In the southern Italian region of Puglia, the stroke network for ASL Lecce centers around Ospedale Vito Fazzi in Lecce, which serves as the main comprehensive stroke center, where stroke patients can receive specialized treatment, including mechanical thrombectomy.
Patients with suspected stroke are transported directly to the Neuroradiology department of Vito Fazzi hospital, which since March 2020 has been under the guidance of Dr. Adriana Paladini. The diagnostic neuroradiologist and all the staff of the department (technicians and nurses) are involved in the stroke workflow. Adriana and her colleagues, Dr. Emilio Lozupone and Dr. Alfredo Pauciulo, carry out the interventional neuroradiology service and treat cerebrovascular disease.
Since 2019, e-Stroke has been deployed across the network, enabling image sharing and improved communications across the sites. Dr Emilio Lozupone shares his experience with e-Stroke, highlighting the benefits that he sees the AI-powered software bringing to him and his team: “The e-Stroke platform is a valuable and trustworthy tool in stroke care. We have managed to reduce the time it takes to treat patients, which enables us to choose the best treatment. Under the wise guidance of Adriana Paladini, we doubled the number of thrombectomies in two years’ time, going from 60 in 2020 to 97 in 2021 to probably 140 by the end of 2022. With the e-Stroke mobile app the team have easy access to the scan images even if they are not in the hospital – which also contributes to saving critical time and simplifying the treatment decision making process."
The team shared the story of a recent patient who had experienced an ischemic stroke due to an occlusion of the right M1 segment and dissection of the internal carotid artery.
The patient said: “ In the middle of the night last August, I tried to get up but struggled due to extreme fatigue. A series of lucky events then ensued: my wife, due to a past bad experience, immediately recognized the problem (stroke) and called the ambulance.” The patient was directly transferred to the Vito Fazzi hospital, the Hub hospital for cerebrovascular disease. He was promptly evaluated by the neurologist, who then ordered a CT scan to be run (Figure 1). The interventional neuroradiologist and all the angio-suite staff were immediately alerted, thanks to the e-Stroke network. The patient was transferred to the angio-suite, where mechanical trombectomy was performed allowing for full reperfusion of both the ICA and MCA.
The patient remembered: “The earliest memory goes back to the night of August 15, 2020 when an angel held my hand and tried to keep me alert, while a multitude of people bustled around me. The day after, I woke up in the stroke unit and found that I had been operated during the night.” Mario spent one week in the stroke unit and then completely recovered.