Endovascular Rescue Therapy

UT Southwestern Medical Center offers endovascular rescue therapy for stroke, 24 hours a day, seven days a week. Our team includes highly qualified and experienced physicians who can perform the treatment at any time.

The number of patients we have treated with endovascular rescue therapy has doubled year after year. Other hospitals refer their most severe ischemic stroke cases to UT Southwestern for treatment because we are the only Advanced Comprehensive Stroke Center in North Texas. 

If you or a loved one is experiencing signs of a stroke, it is a medical emergency. Call 911 and go to the nearest stroke center in an ambulance. 

Offering the Latest Innovations in Stroke Treatment

Endovascular rescue therapy, also known as neurointerventional therapy, is a relatively new treatment available for eligible patients experiencing acute ischemic stroke – a stroke caused by a blood clot in the brain. The treatment involves placing a catheter into the brain and removing the clot that’s causing the stroke. 

Endovascular therapy must be done within six to eight hours of the onset of a stroke, depending on the location. Endovascular treatment can restore blood flow within minutes.

Studies show that patients who receive endovascular rescue therapy after intravenous tissue plasminogen activator (IV tPA) have better outcomes than patients treated with medical therapy alone.

Evaluation

Not all patients experiencing ischemic stroke are eligible for endovascular therapy. It is considered only in patients who:

• Are at least 18 years old
  
• Score 6 or higher on the National Institutes of Health Stroke Scale (NIHSS)
  
• Have received IV tPA within 4.5 hours of the onset of symptoms
  
• Have a proven large arterial blockage on imaging
  
• Are eligible to receive endovascular therapy within 6 to 8 hours of the onset of stroke symptoms, depending on location 

Treatment With Endovascular Rescue Therapy

Most hospitals can apply IV tPA to begin breaking down the blood clot that’s causing the ischemic stroke. Once a patient is stabilized, he or she can be transferred to a higher-level stroke center such as UT Southwestern for endovascular rescue therapy. 

If a patient qualifies for endovascular rescue therapy, a neurosurgeon or neurointerventional radiologist will begin endovascular therapy as soon as possible. The physician will thread a thin wire tube with a wire mesh (called a stent retriever) at its end through an artery in the patient’s groin and use X-ray and contrast dye to guide the tube up into the brain until it reaches the blocked vessel. Once the tube is pushed into the clot, the physician expands the stent retriever to grab the clot, which is removed as the tube is pulled out. 

The procedure takes about 2 hours. After surgery, patients receive care in UT Southwestern’s dedicated neuro intensive care unit (neuro ICU).