Emergency surgery saves Andy from deadly type of stroke

About nine out of 10 people do not survive this type of stroke — called a basilar artery stroke — and even some who survive lose much of their quality of life. It's nothing short of miraculous that Andy, 74, not only survived, but thanks to an incredibly fast response from his wife Kathy, the Cross Plains Area EMS team and the UW Health stroke team, Andy went home from the hospital three days after the stroke. Seeing him today, you would have no idea how close he came to a very different outcome.

Kathy vividly recalls the moment it all began.

“We were sitting in the house after lunch when suddenly, Andy’s arms began flailing,” Kathy said. “I yelled, ‘What’s wrong? What’s wrong?’”

Andy couldn’t speak. He remembers a loud buzzing sound and his head felt like it was spinning. His arms were flailing uncontrollably and his speech was incomprehensible.

Kathy immediately suspected that her husband was having a stroke and called 911. It was less than five minutes before the Cross Plains EMS responders pulled into the driveway. Carefully fastening Andy to a stretcher, the team secured him in the ambulance. Kathy hopped in for the 13-mile ride to University Hospital in Madison.

“While it is not our job to diagnose,” says Cross Plains emergency medical technician Jeff Farrell, “lost time is lost brain tissue if stroke is a possibility. Our crew moved quickly but safely to get Andy to acute care.”

With sirens blaring as the ambulance sped eastward along Highway 14, Kathy says “it was like God parted the waters” as cars pulled over to let the ambulance through traffic.

Because it was around 5 p.m. when the hospital was notified that Andy was on the way, the UW Health stroke team, which gets called in from home during nighttime emergencies, was still at the hospital. Everyone knew their job as soon as Andy arrived in the ambulance.

Surgical clot removal was Andy’s only chance

Although some stroke patients are treated with intravenous clot-busting drugs, Andy was ineligible because he takes blood-thinning medication for an abnormal heart rhythm condition — atrial fibrillation — that significantly increases stroke risk. That left him one option: an advanced surgical procedure in which a highly trained doctor “fishes out” the clot through use of micro-thin catheters. With this procedure, no open surgery is needed.

Dr. Beverly Aagaard Kienitz, a UW Health neuroendovascular surgeon, was on duty when the stroke team was notified. Accordingly, she assembled her team consisting of a neuroendovascular surgery fellow, an anesthesiologist, an anesthesiology assistant, an interventional technologist and a nurse.

“Less than one of every 100 stroke patients we see comes to us with a basilar artery stroke like Andy’s,” she said. “The brain stem, where his clot was found, is the highest-priced real estate in the brain. It controls breathing, body movement and almost everything we associate with quality of life. Fortunately, his wife Kathy was home and called 911 right away, followed by the incredible response from the Cross Plains Area EMS team.”

Minutes after arriving at the Emergency Department, Andy was taken straight to the operating room, where Dr. Aagaard Kienitz began the life-saving procedure, known as mechanical thrombectomy. Similar to a cardiac catheterization, the surgeon goes in through the femoral artery in the groin, guiding a small catheter and instruments through the arteries until reaching the clot. Carefully using a suction-powered syringe, Dr. Aagaard Kienitz used guided imaging to remove the clot with a small stent-like device through the catheter.

Anxiously waiting for news, Kathy was overwhelmed with joy after Dr. Aagaard Kienitz came to find her that evening.

“We got it all,” Dr. Aagaard Kienitz told Kathy. “But,” she cautiously added, “we have to see how he does overnight. The formerly clogged artery was now 100 percent open and blood was flowing beautifully, but we’ll be watching for bleeding in the brain, which could indicate another clot.”

An anxious night before a beautiful morning

Kathy went home but spent most of the night awake, praying for Andy’s survival and the medical professionals caring for him. When the phone rang the next morning and she saw “UW Hospital” on her caller ID, she nervously answered. It was Andy, and Kathy could hardly believe her ears when her husband spoke.

“It’s me!” Andy said without any slur in his voice. “I’m OK. They just gave me a menu and I’m going to order breakfast.”

Just two days later, Andy felt well enough to come home. Today, he is doing great, having recently enjoyed a long-anticipated spring fishing trip to Canada with his son and two friends. He has also resumed the sport of curling, walking the dog, and eagerly looks forward to his 48th consecutive year as a University of Wisconsin Men’s Basketball season ticket holder.

“It’s a miracle that I came through this with no residual effects,” Andy said. “It’s because of Kathy, the EMS team, the Emergency Department, Dr. Aagaard Kienitz and her team, and God’s guidance. There are no words to fully express my appreciation.”

Kathy, too, knows how lucky she is to have her husband not only alive but back to normal.

“Had anything been different the day this happened, the outcome would have been different,” she says.