UTHealth's Mobile Stroke Unit fights stroke through research, technology and patient care

About 800,000 strokes occur in America each year; that's about one every 40 seconds. Houston resident Joe Carrabba experienced one of them.

Carrabba was having a massive stroke last year when UTHealth's Mobile Stroke Unit assessed him, performed a CT scan and administered drugs to dissolve blood clots. The Unit is a modified ambulance that has the specialized training and equipment — which first responders do not — to diagnose and treat stroke patients en route to the hospital.

When a stroke occurs, every minute counts. Because of the Unit's quick action, Carrabba spent only four days at the hospital before he made a full recovery and was sent home.

"I wouldn't be here right now if it weren't for the Mobile Stroke Unit," he said.

UTHealth's Mobile Stroke Unit —the nation's first — is one of many ways the UT System's 14 health and academic institutions are fighting stroke through research, technology and patient care.

Last year, UT System Chancellor William H. McRaven launched "Leading the Brain Health Revolution" one of eight audacious strategic initiatives described as Quantum Leaps. This particular initiative aims to understand, prevent, treat and cure the diseases of the brain, such as stroke.

"We will make a tremendous investment in leveraging and connecting all the cutting-edge science occurring at our UT System institutions to discover new knowledge and solutions to neurological diseases," McRaven said. "This Quantum Leap will drive collaboration, incentivize partnerships and demand scientific and clinical cooperation between our talented physicians and researchers."

Although May is designated as National Stroke Awareness Month, UT System institutions are fighting year-round to defeat stroke and continue Leading the Brain Health Revolution.

Technology
New stroke-related technologies have been developed by several UT System institutions. For example:

UTHealth in Houston used telemedicine to enroll patients remotely into a stroke clinical trial - the first of its kind. UTHealth also launched a clinical trial investigating the use of a physician-monitored app to help first-time minority stroke patients become healthier.

At UT Health Science Center San Antonio, physicians are using devices called stent retrievers to extract clots from stroke patients with large-vessel occlusions.

Meanwhile, UT Dallas researchers Michael Kilgard, Ph.D., and Robert Rennaker, Ph.D. have conducted clinical trials stimulating a key nerve to correct unwanted changes in the brain following a stroke. Their work helped Dallas-based startup MicroTransponder develop its Vivistim® System device, a medical device designed to stimulate the vagus nerve in stroke patients to restore lost arm function. Kilgard and Rennaker will receive $2.3 million from the National Institutes of Health over the next five years to test the effectiveness of using vagus nerve stimulation to enhance stroke recovery.

Research
Researchers at institutions across the UT System are launching studies with the potential to dramatically improve stroke prevention and treatment.

An international team of researchers, led by Clay Johnston, M.D., Ph.D., dean of the Dell Medical School at UT Austin, released a study published in the New England Journal of Medicine, which did not find that the prescription drug ticagrelor was better than aspirin — the current standard — in reducing the risk of stroke, heart attack or death in patients who suffered a minor stroke, also known as a TIA.

UT Austin researchers also discovered that patients who rely heavily on their better-functioning side after a stroke can actually limit the recovery or worsen the use of a limb damaged by stroke.

Researchers from UT Southwestern in Dallas are studying nursing protocols to better triage and treat stroke patients using telemedicine. It will be the first study using a new consortium of medical centers known as The Lone Star Stroke Consortium .

Patient Care
UT Southwestern's Robert D. Rogers Advanced Comprehensive Stroke Center — part of UT Southwestern's Peter O'Donnell Jr. Brain Institute — is among an elite group of stroke centers recognized nationally for its exemplary care of specialized stroke cases. It received certification by The Joint Commission and American Heart Association/American Stroke Association as an Advanced Comprehensive Stroke Center.

For patients with high-risk or specialized stroke cases, this means quick access to the best care, the highest-trained team of neurosurgeons and neurovascular experts, and ability to use the latest stroke treatments and technologies available.

This access to specialized care changed Fort Worth resident Kellie Whitton's life. Whitton was diagnosed with moyamoya disease — a rare condition that causes constriction of blood vessels in the brain and life-threatening strokes — six weeks before her wedding.

Babu Welch, M.D., a UT Southwestern associate professor of neurological surgery and radiology, performed a brain bypass surgery to move an artery from her scalp and attach it to one in her brain that was not affected by her condition. The 3-hour surgery was a success, and Welch even minimized the necessity of shaving Whitton's head since she was determined not to postpone her wedding.

"Dr. Welch was able to part my hair and go in through the hairline," Whitton said. "That's one of the reasons I really love Dr. Welch, because he is so hands-on. I completely trusted him with everything, and his team."