CHATTANOOGA NETWORK FOR STROKE
MISSION STATEMENT AND INTRODUCTION

The Chattanooga Network for Stroke (CNS) is a regional association
of hospitals that has formed a partnership to deliver state-of-the-art therapies for acute stroke. Almost twenty medical centers in five states within a 200–mile radius of Chattanooga are participating members of CNS.

This initiative to promulgate cutting-edge standards of stroke care could not be more timely. The Southeast region of the U.S. is deeply embedded in an epidemiological hot-spot popularly known as
the “Stroke Belt”. This geographical swatch has one of the highest incidence of thrombolytic disease in the country. In the United States as a whole, approximately 700,000 people suffer a new or recurrent stroke each year; one-third die, one-third become disabled, and one-third recover.

There are over 3,000,000 stroke survivors in the United States today. The current cost of stroke is estimated to be over $50 billion per
year. In this era of managed care and cost-containment awareness, advances in stroke management must improve patient outcomes and reduce recurrent stroke in a cost-effective manner.

Shorter hospitalizations; briefer periods of rehabilitation; decreased referrals to nursing homes and more frequent return-to-work by stroke patients, are important priorities. We believe that with advanced medical technology there’s a great potential to meet these goals and still save significant health-care dollars. Current efforts are focused on thromboembolism, the cause of most stroke events. At the moment, treatment of choice is the thrombolytic agent, tissue plasminogen activator (t-PA). With this class of ”clot buster” drugs widely available, for the first time the medical profession has an effective therapy to limit the deleterious effects of an ischemic stroke.

At Chattanooga’s medical facilities, t-PA is administered in two ways.

• Intravenously delivered t-PA must be initiated within 3 hours of the onset of stroke symptoms.
  
  
• Intra-arterial methods offer an alternative form of t-PA intervention. This technique instills the drug directly onto a clot within the brain, opening a wider window for effective treatment. The intra-arterial protocol employs a catheter that’s inserted through the groin, fed up though the descending aorta, into the internal carotid artery, and directly to the source of blockage. While this procedure is not yet FDA sanctioned, it is widely utilized at large academic centers under approved research guidelines. Intra-arterial t-PA is currently anticipated to be the most effective and safest approach to treating acute blood clots in the brain.