSo mechanical thrombectomy for stroke is ten times more potent than percutaneous coronary intervention for STEMI,\u201d he adds. \u201cThere are few treatments in medicine that have such a strong therapeutic effect.\u201d<\/p>\n

It all underscores why seeking care for stroke at a Joint Commission-certified Comprehensive Stroke Center such as Cooper\u2019s is the right choice.<\/p>\n

\u201cJust as trauma centers are ranked by the complexity of patients they can handle, I believe stroke centers should be also,\u201d Dr. Jovin says, \u201cso patients with severe stroke and at risk of high deficit are directly transported to a comprehensive stroke center so they receive thrombectomy in the timeliest manner possible.\u201d<\/p>\n

Similarly, patients with hemorrhagic stroke have timely access to neurosurgeons with specialized vascular expertise.<\/p>\n

\u201cHere at Cooper, we have the entire gamut of stroke care resources available under a single, integrated umbrella,\u201d he adds. \u201cWe can offer patients what is truly the highest level of stroke care.\u201d<\/p>\n

\u201cNo other comprehensive stroke center or thrombectomy capable center in this region comes close to what we are doing in terms of door-to-puncture times. And what we are doing translates into better outcomes.\u201d \u2013 Tudor G. Jovin, MD<\/p>\n

\n

For more information on Cooper\u2019s Comprehensive Stroke Center, or to refer a patient, please call Dr. Tudor Jovin at 412.726.9974.<\/p>\n","protected":false},"excerpt":{"rendered":"

Cooper is the first hospital in South Jersey to earn Comprehensive Stroke Center certification from the Joint Commission and the American Heart Association\/American Stoke Association. This makes Cooper part of an elite group of hospitals. It\u2019s a big deal. \u201cThis national certification means that we have undergone rigorous scrutiny and met the highest standards for … [Read more…]<\/a><\/span><\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,150,161],"tags":[],"class_list":{"0":"entry","1":"post","2":"publish","3":"author-rmineo","4":"post-1855","6":"format-standard","7":"category-featured","8":"category-neurological-science","9":"category-technology"},"_links":{"self":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts\/1855","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/comments?post=1855"}],"version-history":[{"count":1,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts\/1855\/revisions"}],"predecessor-version":[{"id":1859,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts\/1855\/revisions\/1859"}],"wp:attachment":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/media?parent=1855"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/categories?post=1855"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/tags?post=1855"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}