Comprehensive Stroke Center Outcomes

The University of Maryland Medical Center Comprehensive Stroke Center (CSC) provides various acute therapies for the complex stroke patient. In Fiscal Year 2024 the CSC treated 733 seriously ill stroke patients (486 patients with an ischemic stroke (non-bleeding stroke) and 247 with a hemorrhagic stroke (stroke caused by a ruptured blood vessel). Here you will find valuable information about stroke outcomes.

IV Thrombolytic Fiscal Year July 2023 - June 2024

In December 2022, University of Maryland Medical Center CSC and associated system hospitals made a transition from IV Alteplase to IV Tenecteplase as the clot busing medication utilized to treat eligible ischemic stroke patients. One of the known complications for thrombolytics, including IV Tenecteplase, is bleeding into the brain, often referred to as a hemorrhage. The hemorrhage rate after receiving IV Tenecteplase should be less than 6.4%. This rate is reported in the hallmark IV Alteplase to treat stroke trials. At UMMC, the rate of hemorrhage after IV Tenecteplase administration was 3.8% (2/53 July 2023-June 2024).

*NINDS Study Group. Tissue Plasminogen Activator for Acute Ischemic Stroke. N Engl J Med; 19953333:1581-1588

Mechanical Thrombectomy Fiscal Year June 2023 - June 2024

Sometimes a large clot in one of the blood vessels in the brain may cause a stroke. Sometimes a stroke patient may have a procedure called a mechanical thrombectomy to remove the clot. The procedure is performed by a specialty trained doctor called an Interventional Neuroradiologist. The procedure involves placing a thin catheter into the brain to remove the clot. Complications from this procedure may include having a new stroke, hemorrhage or damaging a blood vessel. At UMMC, 175 mechanical thrombectomy procedures were performed. Nationally, the complication rate is expected to be less than 7% (Defuse Trial, Albers et al.).* At UMMC the complication rate was 1.1%.

A good outcome for stroke patients who have a mechanical thrombectomy procedure is a TICI grade of 2b or 3. The TICI stands for thrombolysis in cerebral infarction. The TICI grade is used to describe how well the blood flows in the treated blood vessel after having a mechanical thrombectomy procedure. At UMMC , 89% (153/172) of the TICI scores were 2b-3 compared to the national accepted rate of 76% reported in clinical trials.*

*G.W. Albers, M.P. Marks, S. Kemp, S. Christensen, J.P. Tsai, S. Ortega‑Gutierrez, for the DEFUSE 3 Investigators et al . Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging. NEJM January 24, 2018.
DOIL10.1056/NEJMoa1713973

Interventional Neuroradiology Diagnostic Procedures July 2023 - July 2024

Interventional neuroradiologists perform various procedures to help diagnose patients with problems in the brain, for example aneurysms, tumors etc. Nationally the expected complication rates are expected to be less than 1%, complications may include a brain hemorrhage or a torn blood vessel. During this time frame, UMMC CSC team of doctors performed 548 diagnostic procedures and 0.0036% experienced a complication.

Carotid Artery Procedures July 2023 - June 2024

At UMMC we have physician specialists called vascular surgeons who perform procedures for patients who have disease in the carotid arteries. One procedure performed involves placing a small tube, called a stent, in an artery to keep it open to allow blood flow to go through a narrowed blood vessel. Another procedure performed involves removing plague out of the carotid artery, this is called a carotid endarterectomy (CEA) procedure. Sometimes these procedures are performed when the patient is having symptoms and sometimes they are performed as elective procedures.

Nationally, the complication rates at 30 days are expected to be <6% for patients who present with symptoms and have a procedure. Complications may include stroke or death. At UMMC, 45 patients had a stent or CEA procedure when they had symptoms. Follow up at 30 days revealed no patient had a stroke or died.

Nationally, the complication rates at 30 days are expected to be <3% for patients who present without symptoms and have a procedure. Complications may include stroke or death. At UMMC, 58 patients had an elective stent or CEA procedure. Follow up at 30 days revealed no patient had a stroke or died.