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Endovascular Treatment Returns Mom and Grandmom to Her Family after Stroke

Evelyn Severe family

Evelyn (center) with her family,
son Mondy Dorsainvil, and
granddaughters Wendy, Melody
and Mandee.

"On April 22, 2015, I had gone shopping with a friend," Evelyne recalls. "Suddenly, I dropped my handbag. When my friend asked what was wrong, I said, 'my purse, my purse,' but I knew I wasn't speaking properly. Fortunately, my friend is a nurse, and she instantly suspected a stroke and called 911."

Evelyne arrived at Abington – Lansdale Hospital via ambulance and immediately underwent a CT scan, which revealed a large clot, almost 12 millimeters in diameter, which had lodged in her carotid terminus, an artery behind her eye. Doctors quickly started an intravenous line of the gold-standard “clot-busting” drug, tPA. But it wasn’t enough – the size and location of the blockage kept it from dissolving.

Evelyne doesn’t remember much about the flurry of activity that occurred next, including the ride in the medical helicopter that airlifted her to Abington Hospital – Jefferson Health. “At some point, I was asked to show if I hurt anywhere,” she says. “But I wasn't in pain – all I felt was a slight prickling sensation behind my eye.”

A major stroke temporarily stole Evelyne Severe's power of speech. But thanks to the immediate response of the people around her and the experts at the Neurosciences Institute at Abington – Jefferson health, the 63-year-old is now able to tell her remarkable story of recovery.

A Delicate Extraction

When Evelyne arrived at the hospital, Qaisar A. Shah, MD, director of Neurointerventional and Neurocritical Care at the Neurosciences Institute at Abington – Jefferson Health, and Hana Choe, MD, assistant director of Neurointerventional Care, quickly confirmed that she would need advanced treatment in the Neurovascular Laboratory. The doctors performed a procedure called endovascular treatment (ET), carefully suctioning out the clot through a catheter threaded from an artery in Evelyne’s groin up to her brain.

The procedure itself took minutes, but the effects were dramatic. “When I woke up that evening (her stroke had occurred in the morning), I felt fine,” Evelyne says. “I didn’t even have a headache.”

It was only later that she realized how lucky she had been. “Eighty percent of the time, a clot of this size, in this location, causes severe brain damage or death,” Dr. Shah says. He notes that most people who have strokes don’t get to the hospital within the four-and-a-half hour window of time that tPA can be administered (after that, it can cause fatal bleeding). “Even if they do, tPA only works about 20 to 30 percent of the time,” Dr. Shah notes. “In contrast, ET has a success rate of 80 to 90 percent.”

In retrospect, Evelyne believes there may have been earlier signs that something was wrong. A few weeks before her stroke, she’d experienced dizzy spells, and she’d been forgetting to take her blood-thinning medication regularly. “I realize now that it was a big mistake not to have sought help earlier,”she says. “But I thank God that Abington was there when I needed help most.”

Carotid artery with abrupt cutoff and loss of blood flow to brain due to clot.

Carotid artery with abrupt cutoff and loss of blood flow to brain due to clot.

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