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Greenwich Hospital’s multimillion dollar neuroscience expansion includes life-saving stroke surgery

Thursday, March 5, 2020

Akli Zetchi, MD

Akli Zetchi, MD, a leading cerebrovascular neurosurgeon with Yale Medicine’s neurosurgical department, in the new $4.5 million neuroscience interventional laboratory at Greenwich Hospital. Dr. Zetchi is spearheading Greenwich’s new neuroscience program, which includes life-saving stroke surgery, known as mechanical thrombectomy. Greenwich Hospital is the only medical facility in lower Fairfield County with the state-of-the-art technology and Yale Medicine physicians to offer this advanced treatment for acute stroke around the clock.



Greenwich, CT (March 5, 2020) –
Greenwich Hospital has launched a multimillion dollar neuroscience program that includes life-saving mechanical thrombectomy, becoming the only medical facility in lower Fairfield County with the state-of-the-art technology and Yale Medicine physicians to offer this advanced treatment for acute stroke around the clock.

“Mechanical thrombectomy is a minimally invasive procedure that removes a blood clot from a brain artery. It has revolutionized the treatment of acute strokes because we can perform this intervention up to 24 hours from the onset of symptoms, which means we can potentially treat more people,” said Akli Zetchi, MD, a cerebrovascular neurosurgeon with Yale Medicine’s neurosurgical department who is spearheading the new neuroscience program at Greenwich. “It’s a game changer because this advanced level of stroke care does not require major surgery. We are seeing amazing recoveries right in the operating room.”

For example, a 50-year-old stroke patient from Port Chester, NY, recently arrived at Greenwich Hospital via ambulance unable to speak or move his right arm and leg. He regained his mobility and speech in the operating room within minutes of Dr. Zetchi removing the blood clot with mechanical thrombectomy. The patient was awake with mild sedation during the procedure.

Investment in neurosciences

Stroke patients are treated in a new $4.5 million neuroscience interventional laboratory that features neuro biplane three-dimensional imaging, which was made possible by generous Greenwich donors. A neuro interventionist along with specially trained nurses and technicians are on stand-by 24/7 to respond to a stroke alert. Candidates for mechanical thrombectomy also undergo a brain perfusion scan to assess the size of the stroke and how much brain tissue is at risk of dying.

Biplane imaging plays a crucial role in the delivery of safe stroke care. The system uses two mounted rotating cameras that simultaneously capture detailed images of the brain, which allows physicians to quickly and precisely identify the area affected and the location of the blood clot. During a mechanical thrombectomy, physicians thread a thin catheter with a stent through an artery in the groin up to the blocked artery in the brain using biplane imaging as a guide. The physician removes the stent once the device has trapped the blood clot.

Greenwich Hospital’s neuroscience program is part of a $160 million strategic investment over the next five years to expand clinical services to Connecticut and New York residents. Physicians can now treat stroke, carotid disease, brain aneurysms, vascular malformations of the brain and spinal cord, brain tumors, adult-onset hydrocephalus and traumatic brain injury.

“As a member of Yale New Haven Health, we are collaborating with Yale Medicine physicians to translate research discoveries into actual improved patient outcomes. Patients in our region no longer need to travel to New York or New Haven to receive world-class stroke care,” said Norman G. Roth, president and chief executive officer of Greenwich Hospital.

Time is of the essence

Stroke is the nation’s fifth cause of death and a leading cause of long-term disability, according to the American Stroke Association. A stroke occurs when a blood vessel carrying oxygen and nutrients to the brain becomes clogged by a clot (an ischemic stroke) or bursts (a hemorrhagic stroke). Every minute counts when it comes to diagnosing and treating stroke because brain cells that cannot get blood and oxygen begin to die, which can lead to temporary or permanent paralysis, language and vision deficits and other problems.

“Time is critical because immediate treatment may reduce the long-term effects of a stroke and even prevent death,” said Dr. Zetchi.

Until a few years ago, the only available treatment for ischemic stroke was an intravenous clot-busting drug called alteplase (IV r-tPA) that must be administered within 4.5 hours of the onset of stroke symptoms. Mechanical thrombectomy, in contrast, can be performed on eligible patients with large clots in an artery within 24 hours of stroke symptoms. Patients who are eligible for alteplase receive this medication prior to mechanical thrombectomy.

The 24-hour window for treatment means individuals who wake up in the morning to discover they are experiencing symptoms of stroke should immediately call 9-1-1. Symptoms include face drooping, arm or leg weakness, speech difficulties, vision problems and balance issues.

“We need to change people’s mentality when it comes to stroke,” said Dr. Zetchi. “It’s not about ‘I had a stroke.’ It’s about ‘I’m having a stroke.’ There’s still a chance that mechanical thrombectomy can reverse stroke symptoms and, in some cases, save lives.”