Rawalpindi Institute of Cardiology pioneered brain angioplasty in Pakistan

Islamabad: The Rawalpindi Institute of Cardiology (RIC) has earned the distinction of becoming Pakistan’s first cardiac centre to perform percutaneous emergency brain stroke intervention by removing clots obstructing blood flow to the brain vessels.

The first beneficiary of the successful intervention, which took place on April 13, was a 50 year-old gentleman who presented to the hospital’s emergency with a four-hour history of sudden paralysis of one side of the body, along with loss of speech.

Like emergency angioplasty and stent for heart attack, now the standard of care for acute ischemic brain stroke is urgent endovascular stroke intervention in which emergency angiography of the brain is performed and blood clots obstructing the brain’s blood vessels are removed percutaneously, leading to restoration of blood flow to the brain.

According to RIC’s Executive Director Azhar Mehmood Kayani, brain stroke is the second leading cause of death worldwide; 87% of these strokes are caused by ischemia i.e., obstruction in blood vessels of the brain, leading to cessation of blood flow, whereas the remaining 13% are due to bleeding in the brain.

“Looking at the natural history of stroke, one-third of these patients die, another one-third will have permanent, moderate to severe disability, and the lucky one-third will be left with minor disability or recover fully. Brain stroke may present with paralysis of half side of the body with or without speech difficulty, facial deviation, loss of consciousness etc.,” Dr. Azhar explained.

Responding to a query about the success rate of the intervention, Dr. Azhar said, “The chances of opening the blocked artery in the brain through this emergency intervention is around 80%, and almost 70% patients achieve minimal disability at the end of 90 days after the procedure or recover completely.”

Terming it a noble cause, Dr. Azhar said RIC has taken the initiative to set up acute brain stroke intervention services in best public interest. “We organized a systematic training programme involving simulators, 3D flow models, and hands-on animal laboratory experience in Malaysia, followed by training in a comprehensive stroke centre in the USA,” he informed.

Dr. Azhar believes that the availability of infrastructure for interventional cardiology, alongside skilled manpower, functional Cath. Labs and CT scan machines, etc. makes it imperative for stroke interventions to be performed after requisite training.

“Acute stroke intervention is now the need of the hour, and in order to reduce the mortality and morbidity associated with brain stroke, all concerned specialties like neurology, interventional radiology, neurosurgery and interventional cardiology need to join hands and start this service forthwith. By taking the lead, RIC hopes to motivate other well cardiology setups to start this vital service,” he hoped.