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MUSC Health Florence Adds Advanced Stroke Capabilities to Improve Pee Dee Patient Outcomes

Kat Hendrix, Ph.D.
February 25, 2021
Dr. Christine Homstedt

The Medical University of South Carolina (MUSC) now provides advanced stroke treatment and neuro-critical care to residents of the state’s Pee Dee region through the MUSC Health Florence Medical Center. People in this predominantly rural area have long been underserved in terms of stroke care and often experience poorer outcomes than residents of more urban locations. Without local access to advanced technologies and staff who are specially trained in stroke management, rural residents have had to be transported long distances to receive care. Time lost during transportation can mean lost opportunities to benefit from life-changing therapies.

Christine Holmstedt, M.D., medical director of Clinical Stroke Services and co-director of the Comprehensive Stroke and Cerebrovascular Center at MUSC Health explains, “With stroke, time is brain. The longer the lag-time between symptom onset and getting treatment, the more function a patient is likely to lose. Longer delays in care mean more brain swelling and a higher risk of brain tissue death and mortality.” In addition, delays in getting care can close the window of opportunity for some patients to receive a thrombectomy–a brain-saving procedure to open blocked blood vessels after a stroke. “Thrombectomy is the absolute best treatment for patients with occlusive strokes as long as the brain tissue is still salvageable,” says Andrew Nicholson, MD, chief neuroradiologist at MUSC Health Florence. “But if too much time has passed, re-opening the vessels is no longer an option because it can trigger a significant bleed. The ability to provide this service here, locally, is a game-changer for people in the Pee Dee. Before, by the time many patients got to a place where they could get the care they needed, they were already ineligible for thrombectomy.”

Recognizing that rural residents often faced several hours in an ambulance to even reach a stroke center, Holmstedt and her colleagues began working on a solution. “About a year ago, we started discussing how we could bring this level of care to people in the Pee Dee instead of having them come down to us in Charleston,” says Holmstedt. Putting the technology in place was one thing, but making sure the center could provide the high standard of care needed to pursue accreditation by the Joint Commission took many months. “We didn’t want to just open the angio-suite and start doing procedures,” says Holmstedt. “We did a lot of training to develop a team of skilled neuro-critical care providers who know how to work quickly and in close coordination to assess and treat stroke patients. By far, the biggest investment we made was in the people and their training,” says Holmstedt.

Outreach and training efforts went far beyond the walls of the facility to ensure that everyone in the chain-of-care was aware that advanced stroke treatment was now locally available. “It’s really important for the first responders and EMS crews to know that we have the ability to treat strokes here,” says Nicholson. “They’re the ones who get the patients to where they need to go.” Holmstedt agrees, “In stroke, it really does matter where you get taken. There’s only one chance to get a stroke response right.”

With a firm foundation of trained staff and a new angio-suite adjacent to the emergency department, the MUSC Health Florence Medical Center is positioned to provide an advanced, rapid response to optimize stroke outcomes. “Especially when there’s a blockage in a main blood vessel, strokes can be very devastating or even fatal. One statistic you hear a lot is that patients lose 1-2 million brain cells for every minute a large vessel stays blocked. The longer it takes to restore that blood flow, the more brain damage is done,” explains Nicholson.

Although it has only been open a short time, many people in the Pee Dee area have already benefitted from having access to advanced stroke care. Nicholson recalls the center’s very first emergency thrombectomy patient. “The first responders got her to where she needed to be, and our staff had everything ready in the thrombectomy suite before the patient was even done being imaged. It all went as smoothly as one could hope. Everyone did an amazing job,” says Nicholson.

While that patient is currently doing well, it is impossible to predict how any particular individual will fare over the long-term after a stroke. However, Nicholson says everyone on his staff is excited and optimistic about the level of care they can now give their patients. “Overall, being able to provide this type of stroke care, gives these patients the best chance possible and vastly increases their odds of a good recovery,” he says.

Holmstedt also sees a bright future for the center and expects it to soon receive Joint Commission designation as a Thrombectomy-Capable Center, in addition to its current designation as a Primary Stroke Center. “The people of the Pee Dee region deserve to have access to this care, and I’m really glad we are there to offer it to them. We look forward to being here for everyone who needs stroke care to help them have the best outcomes that they possibly can,” says Holmstedt.