Patients in Marin have another weapon to help them avoid the disabling effects of a stroke - a corkscrew shaped device that is guided into the arteries of a patient's brain to remove the blockage.

"Time is of the essence for the brain," said Dr. Chad Goodman, an interventional radiologist on staff at Marin General Hospital. "The longer it's deprived of oxygen, the more the brain is damaged and body function becomes impaired. This tool allows us to remove a blockage safely and restore blood flow, so positive outcomes are more realistic."

Stroke is the number one cause of disability and the third greatest cause of death in the nation.

The MERCI Retrieval System uses minimally invasive surgery and is deployed using a catheter guided through a patient's artery. The physician ensnares the blockage inside a brain artery with a corkscrew shaped device located at the tip of the catheter. The blockage is then removed and blood flow is restored to the brain. MERCI stands for Mechanical Embolus Removal in Cerebral Ischemia.

Corkscrew device, highly magnified.

Close-up showing the ensnarement of the blockage inside a brain artery.

MGH is the only hospital in the county and the immediate North Bay (Sonoma and Napa Counties) using this retrieval system and the device is the only one of its kind.

The window of opportunity is six hours for treating strokes successfully. The Stroke Team at MGH is poised to treat stroke patients 24/7.

"It is so important for stroke patients to get help as soon as possible," he said.

The Stroke Team at MGH initially evaluates a stroke patient with a CT Scan of the brain.

"Once we determine what type of stroke we're dealing with, we proceed with treatment so patients have a better chance at regaining full function," he said.

Treatment may include using tPA, a clot-busting drug that can restore blood flow to stroke damaged tissue. tPA is tissue plasminogen activator.

"Brain cells near the stroke source die fast," he said. "Nearby cells can live longer and may be salvaged if we use this drug within three hours."

Goodman said once the blood clot is dissolved, a cholesterol blockage may be the problem. tPA only works on blood clots.

"Blood clots usually form around a cholesterol deposit," he said. "Once the blood clot is dissolved with tPA, we can use the MERCI Retrieval System to remove the cholesterol."

Studies show a majority of stroke patients unfortunately don't seek medical attention until 24 hours after symptoms appear.

Goodman said recognizing the early signs of a stroke and seeking immediate medical attention are vital to full stroke recovery. Classic symptoms include vision abnormalities or sudden numbness or weakness in the face, arms or legs, particularly on one side of the body.

"Some strokes can be subtle," Goodman said. "The initial symptoms may be sudden dizziness or nausea, fainting, confusion, severe headache. Many people experiencing these symptoms just take it easy and rest, but they are losing valuable time. A stroke can be devastating if medical attention is not sought right away. The patient and their family could be living with the effects of a stroke for a long time."

The hospital's Stroke Team is a multidisciplinary group of physicians, nurses and technicians. Physician specialists include those practicing neurology, interventional radiology and emergency medicine.