A 'how-to' guide to help accelerate the spread of ‘game-changing’ mechanical thrombectomy (MT) emergency treatment for acute stroke has been launched by national stroke experts.
The NHS Long Term Plan identifies stroke as a clinical priority; stroke is the leading cause of disability and the fourth largest cause of death in the UK. The plan sets out an aim to deliver a ten-fold increase in thrombectomy so that 1,600 more people are independent following stroke.
There is overwhelming evidence that mechanical blood clot removal (known as mechanical thrombectomy or MT) for the treatment of ischaemic stroke due to large artery occlusion (blockage of one of the major arteries in the brain, causing a severe stroke) is highly effective and could benefit at least one in ten patients admitted to hospital with an acute stroke.
However, implementation of MT across the UK has been limited, with only 1,200 MT procedures in England and Northern Ireland in 2018/19. That represents just 1.4% of all people with acute stroke or one in 71 stroke patients. In Scotland and Wales, there are no services providing this emergency treatment at all.
Now, for the first time, the best available expertise, evidence, analysis and experience relating to MT have been distilled into a single definitive volume.
Mechanical Thrombectomy for Acute Ischaemic Stroke: an Implementation Guide for the UK has been developed by a group of professors including Professor Martin James, a Consultant Stroke Physician at the Royal Devon and Exeter NHS Foundation Trust.
“Mechanical thrombectomy is a classic example of a ‘disruptive innovation’, particularly within the unique circumstances of the UK NHS, where service development has been held back while the research evidence is awaited. Now that evidence is available, such a step-change in treatment for many people with major disabling stroke requires a rapid response from the NHS to deliver and this is sure to involve further centralisation of services for hyperacute stroke.”
This implementation guide builds on the work of PenCLAHRC's operational research team, PenCHORD, who carried out geographical modelling of thrombectomy services in the UK in order to maximise the number of patients able to receive this life-saving treatment.
Juliet Bouverie, Chief Executive of the Stroke Association, said:
"The Stroke Association firmly believes thrombectomy to be a game-changing intervention that could and should act as a catalyst for change and improvement across the whole pathway. I hope this new ‘how-to’ guide will provide the evidence and information the NHS needs to help make thrombectomy a routine option for stroke treatment for the benefit of people affected by stroke across the UK."