“I have to thank life for this second chance it has given me,” celebrates Antonia Pérez, about to turn 53. On January 8, this resident of Les Roquetes (Sant Pere de Ribes) suffered a serious stroke and now she hardly has any after-effects. Some memory lapse, some word that does not appear. Nothing more, except an amalgamation of medications to keep various health parameters at bay. “I lead a normal life, like before, except that I smoked a little and I have stopped smoking,” she explains.
Thanks to her husband, who identified the symptoms, Antonia was urgently transferred to the Bellvitge hospital. If it were up to her, she says, she would have gone back to bed to sleep. “And who knows what could have happened to me.” Because, when it comes to stroke, time is the brain, doctors say. Every minute that passes until treatment, 1.9 million neurons are lost, and every 15 minutes without receiving adequate care, a month of disability-free life is deducted. “It is a devastating disease, the leading cause of mortality in women and the leading cause of disability in the population,” says Carlos Molina, head of the Vall d’Hebron stroke unit.
Since the challenge consists of subtracting time from time, Antonia Pérez's journey began fatally. The Bellvitge operating room was busy and the ambulance had to head to Vall d'Hebron. There, the patient was subjected to a pioneering technology and approach to stroke in the world. The so-called One Step Stroke, a revolutionary procedure, which was in the trial phase, was presented yesterday after a year of testing. The normal thing, in view of the results, is that it extends from the Vall d'Hebron to all hospital centers specialized in the treatment of stroke.
One Step Ictus represents a transformation of care for ischemic and hemorrhagic stroke patients based on the concentration of the entire procedure in a single room: directly from the ambulance or emergency department to the One Step Ictus room, where the diagnosis is made. , clinical assessment, surgical intervention and patient stabilization. “This project is not only a new way of dealing with the stroke code, it also means saving time, gaining time, and in strokes acting quickly is key,” explained the Health Minister, Manel Balcells.
“The pioneering technological solution of the One Step Ictus room combines a biplane angiograph to perform mechanical thrombectomy (removal of the thrombus that blocks blood circulation) with equipment to perform CT before, during and after the thrombectomy and evaluate the cerebral blood flow of the patient,” said Manel Escobar, clinical director of the diagnostic imaging service.
This unification of examination and treatment – which avoids running through the corridors and, above all, means saving time – almost doubles the probability of recovery from the most serious strokes. “We estimate that 48% can achieve practically total clinical recovery after undergoing a direct thrombectomy, compared to 27% of patients who follow the traditional circuit,” said Dr. Molina. The objective of Vall d'Hebron is to normalize a period of 17 minutes from the time the patient arrives at the hospital until he is intubated in the stroke room. Currently the average is 47 minutes, but it is trending downward, according to Molina: “Last Wednesday, an ischemic stroke patient, 27 minutes passed between the time he arrived and we already had him intubated. Before it took us between an hour and a half or two hours.” More than a hundred million neurons saved.
“It involves removing the thrombus or covering the closed aneurysm. It occurred to us that by doing everything, diagnosing with a scanner and performing the intervention, at the same point we would save a lot of time, and time is brain," recalled Manel Escobar, director of the diagnostic imaging service: "It is a unique room in Catalonia. and in Europe. We do not have to move the patient from the table, what moves is the scanner, which works with magnetic rails, so that the patient is always in maximum safety conditions."
With an investment of 18 million euros financed 50% with European Feder funds, the project incorporates the most innovative technology to speed up diagnosis and intervention, developed by Medtronic and Siemens Healthineers. In addition, it is completed with the SmartStroke digital platform, which integrates the patient's clinical history with the rest of the data generated in the hospital and facilitates remote monitoring, allowing vascular risk factors and rehabilitation to be monitored from home.
Antonia Pérez did not find out that she was treated using the revolutionary Vall d'Hebron model. “The worst moment – she remembers – was when they told me that they had to operate, that they entered through the groin and reached your brain through an artery. I thought: 'My God, what progress.'" It happened on a Sunday, the same week that she had closed the Les Roquetes market stall where she worked. Antonia got out of bed at eight in the morning, she noticed that her body was not supporting her, she began to sway until she lost her balance and fell to the floor. “I didn't know it could be a stroke, I thought it was dizziness or a drop in blood pressure. In any case, I have been very lucky, it was a coincidence that it happened at that moment. "If it happens to be a Monday when my husband is working and my daughter is at school..."
It is estimated that about 560 patients a year will be able to benefit from the new treatment system. Last year, Vall d'Hebron treated 1,945 cases, of which 1,433 were ischemic strokes, 180 were transient ischemic attacks and 64 were hemorrhagic strokes.
