Nichole Carreon

July 24, 2008

RNSG 1262- formative rotation article

New Procedure to Fight Off Strokes

I found this article through the Nursing Reference Center by EBSCO. It was published in
the March 2006, Vol. 69, No. 3, of the RN nursing journal. The author of this article is
Ellen Barker, who is an advanced practice nurse who is also a neuroscience clinical
specialist who happens to be the president for Neuroscience Nursing Consultants in
Greenville, DE and a member of the RN Journal editorial board.
The reason that I picked this article was because I know eventually I am going to
have a patient who presents in the hospital post stroke or who could possible have a
stroke while staying in the hospital. I haven’t had a patient like this one yet but I know
throughout my career I am bound to come across one.
This article was printed in 2006, but from what I have researched, the procedure
has only been performed on about 8,000 patients worldwide with this system. The
procedure is called the Mechanical Embolus Removal in Cerebral Ischemia Retriever, or
shorted as MERCI. The procedure consists of a long balloon like catheter that holds a
cork-like wire inside that is straight inside the catheter but then coils up like a cork screw
when pushed outside the catheter. The catheter is inserted into the body through the
femoral artery and laced up all the way to the point of the clot. It slightly passes the clot
then the wire is pushed out of the catheter where it ad heirs itself to the clot in the coil
part of the wire. The balloon catheter is then blown up so that the wire with the clot can
fit back into it. At this moment blood flow will temporarily stop while the catheter is
pulled out of the body. If everything pulls through fine, then blood flow to the brain can
be restored to the brain in as few as 20 minutes. Sometimes it can take a few times to get
the clot out but the procedure only allows for the surgeon to attempt removal of the clot
up to six times before he/she has to close the site. The procedure takes about a little over
an hour to complete. I think that this procedure is an improvement in the way we will
treat strokes. As of now when someone has a stroke they must be treated within 3 hours
in order to receive TPA and be treated. With this new procedure, if a patient arrives at the
ED post 3 hrs from the onset of an attack, it is a new window for treatment and cure.
With over 7000,000 strokes suffered each year in this country, this new procedure will
improve the chance of recovery up to 30%. Nurses would contribute to post operative
care by care observation of the patient for the first 24hours looking for any adverse
effects by monitoring patients neurological status, LOC, blood pressure changes, any
signs of intracranial hemorrhage, or new stroke or MI.
I feel that once this procedure is accepted by more medical facilities as surgeons,
that it would make a vast improvement in the way we treat stroke patients. This
procedure could help patients who suffer from a stroke recover with better results and in
sooner time. Hopefully we will see it used often in the near future.
 Nichole Carreon
July 24, 2008
RNSG 1262- formative rotation article

Works Cited

The EBSCO data base at:

http://web.ebscohost.com/nrc/results?vid=32&hid=107&sid=3ceb5fcd-a842-4941-bfbb-
75843b0568ff%40sessionmgr107&bquery=(%22embolectomy%22)&bdata=JmRiPW5y
YyZkYj1ucmNuJmRiPXJ6aCZkYj1tbmgmY2xpMD1GVCZjbHYwPVkmdHlwZT0wJn
NpdGU9bnJjLWxpdmU%3d Article number 49.

RN Nursing Journal, March 2006, Vol. 69, No. 3, pg 26 Article by Ellen Barker, MSN,
APN, CNRN, CLCP,ABDA http://rn.modernmedicine.com/rnweb/CE+Library/A-new-
weapon-to-combat-stroke/ArticleStandard/Article/detail/310563

http://www.concentric-medical.com/index.html