Artificial intelligence speeds up care, improves outcomes for stroke

When someone suffers a stroke, getting treatment as quickly as possible is critical to save brain function and brain cells.

Like a heart attack harms the heart, strokes signal distress in the brain. When that happens, the supply of oxygen-rich blood to parts of the brain is reduced or cut off, which can cause areas of the brain to die.

That's why streamlining care for stroke patients is so vital, and why doctors who care for them have embraced time-saving software technology called Viz.ai. The technology maps out blood flow in the brain in real-time. Then, it uses artificial intelligence to alert doctors when it finds clots in the brain blocking blood vessels or bleeding into the brain tissue. Viz.ai also identifies brain tissue that can be saved by immediate removal of the clot.

Viz.ai creates a user-friendly, organized platform that allows stroke team members to swiftly communicate with each other, ensuring rapid and seamless coordination of patient care, whether the experts are on-site or off.

"By saving time, we can protect the patient's brain and try our best to preserve their quality of life," says Alexander Grunsfeld, MD, medical director of neurosciences for Sentara Healthcare, based in Norfolk, Va. "Without a doubt, Viz.ai makes our already rapid stroke evaluation process even more efficient and gives us valuable information to develop a treatment plan for our patients,"

How strokes harm the brain

Nearly 90% of strokes occur when a blood clot blocks vessels that carry blood to the brain, reducing oxygen to the brain. These are known as ischemic strokes.

"When the brain is deprived of oxygen, about 1.9 million brain cells die each minute," explains Lee Jensen, MD, an interventional neuroradiologist with Sentara. "In order to restore flow, we want to do that as quickly as possible so as much of the brain can be saved as possible."

Doctors can treat these ischemic strokes by removing the clot through a minimally invasive procedure done by threading a catheter usually through a groin artery to grab the clot and pull it out of the brain vessel. They also can administer IV medication that breaks up the clot. The sooner the therapies are provided, the more likely they are to work, so getting a fast diagnosis is essential.

Another type of stroke, known as hemorrhagic stroke, is less common and occurs when a blood vessel breaks and bleeds into the brain. The accumulating blood puts pressure on brain tissue, which damages it. Prompt treatment is also necessary to stop the bleeding or decrease pressure in the brain. Because of Viz.ai's enhanced imaging and communications, patients have even greater potential for a more promising, positive outcome.

"A positive outcome is usually an improvement in whatever deficit they had," Dr. Jensen points out. "So, if they were having trouble speaking, they can go back to speaking normally. If they are weak on one side, then they can go back to having strength on that side.

Diagnosing a stroke When ambulance crews suspect someone is suffering stroke symptoms, they begin to communicate with the emergency department, which issues an alert to those involved in diagnosing and treating stroke patients, whether they are on or off-site.

The neurologist must then determine if the patient is, in fact, suffering a stroke, and if so, if the stroke is due to a blockage or bleeding within the brain. If the stroke is due to a blockage, a neurointerventionalist must assess whether the blot clot can be removed.

Finally, doctors must determine if removing the blood clot would benefit the patient. If a large amount of brain tissue has already died in the area of the blood clot, pulling it out could do more harm than good, Dr.Grunsfeld notes.

All these assessments rely on a physical examination of the patient and highly detailed CT images of the brain. The images provide physicians with information about brain health, the presence or absence of bleeding in or around the brain and the status of blood flow to and from the brain.

How Viz.ai technology speeds up treatment

Viz.ai processes the raw data from the CT and packages it into a format that allows neurologists, neurointerventionalists and neurosurgeons to visualize and interpret the images more accurately and rapidly. Viz ai also uses artificial

intelligence to examine the CT scans and quickly alert the doctors if it detects blood clots or brain bleeds.

Another significant benefit of the app is that it gives neurologists and neurointerventionalists the ability to see the images and data on a phone screen.

"This allows us to immediately and conveniently look at the images on our phones because sometimes we aren't sitting in front of a computer screen," Dr. Grunsfeld says. "If I'm home, and the stroke happens in the middle of the night, I can see these images right away just by picking up my phone, saving precious time."

Swift, organized communications

The other aspect of Viz.ai that's a game-changer is how the secure platform efficiently allows all stroke team members to communicate in one messaging system.

Since Sentara Healthcare operates 12 hospitals and five free-standing emergency departments in two states, the streamlined communications link a core team of neurologists, radiologists, neurointerventionalists, neurosurgeons and other patient care team members, whether they are on-site or off-site.

"Every hospital in the system has access to Viz.ai, so it allows teams to work across the system together, making it an even more powerful tool," Dr. Grunsfeld adds