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Optimized Clinical Workflow for Stroke Management

IP.com Disclosure Number: IPCOM000199042D
Published in the IP.com Journal: Volume 10 Issue 9A (2010-09-09)
Included in the Prior Art Database: 2010-Sep-09
Document File: 2 page(s) / 124K

Publishing Venue

Siemens

Related People

Juergen Carstens: CONTACT

Abstract

One of the most important points in stroke treatment is time. Usually, the sooner a stroke is treated the bigger is the chance to save brain tissue at risk. In order to know how to treat the patient, the first thing health professionals do is to check for bleeding vessels in the brain. If there is a bleeding, it has to be embolized. After that, non-salvageable tissue must be distinguished from salvageable tissue. The third step is to localize the clot, so as to remove or destroy it, which can be done by injecting tissue plasminogen activator (tPA) for example. This injection is done whether intra-arterial or intravenously. The maximum time the stroke can be treated by tPA after the stroke itself is three hours if injected intravenously and six hours if injected intra-arterial. For most of these steps, including the intra-arterial injection of tPA, imaging systems and corresponding software are essential.

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Optimized Clinical Workflow for Stroke Management

Idea: Dr. Hayo Knoop, DE-Forchheim; Stefan Lautenschlaeger, DE-Forchheim

One of the most important points in stroke treatment is time. Usually, the sooner a stroke is treated the bigger is the chance to save brain tissue at risk. In order to know how to treat the patient, the first thing health professionals do is to check for bleeding vessels in the brain. If there is a bleeding, it has to be embolized. After that, non-salvageable tissue must be distinguished from salvageable tissue. The third step is to localize the clot, so as to remove or destroy it, which can be done by injecting tissue plasminogen activator (tPA) for example. This injection is done whether intra-arterial or intravenously. The maximum time the stroke can be treated by tPA after the stroke itself is three hours if injected intravenously and six hours if injected intra-arterial. For most of these steps, including the intra-arterial injection of tPA, imaging systems and corresponding software are essential.

Nowadays, various ComputerTomographic scans (CT-scans) are needed to go through the steps described above. To examine the brain for bleedings, a non-contrast-enhanced CT-scan is made. In order to detect tissue at risk and non-salvageable tissue, special CT-scans are made to visualize Cerebral Blood Flow (CBF) and Cerebral Blood Volume (CBV). By comparing those two images, health professionals are able to distinguish the differing tissues. The clot can then be localized with the aid of a CT-Angiography. When needed, an intra-arterial injection is usually made by a physician with help of angiography equipment like c-arms for example.

In the following a novel solution is proposed which consists in an optimized clinical workflow for stroke treatment using special angiographic c-arm systems as sole image acquiring device. These c-arm systems and the corresponding software are able to produce images like the ones obtained in CT- scans, allowing soft tissue distinction. According to th...