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29 Nov 2016

Thousands could benefit from greater use of revolutionary stroke treatment

Mechanical thrombectomy is a more effective treatment than clot-busting drugs alone for acute stroke caused by blockage of a large blood vessel by a clot.

Almost 10,000 UK stroke patients a year could benefit from a new procedure, according to research presented at the UK Stroke Forum Conference in Liverpool.

Thousands of people who are admitted to hospital following a stroke each year are eligible for mechanical clot removal, which can substantially reduce disability if carried out within 6 hours of the onset of symptoms. However, only a tiny minority currently receive it.

Mechanical thrombectomy is a more effective treatment than clot-busting drugs alone for acute stroke caused by blockage of a large blood vessel by a clot. It involves a specialist inserting a catheter into the arm or leg and removing the clot from the blood vessel to the brain using a mesh (stent) or suction.

The new research findings presented at the UK Stroke Forum in Liverpool show that as many as one in ten stroke patients admitted to hospital –8,770-9,750 patients each year – could benefit from this revolutionary treatment. Currently very few UK hospitals have enough specialists and the necessary support teams to be able to provide mechanical thrombectomy 24 hours a day.

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

Prof Phil White, Professor of Neuroradiology at Newcastle University and Consultant at Newcastle upon Tyne Hospitals, said: “Mechanical thrombectomy is a highly effective treatment for acute ischaemic stroke, with eight 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 and a researcher with NIHR PenCLAHRC, said: “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.”

Prof Gary Ford CBE, Chief Executive of Oxford AHSN and Consultant Stroke Physician at Oxford University Hospitals NHS Foundation Trust, said: “AHSNs have a key role in ensuring the uptake of medical innovation that improves patient outcomes. In order to accelerate UK stroke patients’ access to life-changing innovation, a first step is to have a clear understanding of the number of people who could benefit from mechanical thrombectomy every year. Our research presented today provides that information.”

Prof Stuart Logan, Director NIHR PenCLAHRC said: “I am delighted about the results of this study and the CLAHRC’s continued involvement in research around treatments for patients who have suffered a stroke. We hope that this will lead to further collaborative work within this group and ultimately improved outcomes and experiences for patients.”

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