National guidelines say that clot busting medications must be administered less than three hours after a stroke in order to be effective. In this case, the speed of medication delivery “was remarkable,” Dr. Zack said.

“But there was a problem,” Dr. Zach said. “While the standard of care was met, I could see that this wasn’t going to be enough to save Ms. Jones.”

A CT of Jones’ brain revealed density in the middle cerebral artery and that her carotid artery was still completely closed. “This is an ominous sign that indicates the clot busting medication may not work well.”

So Dr. Zach reached out for more help, paging an interventional radiologist in hopes that one would be in the hospital. Amazingly, David LoPresti, MD, just happened to be in the house.

“Dr. LoPresti arrived in less than five minutes, and together we watched what normally is every vascular neurologist’s and stroke patient’s worst nightmare: We watched the clot busting medication failing to reverse the stroke.”

Although Jones did regain weak control of her leg and was able to understand basic words, she was still mute, unable to move her right arm, and unable to swallow.

“It was at this time that Dr. LoPresti took over,” Dr. Zach said. Jones was transported to the interventional radiology suite where Dr. LoPresti passed a catheter through her femoral artery at the top of her leg all the way up into the clogged carotid artery.

The first images revealed that the tight carotid had been barely reopened by the clot busting drug and that only a trickle of blood flow was getting through.

After a brief conference, the physicians decided to proceed with an intra-arterial injection of the lifesaving clot buster drug, directly through the catheter.

“After only four milligrams of the drug, the patient began to get control of her arm,” Dr. Zach said.  At that point, I contacted my mentors back in New York and was instructed to advance further into the artery and give an additional dose.

“Dr. LoPresti pushed on and skillfully passed a microcatheter through the tight vessel,” Dr. Zach said. “He slowly delivered four more milligrams of the life-saving medicine in the immediate vicinity of the clot. The patient began to speak.”

The team was awestruck and overjoyed.  They had just witnessed a miracle.

Medical protocols required a seven-day wait before Jones could get the surgery that she came to the hospital to receive in the first place. During that time, Dr. Zach monitored Jones’ condition with a special ultrasound procedure to make sure her carotid artery remained open.

A week later, Dr. Brady performed the carotid endarterectomy, removing all the plaque and clotted material in her artery. “She did very well after her surgery and went home with no neuro deficits,” Dr. Brady said.

All the physicians who teamed together to save Jones are incredibly happy about her virtually complete recovery. “Someone was definitely looking over her shoulder,” Dr. Pavelonis marveled. “I’m so glad she’s now doing so well.”

As for Jones, “God put everything in perspective for me,” she said. “I was so blessed to have all of my doctors when I needed them. Life is different now and I am happy. I give all the glory to Jesus Christ, my Lord.”