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Stroke patients 'miss out on clot removal'

WebMD UK Health News
Medically Reviewed by Dr Keith David Barnard
brain illustration stroke

29th November 2016 – Thousands of stroke patients in the UK are missing out on a treatment that can substantially reduce their risk of disability, say researchers.

Strokes can kill and can also lead to debilitating disabilities that affect the patient and their family alike.

In the UK, almost 90,000 people are admitted to hospital each year after having a stroke, and many of the survivors will be left severely disabled.

Blood clots

A stroke happens when the blood supply to a part of the brain is cut off. In many cases this happens because a blood clot has formed in an artery. This is called an ischaemic stroke, and about 80% of strokes are of this type, as opposed to the less common haemorrhagic stroke, where the cause is bleeding into the brain.

In ischaemic stroke, where a blood clot is responsible, some people are given clot-busting drugs to clear the blockage. However, thousands would benefit from a procedure involving mechanical clot removal, which experts say can minimise oxygen starvation to the brain and reduce disability if carried out within 6 hours.

The treatment is called mechanical thrombectomy – or clot retrieval. The technique amounts to carefully 'fishing' for the problem clot with a tiny guided net. A catheter is inserted into the patient's arm or leg and a furled mesh is guided to the affected area of the blood vessel. The mesh, or stent, is then unfurled and the clot caught and removed.

Shortage of specialists

The technique is highly skilled and the latest research being presented to the UK Stroke Forum in Liverpool suggests that very few UK hospitals have enough specialists and support staff to provide the service round-the-clock.

The findings show that as many as 1 in 10 stroke patients admitted to hospital – between 8,770 and 9,750 each year – could benefit from this treatment.

The study was carried out by researchers from Newcastle University, Northumbria University, Oxford Academic Health Science Network and the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care - South West Peninsula.

Phil White, professor of neuroradiology at Newcastle University and Consultant at Newcastle upon Tyne Hospitals, says in a statement: "Mechanical thrombectomy is a highly effective treatment for acute ischaemic stroke, with 8 clinical trials showing a significant reduction in disability after stroke if it is used immediately in the right patients.

"The challenge is to make this technique more widely available, as current figures suggest that fewer than 600 patients receive this treatment each year in the UK."

Dr Martin James, consultant stroke physician at the Royal Devon and Exeter Hospital, adds in a statement: "Delivering mechanical thrombectomy to the 9,000 people who need it will require major changes to the configuration and skill sets of existing acute stroke services.

"We must work quickly to establish what needs to be done so that more people in the UK can benefit from a treatment which can dramatically reduce disability after a stroke as well as cutting associated costs to the NHS and social care."

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