Stroke patients can now have the blood clot in their brain removed if they make it to hospital in time – and in some cases walk off paralysis-free.

The clot retrieval treatment is finally possible in Malta through a new tool which is now available at Mater Dei Hospital.

The size of the island is an advantage, allowing victims of acute stroke enough time to reach the hospital – one condition for successful retrieval of the clot from the brain is to reach the operating table within six hours.

Neuroradiologist Reuben Grech is in fact appealing to those struck by a stroke to skip the GP and head straight to Mater Dei.

People should act fast and head to emergency if they see any of the stroke symptoms

“People don’t mind heading to emergency if they hurt their thumb, but unfortunately some people even sleep off a stroke. People should act fast and head to emergency if they see any of the stroke symptoms.”

The young radiologist accesses the clot through the femoral artery and then uses the Stentriever tool to pull it out of the sedated patient.

“Most patients regain functions immediately within the first few hours or couple of days. There have been patients who actually walk off the operating table.”

Dr Grech is one of a group of young radiologists who have completed their training in different sub-specialties and are offering new services at Mater Dei Hospital.

Some of these services used only to be offered abroad, such as cardiac MRI, when about five patients used to be sent to Monza, Italy, every month.

Other patients who may have been unfit to travel would have had to skip the scan altogether and undergo intervention without proper diagnostic information.

Cardiac radiologist Luise Reichmuth points at MRI footage of a pumping heart on the screen behind her, which is now available at the hospital through new €60,000 software.

This new procedure does away with CT scan radiation and makes diagnosis even more accurate.

It is also much less invasive than an angiogram, which usually requires the insertion of a needle into the femoral artery through the groin.

It allows the radiologists to see the heart from different angles and virtually dissect the organ, providing information about the cardiac muscles.

“This way, we can see how the heart is functioning – whether the valve is closing properly, or if there is any backflow, for example. It is ideal for those born with heart malformations and other issues that need regular check-ups,” Dr Reichmuth noted.

Most patients regain functions immediately within the first few hours or couple of days

When the team of radiologists spoke to this newspaper last year, they were trying to get the funds for a new machine that would mean less need for invasive procedures. The €130,000 contrast ultrasound machine has now been delivered to Mater Dei. One of this machine’s functions is to scan livers to see how elastic the organ is.

Kelvin Cortis, a hepatobiliary radiologist, explains that there is a risk of the liver getting stiffer in people who have liver disease caused by chronic alcohol intake, or who have Hepatitis B or C.

Through this ultrasound, such diseases can be diagnosed early without the need of a biopsy (taking a sample of the liver to study it more closely).

With the same machine, Dr Cortis can also diagnose lesions through a special type of contrast now available at Mater Dei, which is made up of bubbles that are one-third the size of a red blood cell, that is injected in veins – doing away with MRIs and CT scans.

These innovative interventions are not limited to radiology.

Cardiologist Alex Borg also uses this new contrast to diagnose narrowing in the coronary artery through a stress echo that does away with invasive angiography, nuclear scans and radiation.

The procedure is done through a plain ultrasound scanning of the heart before, during and after stressing the organ through cycling and treadmill exercising for example.

The method can allow Dr Borg and others to immediately understand why the patient is suffering from chest pain.

A blood clot on the brain.

When stroke strikes, skip the GP and act Fast*

Face: Has the face fallen on one side? Can they smile?
Arms: Can they raise both arms and keep them there?
Speech: Is their speech slurred?
Time: Call emergency if you see any single one of these signs.

*From the NHS’ Act Fast campaign