2023-05-05 00:55:00
Discussion table seeks to evaluate care alternatives for patients with ischemic strokes on the island, to improve hospital response capacity
By: Maria Camila Sanchez
On the occasion of the Conexión Stroke Puerto Rico event, held today on the island, the Journal of Medicine and Public Health (MSP) spoke with Dr. Juan Vicenty, Cerebrovascular and Endovascular neurosurgeon, and with Dr. Marc Ribo , Interventional neurologist at the Vall d’Hebron Hospital in Barcelona on the points to be dealt with in this roundtable discussion of ischemic strokeand the care alternatives provided to these patients on the island.
“The stroke is one of the first causes of disability and death in Puerto Rico and the United States,” warned Dr. Vicenty. “Due to genetic, dietary, and social characteristics, among others, it affects us greatly.”
Over the years, the treatment of this condition has evolved for the benefit of patients, so that, currently, it is possible to recovery and social reintegration of those people who have suffered an ischemic stroke.
“The disease has gone from being a death sentence and disabilityto be something that can be rehabilitated and that can benefit many people,” added the expert.
And we must not forget that this disease occurs, especially, in young people, that is, in individuals who have an important social role. However, when they go through a stroke like this, the greatest risk is that they may be disabled for life and therefore their social participation is much more limited.
However, medical advances have allowed these patients to have different safe and effective alternatives to be able, in part, to improve the functionality of this person.
“One of the most powerful therapies that we currently have is mechanical thrombectomy, which is a neurosurgical or endovascular intervention through which the clots responsible for the effusion are aspirated”, explained the specialist. “In addition, we restore adequate blood flow, we limit the possibility that the patient needs a more aggressive process such as a decompressive craniectomy, and we increase the possibility that the person continues to function as they did before.
For his part, Dr. Marc Ribo assured that the objective of said event is to improve all the care of these patients on the island.
“We have not come to say that there is only one way to do things. We have come to explain how things are being done in Catalonia; we are known because we are well organized, but of course, what we explain must be adapted to the reality of Puerto Rico,” he mentioned.
For Dr. Ribo, there must be a coherent alignment between the different levels of care for these patients in order to provide them with adequate care, and therefore, the necessary treatment effectively to reduce the capacity of the disease.
“It is necessary to align everything that is done at the prehospital level with the medical emergency system. To identify the entire hospital network that is capable of receiving and quickly treating patients with suspected stroke, and to determine which they are going to be the fast and urgent derivation circuits”, he explained.
Additionally, the Catalan expert assured that it is necessary to activate the codes that alert all the actors involved so that everything happens efficiently, quickly and safely for the patient.
“In this way, we hope that in a few years these quality indicators, the response time, the number of fibrinolytic treatments with endovenous thrombosis and the number of mechanical thrombectomies that are going to be performed in Puerto Rico, will increase progressively, and that this will there is less stroke-related social and economic burden,” added Dr. Ribo.
The truth is that both specialists agree on the importance of the medical community being clear that it is necessary to recognize the signs of an ischemic stroke in order to provide the patient with the best possible treatment.
“Today we can treat these strokes from the moment they occur, up to 24 hours later, with specialized tools that we have here in Puerto Rico,” said Dr. Vicenty. “It is important to be able to spread the word, and thus manage to save more lives.”
A condition that requires immediate medical attention
Signs and symptoms experienced by people who have a cardiovascular accident (CVA) usually include difficulty speaking or understanding what other people are saying, paralysis or numbness on one side of the face, arm or leg, pain in the head, trouble seeing in one or both eyes, and weakness in the legs.
Experts recommend consulting as soon as possible if any of the aforementioned signs occur, even if they seem to come and go, because the longer it takes to treat a stroke, the greater the chances of brain damage and disability. .
Currently, 1 in 4 people will have a stroke in their lifetime and it is estimated that more than 5,000 new cases are reported in Puerto Rico each year.
Fortunately, it is estimated that 80% of strokes are preventable. Generating better knowledge of the symptoms among the population, having an optimal stroke care network for timely admission to the hospital, and access to adequate treatment are key elements to reduce the impact of this condition on the health of Puerto Ricans.
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