Stent restores speech and movement for 26-year-old stroke victim

The consequences of a stroke can last a lifetime. But for Isabel Vinueza, paralysis, blurred vision and slurred speech came and went in less than three hours thanks to an alert boyfriend and a new medical device that can grab the clot and pull it out.

On the morning of Aug. 6, Vinueza was about to leave her Brickell apartment when she suddenly lost control over her right arm and leg and lost the ability to speak. A blood clot several centimeters long was clogging the 26-year-old's carotid artery, stopping the flow of blood to the left side of her brain and leaving her confused and unable to move her right hand or leg.

She tried through gestures and slurred words to convince her boyfriend that she was fine and just needed a nap. But after Michael Sullivan carried her to their bed, he called Vinueza's family in Ecuador, his mother and then 911.

"Thank God he has better judgment," she joked Tuesday, showing no signs of the physical impediments that alarmed Sullivan just one month ago.

When Miami paramedics arrived, they quickly diagnosed her with a stroke and sped a dazed but calm Vinueza in an ambulance to Jackson Memorial Hospital, where a team of UHealth doctors with the University of Miami ran a CT scan and confirmed she was suffering from an acute ischemic stroke, in which a clot blocks blood to the brain.

Doctors administered clot-busting medications within minutes. Then they wheeled her into a suite, where Dr. Dileep Yavagal ran a catheter just fourteen-thousandths of an inch wide up her groin and into her brain. He then pushed a netlike retrievable stent through the catheter and into her artery. The weblike stent, created by Medtronic and called the Solitaire, fastened itself to the clot like a fishing net and pulled the entire obstruction back into the catheter and out her leg.

When she awoke about three hours after suffering the stroke, her speech and movement had returned. With her eyesight no longer blurry, she could see the blood clot, intact, sitting in a jar by her bedside.

"I feel so blessed, so grateful for the people around me," she said, brushing her hair back from her eyes with her right hand. "I'm here. I'm fine. It's incredible."

Doctors say Vinueza's spectacular recovery is due to her boyfriend's quick actions, well-trained paramedics and the Solitaire - a product gaining national attention for revolutionizing stroke treatment.

"We can actually reverse stroke paralysis now," said Yavagal, chief of UHealth Interventional Neurology. "This is really a great, ground-breaking shift in the treatment for stroke."

That's good news in the U.S., where stroke is the fifth-leading cause of death and affects some 800,000 people a year, according to the Centers for Disease Control and Prevention. And Yavagal says South Florida is on the forefront of improving stroke treatment.

Earlier this year, Yavagal led South Florida's participation in a multicountry clinical trial of the Solitaire, created to be a more effective stent than its predecessors. A study published about the trial showed that roughly 55 percent of patients treated with the Solitaire through this procedure, called a thrombectomy, regained full independence - almost double the rate of recovery than with just intravenous medications.

Yavagal said doctors have treated strokes with clot-busting medications and catheters for years, and UHealth and Jackson have performed nearly 300 thrombectomies since 2007. But he said that before the Solitaire became a proven tool, removing clots often took 90 minutes on average because clots would break into pieces as doctors tried to remove them. Many times, the clot wasn't entirely removed.

With the Solitaire, he said the procedure often takes only 20 or 30 minutes because the tool grabs the entire obstruction on the first pass. Once the clot is removed, blood flow is restored instantly, stemming the damage to the brain.

"The result we had in Isabel was just unbelievably dramatic," he said. "Within a day or so she was pretty much back to normal."

The treatment isn't available for all stroke patients, and quick detection remains vital to treatment. Yavagal said the new device can be administered up to six hours from the time of the stroke, and some patients have other impediments that might keep doctors from utilizing the retrieval stent or clot-busting meds. But he said the treatment - recently called a "game-changer" by Newsweek - should be available nationwide and is successful in patients of all ages.

Today, UHealth is seeing about 40 percent of stroke patients "walk out" of the hospital after being treated with Solitaire, Yavagal said, and the success rate is rising.

For Vinueza, who was working out three times a week and doing Pilates on a fourth day, regaining her full movement and speech was almost miraculous. Doctors say it's unusual for a young person in good shape to have a stroke. She left the hospital after five days and is helping Sullivan run The Golden Fig, a Brickell restaurant he opened just weeks before her stroke.

"It saved my life," she said.

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