Using AI to quickly assess stroke

Artificial intelligence (AI) is evolving rapidly every day, and its use cases are becoming more widespread, including in the health care sector.

One of these applications is in the detection of stroke.

When Deanna Livingston arrived at MultiCare Tacoma General Hospital this past January with stroke symptoms, AI was already coordinating her care behind the scenes.

The 50-year-old from Puyallup had just finished a morning workout at her gym. As she got in the car, she dropped her bag — but instead of picking it up, she grabbed her left finger instead. She says it felt rubbery, but since it was cold outside, she thought it had gone numb.

She turned the car on and started driving, but she continued to have trouble with her left side.

“My left hand wouldn’t work, and I couldn’t put on the blinker,” recalls Livingston. “The next thing I know, I’m waking up to someone saying, ‘She’s having a stroke, she’s having a stroke!’”

Livingston hit two cars and a curb while she was passed out. The impact caused her head to hit the steering wheel, which woke her up.

“I could move my right hand, but my left arm wasn’t working, the left side of my face was droopy and my words weren’t coming out correctly,” she says. “Thankfully, the fire department was on the scene so fast and got me to the hospital immediately.”

With stroke, ‘time is brain’

Using Viz.ai, an artificial intelligence app that helps assess the severity of a stroke patient’s condition, staff at Tacoma General’s emergency department went into action when Livingston arrived.

“Viz.ai allows us to quickly and accurately detect stroke patients who might benefit from emergent stroke intervention,” says MultiCare interventional neuroradiologist Dennis Wang, MD. “Within a few minutes, the app communicates those results to the correct providers, allows them to review the relevant information and calls in the stroke team.”

This substantially decreases the amount of time it takes to get patients the care they need.

And with stroke, time is brain. That means every minute that passes matters. The longer medical care is delayed after experiencing stroke symptoms, the more permanent damage is done to brain tissue.

“When the ER calls me and I call back, I usually wait on hold for a minute or two before I can speak to the ER provider,” says Dr. Wang. “In those one to two minutes, I can open the Viz.ai app, look to see if there’s an LVO (large vessel occlusion stroke) detected, review the images and come to a decision regarding intervention — all before the ER provider gets to the phone.”

“They had everything ready for the procedure. The clot was sucked out so fast — it only took about three minutes — that there was barely any damage to my brain from the stroke.”

Livingston had an ischemic stroke, which was caused by a clot blocking a vessel that supplies blood to the brain. When her husband Wayne arrived at the hospital, he was asked if a clot-busting medication should be administered or if a procedure to remove the clot, a thrombectomy, should be performed.

“He asked Dr. Wang about pros and cons and decided on the thrombectomy,” she says. “They had everything ready for the procedure. The clot was sucked out so fast — it only took about three minutes — that there was barely any damage to my brain from the stroke.”

Livingston with husband Wayne

To check to see if her symptoms resolved after the procedure, she was asked to move her fingers, lift up her arms and legs, and talk.

“Dr. Wang had seen me before the procedure,” she says. “So when I was able to move my left hand and leg and my face wasn’t droopy afterward, he was amazed.”

In addition to her physical symptoms resolving, her bloodwork, EKG, MRI and CT scan all came back normal.

“I am incredibly happy we were able to help one of our seriously ill stroke patients make a full recovery and return home,” Dr. Wang says. “This outcome underscores the critical importance of rapid assessment and treatment in the management of acute stroke, and highlights our team’s expertise and commitment to providing the highest level of stroke care.”

Coordinating care behind the scenes

Although patients like Livingston aren’t aware of how care is being coordinated in the background, she recognized that her team was on the same page.

“Every time I switched rooms or talked to a different provider, everyone knew what was going on,” she recalls.

Livingston says she’s grateful for the quick care she received.

“It’s bizarre this happened. I have great blood work, I eat healthy, I work out all the time,” she explains. “We don’t actually know why it happened, but if it weren’t for the fast-acting paramedics and the staff at Tacoma General, I wouldn’t be in as good of shape as I am after having a stroke.”

Dr. Wang and Brian Kott, MD, Tacoma General stroke program director, agree Viz.ai has a beneficial impact on stroke patients at MultiCare.

“Having a platform like Viz.ai has been transformational for acute interventional stroke care,” says Dr. Kott. “Our ability to see real-time imaging gives us an immediate and unprecedented advantage to maximize interventional stroke treatment.”