Surviving The Unexpected

Organization: Service: Story Topics:
Stroke

Saving Janice's Life with Advanced Interventional Techniques 

When Cypress resident Janice Fraser went to work last New Year's Eve, she thought her persistent neck pain was just a pulled muscle.

An intensive care nurse, Janice, 62, recalls it seemed to take longer than usual to drive home that night, and her head hurt "like someone was pulling on the back of my scalp." Thinking she might have the flu or a migraine, she went to bed, hoping to feel better in the morning. But when her daughter had difficulty waking her the next day, Janice was rushed to the nearest emergency room.

A CT scan showed the real cause of Janice's symptoms: a ruptured cerebral aneurysm that was leaking blood into her brain. Worried family members had Janice transferred to Long Beach Memorial, where state-of-the-art aneurysm treatments are available through the hospital's new Division of Interventional Neuroradiology (DINR) at the MemorialCare Neuroscience Institute. It's the result of a unique partnership between Long Beach Memorial and UCLA.

The DINR team, which is composed of UCLA interventional neuroradiologists, works closely with Long Beach Memorial neurologists, neurosurgeons, critical care and rehabilitation specialists, providing round-the-clock care for neurovascular emergencies — including ruptured aneurysms like Janice's. Unlike surgeons whose major tool is the scalpel, interventional radiologists use microcatheters to gain access to the brain and repair it.

"The interventional neuroradiologists on our DINR specialize in minimally invasive, image-guided methods to treat blood vessel disorders of the brain and spinal cord, including aneurysms and strokes," says Angela West, R.N., neuro/stroke program director at Long Beach Memorial.

An abnormal, balloon-like growth on the wall of a blood vessel, an aneurysm typically causes no symptoms until it ruptures. Death occurs in about half of all cases. "The most urgent goals are to secure the aneurysm and reduce the risk of re-rupture, preventing further damage," says Sachin Rastogi, M.D., interventional neuroradiologist, MemorialCare Neuroscience Institute, Long Beach Memorial.

The conventional treatment for a ruptured aneurysm is surgical clipping — a major surgery that involves opening up the skull and placing a tiny metal clip to block blood flow to the aneurysm. But thanks to the DINR team at Long Beach Memorial, Janice had a less invasive option with a shorter recovery time — an innovative procedure pioneered by the UCLA DINR team called coil embolization.

Guided by continual X-ray imaging, a microcatheter is advanced through an artery to the aneurysm site. Through the microcather, soft tiny platinum coils are used to pack the space within the ruptured aneurysm. "The coils cause the blood flow in the aneurysm to stagnate which allows the blood to form a clot which seals off the aneurysm from the artery and prevents further rupture and bleeding," says Dr. Rastogi. The coils are then detached from the delivery wire and left inside the aneurysm.

For Janice, the procedure was a resounding success. She remained in the hospital for nine days after the surgery, which was shorter than a traditional procedure while the DINR team monitored her closely for signs of further bleeding, using tests such as transcranial Doppler — a type of ultrasound that measures blood flow within the brain — and the hospital's state-of-the-art 320-slice CT scanner. In late February, she returned to her job as an ICU nurse and didn't have any visible signs from surgery, such as a bad haircut.

Reflecting on her ordeal, Janice is grateful to have her life back. "As a nurse, I've cared for a lot of aneurysm patients, but I just never thought it could happen to me," she says. "I feel great, and blessed to be alive to enjoy my family and grandkids. Dr. Rastogi saved my life."