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A better fix for brain bleeds

UCI Health first in nation to use new device for clot removal

March 26, 2021 | UCI Health
Retired university president Horace Mitchell, PhD, is back on the tennis court after treatment for a brain bleed at UCI Health, the first in the national to use a new device to remove clots.i

Horace Mitchell is back in the swing of things after treatment to remove blood clots from his brain. Photo by Michael Neveux for UCI Health

Retired university president Horace Mitchell, 76, was storing Christmas decorations when he fell off a ladder. While pulling on a heavy box, he tipped backward and hit his head on a refrigerator in the garage of his Huntington Beach home.

The accident resulted in a subdural hematoma — a blood clot under the outermost layer of the brain that grows and puts pressure on the brain. These injuries can lead to headaches, weakness, seizures and slurring of speech.

When Mitchell began showing symptoms, his wife, Barbara, a retired educator and nurse, insisted that he seek care at UCI Medical Center, where he underwent an innovative surgical procedure with a promising new device called the IRRAflow® catheter to treat the clot in a more effective manner.

“We make an incision, as usual, to drain as much blood as we can,” says Dr. Sumeet Vadera, a UCI Health neurosurgeon who was the first in the nation to begin using the system for treating intracranial bleeds.

“Rather than just draining the blood, IRRAflow has a pump that gives it an irrigating component. You can actually see the blood getting washed out, which continues another day or so after the procedure.”

Shorter stay, reduced recurrence

The result, Vadera says, is a significantly reduced risk of a clot recurring and a shortened hospital stay of only a day and a half instead of six days with traditional hematoma removal. The team had used the IRRAflow catheter on just seven patients before Mitchell.

After his fall in December 2019, the president emeritus of California State University, Bakersfield, initially seemed OK. About a week later, he began feeling listless and fatigued and had trouble keeping his balance while walking. He didn’t really connect these symptoms with hitting his head.

His wife took him to UCI Medical Center’s emergency department, where he was diagnosed with a possible infection of the lining covering the brain and spinal cord. He was given antibiotics, spent a few days in the hospital and went home.

When he started feeling tired and weak again in March 2020, they returned to the medical center. He began having a seizure while waiting to be seen. That’s when doctors found the subdural hematoma.

Hematomas common with aging

“They usually result from trauma and can happen even from a mild bump to the head,” Vadera says. “Subdural hematomas are one of the most common medical issues for older people. People can experience them even without trauma because as we age, the brain shrinks, which can cause the veins attached to the outer layer to bleed."

For Mitchell, having the procedure at the medical center was a reassuring experience from the outset, given his earlier tenure as a leader at UCI's medical school.

“First, before agreeing to the IRRAflow surgery, my wife used her nursing background to do some research on Dr. Vadera, which came back with very positive results,” he says.

“Having spent four years in the 1980s as associate dean of the medical school, my experience with the doctors at the medical center gave me confidence in them. Dr. Vadera was really excellent and very patient, explaining everything he did."

After the surgery, Mitchell felt more alert right away and had no pain, even when Vadera removed staples from his head. He did have some dizziness for a couple of days, as expected. Walking normally took weeks of therapy. Now he says he’s “back to normal.”

Practicing his swing

Mitchell completed courses and renewed his psychologist’s license in October. He’s writing a book on leadership and management in higher education and is active in academic executive organizations. He also takes regular walks and is practicing his swing to begin playing tennis again with friends.

Vadera is pleased with his patient's progress and gratified by the hospital’s commitment to trying out the IRRAflow catheter.

When IRRAS, a San Diego-based company, showed the device to the UCI Health neurosurgery team in 2019, Vadera was intrigued and began testing it. He and his team performed the first procedures on patients in 2019. Now it is being used in several hospitals across the country, although no others in California.

“We thought their presentation made a lot of sense, so we got it into the hospital quickly,” Vadera says. “It has really improved patient care and is the future technology for subdural hematomas.”

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