Carlos Jorge was a high-energy 45-year-old executive chef for nearly 20 years when he collapsed in his Kailua home in September 2016.

One Sunday morning he woke up unable to get out of bed after three days of “ripping headaches” that were so intense, the pain made him throw up.

Jorge recalls falling on the floor because his “entire left side was dead.” He began slurring as he tried to speak. His girlfriend, recognizing that he was having a stroke, called 911.

The fine-dining chef was rushed to Adventist Health Castle, where he received clot-busting medication to prevent further damage from his ischemic stroke, triggered by a clot that forms in a major artery supplying blood to the brain.

Within a couple of hours, Dr. Sung Bae Lee at The Queen’s Medical Center was navigating a stent retriever the size of a spaghetti noodle through the artery in his right groin. Jorge felt the pressure in his head as the doctor fished out the blood clot, all while he was awake.

Queen’s is expanding the number of this type of procedure, known as a mechanical throm­bectomy, that it performs. Mechanical thrombectomies are the latest minimally invasive surgical technique used to remove blood clots, with dramatic results in survival rates and quality of life for stroke victims.

“Within 10 minutes of that procedure, I could move my left side. I was blinking, smiling and lifting both my arms at the same time,” Jorge said while preparing to open his own restaurant, HICRAFT Kitchen in Kakaako, at the end of the month. “Without a doubt I don’t feel that I’d be here with the ability to deftly maneuver a knife as my work requires of me had I not had the thrombectomy. Strength-wise I’m at 150 percent. I’m back to normal.”

Using special machines with live X-rays, doctors insert a catheter into the blood vessel and work their way up toward the aorta, the main blood vessel into the heart, up through the neck. A stent retriever is inserted into the catheter to expand the artery walls and pull out the clot.

“Stent retrievers and catheters revolutionized our ability to pull out the clot intact, retrieve it and open up the blood vessel. The success rate has dramatically improved,” Lee said. “Imagine the main tree trunk being blocked that would take nutrients and oxygen and good things to the brain, to be able to open that up as quickly as possible to allow the brain to survive the acute blockage.”

Queen’s, which has more than 1,000 admissions for stroke patients annually, is trying to expand the number of thrombectomies in the islands. Of the 1,000 admissions, about 100 stroke cases qualify for the procedure. But once the hospital improves its technology to be able to more accurately detect eligible patients, Queen’s expects around 200 to 250 patients annually would benefit from the surgery. Statewide, nearly 700 people die on average each year from strokes, the No. 3 killer in Hawaii, according to the American Heart Association.

To qualify, patients would need to have had a sizable ischemic stroke, the obstruction within a blood vessel that accounts for nearly 90 percent of all stroke cases. Patients do not qualify if they have a hemorrhagic stroke, which occurs when a blood vessel ruptures. Parts of the brain must also be salvageable versus completely injured, which is why time is of the essence in stroke cases.

“Typically the biggest challenge … is despite having a stroke, patients may not arrive to a hospital in timely manner. They don’t recognize it to be a stroke, and by the time they end up coming to the hospital, they are outside the treatment window,” Lee said.

While the treatment has been around for years, previously the surgery was offered only to younger patients. As the technology has developed, researchers have found that it could benefit significantly more people.

With newer imaging technology, a particular scan is helping doctors better determine which patients would likely benefit from thrombectomy up to 24 hours after a stroke. Last year the American Heart Association widened the safety window for stroke patients to get the procedure to 24 hours from six hours since onset of the condition.

“It has been a game changer in terms of really being able to help us know which individuals have a complete stroke versus those who have areas that are really salvageable,” Lee said. “It makes a huge difference in our ability to know who would benefit.”