MUSC Florence expands stroke care options

A stroke patient is recovering at MUSC Health Florence Medical Center after being the first to undergo a neuroendovascular procedure at the hospital. 

A thrombectomy, one such neuroendovascular procedure, is a brain-saving treatment that removes a blood clot blocking a large blood vessel in the brain, but it must be performed emergently to save the brain. Previously, patients had to be sent to comprehensive stroke centers outside the region for this procedure – and the time involved in transport meant that as many as three-quarters became ineligible for the procedure by the time they arrived.

Christine Holmstedt, D.O., medical director of Clinical Stroke Services and co-director of the Comprehensive Stroke and Cerebrovascular Center at MUSC Health, said this moment was the result of a lot of behind-the-scenes teamwork since March.

That’s when the teams got together and decided they needed to find a way to offer this procedure in the Pee Dee region – pandemic or no pandemic.

“Stroke did not stop during the pandemic. Our efforts to provide advanced sophisticated technology to help our patients did not stop either. We are proud to offer this treatment. The patients of the Pee Dee deserve access to cutting-edge care, and we are committed to keep providing it,” said Rami Zebian, M.D., chief medical officer, MUSC Health Florence Division.

“The goal is to make sure that every one of those patients gets the procedure close to home, in a very safe way. We don’t want to just do procedures. We want to make sure all the supports are in place. And so, our goal is to really have that presence there to make sure that every stroke patient gets the procedure they need,” Holmstedt said.

"Our goal is to really have that presence there to make sure that every stroke patient gets the procedure they need."

Christine Holmstedt, D.O.

To prepare for this moment, the team designated four neurocritical care beds, added neurocritical care doctors, provided additional training to nurses and techs so they could prep for the procedure and knew the warning signs to look for in recovering patients, and brought in an experienced neuroradiologist, Andrew Nicholson, M.D., to perform these procedures.

Holmstedt said that this particular patient showed up at a hospital in Hartsville, South Carolina. She consulted via telehealth and saw that his exam was consistent with someone having a stroke in the right side of the brain. He had already passed the window of opportunity to receive clot-busting medication, so he was transferred to MUSC Health Florence for the thrombectomy.

“What’s amazing is normally when we transfer patients from that region, it can take three hours to get a patient from a hospital to MUSC Health Charleston for the procedure, and unfortunately, it’s usually too late at that point, because the brain tissue has suffered too much.

“But this patient, from the time I saw him to the time they were finished with the procedure, was an hour and 33 minutes,” she said. 

When the patient arrived at MUSC Health Florence, the time – from the moment he was wheeled through the Emergency Department doors to the moment Nicholson punctured a vessel in the groin to guide a catheter to the blood vessels in the brain – was a mere six minutes.

“It was incredible teamwork. All of the nurses and techs were totally prepared, waiting for the patient in the angio suite. It’s an incredible time,” she said.

Holmstedt said she’s proud of the team for making this happen as well as the administration for supporting the idea.

“It takes a lot of resources to do this, and the goal is really to improve patient care in that area, reduce disability and keep patients closer to home.”