omar Goktekin highlights the importance of need and training of stroke cardiologists

Stroke intervention gradually picking up
Omar Goktekin highlights the importance
of need and training of stroke cardiologists
Selection of patients, timely arrival, and
multidisciplinary team approach is important

ISLAMABAD: One of the scientific sessions during the just concluded Pakistan Live 2022 organized by Pakistan Society of Interventional Cardiology (PSIC) was devoted to Acute Stroke Interventions. Speaking in this session Dr. Omar Goktekin an eminent interventional cardiologist form Turkiya highlighted the need and importance of training stroke cardiologists. He alongwith his team has been doing lot of stroke interventions for the last many years which helped many stroke patients who were saved from disability or the severity of disability was minimized. However, he laid emphasis that it is important that the patient arrives at the stroke unit immediately after the episode, the unit should be working round the clock, the patients gets examined immediately. Patients for stroke intervention should be carefully selected.

An experienced, well trained multidisciplinary team is a pre-requisite for starting stroke intervention. The team should include interventional cardiologist, interventional radiologist, interventional neurologist, anesthetist, internists while neurosurgery help should also be available. Neurosurgeon should be a part of the team and the center should be well equipped and well-staffed with well-trained nursing staff, other support medical staff and technicians to ensure quality post-operative care. As the team gets more experience, the results also improve and many patients who reach the facility in time, can be helped with a positive outcome. Interventional cardiologists, he further opined, need to be trained as stroke cardiologists and they are going to play an important role in the management of stroke patients in the days to come.

Earlier a case of basilar intervention was presented by Dr. Hamza Ghauri from Rawalpindi Institute of Cardiology. RIC it may be mentioned here had initiated stroke intervention studies about two years ago. A case of MCA intervention was also presented from National Institute of Cardiovascular Diseases Karachi by Dr. Kamran Khan. Dr. Abdus Salam from Tabba Heart Institute Karachi also presented a case of MCA intervention.

During the panel discussion Maj.Gen. (Retd) Azhar Keyani an eminent interventional cardiologist, former Executive Director of RCI who took this initiative to start stroke intervention at RIC strongly supported the idea of training stroke cardiologists. In view of the increase in number of stroke patients, all cardiac centers where intervention procedures are being performed and are well equipped having support of back up surgery, should start this service to help stroke victims. However, he also emphasized the importance of careful selection of patients and ensuring availability of multidisciplinary well trained experienced team. Prof. Nadeem Rizvi however, felt that it was very expensive and we already have too much disease burden of cardiac patients, hence the available resources and facilities should be used for cardiac patients. Gen.Azhar Kiyani it may be mentioned here using his contact, had acquired funding and judiciously utilized it to arrange most advanced, sophisticated equipment and instruments for Rawalpindi Institute of Cardiology as its Project Director. Not only that, he also managed to acquire the services of competent, well trained interventional neurologists, radiologists, anesthetist while interventional cardiologists team was also further strengthened and he also made sure that this facility for stroke patients alongwith cardiac patients should be available round the clock. It needed people to work in different shifts to entertain stroke and cardiac emergencies. At present stroke intervention is being performed not only at RIC but NICVD as well as at Tabba Heart Institute. Trained neurologists are also training people at other centers and results in carefully selected patients are very encouraging.

During the discussion Dr. Osama Mansour from Egypt shared some tips and tricks in mechanical thrombectomy in acute stroke while Dr.Salman Abdul Qayyum from Rawalpindi Institute of Cardiology shared their experience of setting up a stroke intervention service at a cardiac center.