An advance emergency treatment which can have exceptional results is to be made available to thousands more stroke victims across England.
Called a “mechanical thrombectomy”, the surgical procedure physically removes a blood clot which has caused a stroke. If performed within the first six hours of stroke symptoms appearing, the procedure has been shown in clinical trials to significantly improve survival and recovery rates, and future quality of life.
By restoring blood flow quickly through physically removing the clot, damage to the brain is limited, allowing patients to recover much more quickly, and in some cases completely, with little or no long-term disability. Having thoroughly assessed the treatment, and the costs of implementing it, NHS England plans to make it available at 24 specialist neuroscience centres across the country.
That will mean an estimated 8,000 stroke patients per year benefiting from the revolutionary treatment once it is fully implemented. However, it will take some time to phase it in, beginning this year, as surgeons at the specialist centres are trained to carry out the procedure.
During a stroke caused by a blood clot, the blood flow to parts of the brain is interrupted, often by the clot blocking or partially blocking a major blood vessel in the head. The longer a part of the brain is deprived of blood, the more likely it is that there will be lasting damage, such as paralysis and speech problems.
More traditional treatments involve the patient taking drugs designed to break up the clot, but this can take longer, during which time the lasting damage is done. In a thrombectomy – also known as “clot retrieval” – a thin metal wire housing a mesh is inserted into a major artery in the leg and guided under X-ray to the site of the clot in the brain. The mesh is then expanded, like a miniature fishing net, to capture and remove the clot, restoring the blood supply.
In November last year the Royal College of Physicians called for the procedure to be made much more widely available after an audit showed only around 600 patients per year in England were receiving it, due to a lack of trained staff and facilities. It pointed out that introducing the emergency treatment could save the NHS millions in the long-term care of stroke patients suffering long-term disabilities.
Announcing the national rollout of the treatment, Simon Stevens, chief executive of NHS England, said: “This major national upgrade to stroke services puts the NHS at the leading edge of stroke care internationally. It’s another practical example of the NHS quietly expanding innovative modern care that will really benefit patients, but which tends to be invisible in the public debate about the NHS.”
Juliet Bouverie, chief executive of the Stroke Association, welcomed the news, saying: “Thrombectomy is a real game changer which can save lives and reduce the chances of someone being severely disabled after a stroke. Stroke is the fourth biggest killer in the UK, and a leading cause of disability. Current treatment options are limited and do not always work.
“This decision by NHS England could give thousands of critically ill stroke patients an increased chance of making a better recovery. It could mean more stroke survivors living independently in their own homes, returning to work and taking control of their lives again as a result. And this will undoubtedly lower NHS and social care costs for stroke.”
• Acting quickly when a stroke hits can save lives and ensure a better chance of recovery. To recognise the symptoms of a stroke or mini-stroke, think ‘FAST’:
- Facial weakness – can the person smile? Has their face dropped at one side?
- Arm weakness – can the person raise both arms and keep them there?
- Speech – Can the person speak clearly? Is their speech slurred?
- Time – if you see any of these signs, it’s time to call 999. Stroke is always a medical emergency which requires immediate attention.
To watch Public Health England’s commercial for its ‘Act FAST’ stroke awareness campaign, click here.