Moving Out from Under the Shadow of a Stroke
In September 2015, Michael Flynn, of Collegeville, was at Abington Hospital – Jefferson Health, facing a life-altering decision. A blood vessel in his brain was significantly blocked, and treatment options were limited.
Michael, 58, listened closely as Larami G. MacKenzie, MD, associate director of Neurocritical Care, explained that he was a candidate for a delicate procedure that would thread a tiny stent (flexible metal scaffold) into the vessel to open it up and improve blood flow to the left half of the brain. He also detailed the surgery’s significant risks – it was possible that it wouldn’t work, or that it would paralyze or even kill him.
Nevertheless, Michael’s response was crystal clear: “I want it done.”
By that point, he’d already survived multiple strokes over the course of the past several months. He had gone blind. His last crisis, the one that had landed him at Abington but had happened many times before, was a transient ischemic attack (TIA), or “warning stroke,” which meant that another major event could be around the corner. He was ready to do anything to make sure that didn’t happen. “And I was just so sick and tired of being in the hospital,” he says.
Patient and Pioneer
Michael would receive the Wingspan Stent System as part of a national clinical trial called WEAVE that is being conducted at Abington Hospital and actively recruiting at a limited number of other locations in the nation; Abington is the only hospital in Pennsylvania enrolling patients in the trial. At this time, the stent is only approved for a narrow subset of patients, including those with significant vessel narrowing who have had two or more strokes despite aggressive treatment with medications. According to the manufacturer, on average, only about 2,000 patients per year in the U.S. receive a Wingspan Stent.
“In addition to being at high risk for another stroke, Michael had many complicating health issues, including diabetes, hypertension, a smoking history, and uveitis (an inflammatory eye disease),” Dr. MacKenzie notes. “But he had two things going for him: He met the strict eligibility requirements for the stent, and a CT angiogram showed that he had only one severely narrowed vessel – his left intracranial carotid artery, located a short distance behind his left eyeball and just in front of his left ear. Fortunately, all of his other blood vessels were fine.”
During a two-hour procedure, Dr. MacKenzie threaded the stent through the femoral artery in Michael’s groin up to his intracranial carotid. As the device opened, he saw the diameter of the vessel increase, going from 85% to 30% narrowed. In addition to improving blood flow, the stent stabilized the vessel-clogging plaque within the artery walls, decreasing the chances that a piece of it would break off and cause another stroke.
“Dr. MacKenzie was there when I woke up in recovery,” Michael recalls. “He told me that I’d done great, and he even made a couple of jokes, which put me at ease.”
Michael went home the next day. Slowly, with the help of physical and occupational therapy, he started feeling better. He celebrated Thanksgiving with his family, and he’s now making plans to return to work at the wire and cable business he started 30 years ago.
He will continue to see Dr. MacKenzie for a conventional angiogram and then regular noninvasive scans for surveillance, and the two keep in close contact. “Dr. MacKenzie calls just to check up on me,” he says. “He’s a great doctor.”
He’s also seen tangible improvements in his quality of life. “I’m able to think more clearly, and my memory and speech have improved,” he says. (Dr. MacKenzie notes that although this is not usually claimed, since the stented vessel helps supply the part of the brain that controls language functions, this makes sense.) “It feels sort of like fresh air is being pumped into my brain.” And with every passing day, Michael’s becoming more confident that the rest of his life will be stroke free.
Abington – Jefferson Health offers comprehensive Neurosciences services. For more information, visit our website, Jefferson.edu/AbingtonBrain or call 1-800-JEFF-NOW.