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Good news for stroke victims as NHS rolls out mechanical thrombectomy

A third more patients are visiting Accident & Emergency after suffering a stroke, analysis of NHS figures has revealed.

Greater awareness is one possible explanation for the rise. A high-profile NHS campaign urging the public to ‘Act FAST’ has brought stroke symptoms to the fore, with A&E admission figures peaking at 126,242 in 2014-15 when the adverts hit our TV screens. Since then numbers have dropped – there were 104,426 visits in 2015-16 – but this still represents a significant increase on 79,373 seven years before.

NHS England has taken note though, and has announced plans to expand provision of mechanical thrombectomy, which until now has only been available to a handful of patients.

Thrombectomies provide a vital safety net if thrombolytic drugs fail to remove a blood clot on a patient’s brain. Using a thin tube, a stent is inserted through an artery, usually via the groin. This is then used to remove the clot, restoring normal blood flow and reducing damage to brain tissue. To be effective, a mechanical thrombectomy must be carried out within six hours of the stroke occurring.

Until now, St George’s Hospital in London has been alone in offering thrombectomies around the clock and only a handful of other centres offer the procedure. In fact, a mere 600 patients a year in England are currently offered them. But by extending the service, we are stepping into line with other Western European countries; Germany undertakes 7,500 thrombectomies a year, while 3,500 patients in France benefit from the procedure. With 24 NHS Trusts now deemed centres of excellence in neuroscience operating 24/7, the number of patients benefiting in England could surge to an estimated 8,000 annually.

Encouragingly, by rolling out mechanical thrombectomy the NHS has recognised that it delivers enormous savings in medical and social care. The Stroke Association agrees. Its chief executive Juliet Bouverie said the decision “could give thousands of critically ill stroke patients an increased chance of making a better recovery”, and that more stroke survivors could be “living independently in their own homes, returning to work and taking control of their lives again as a result”.

24-year-old Joe Wennell is testimony to the benefits of mechanical thrombectomy. Speaking at the House of Commons as part of events to mark the MTG’s Medical Technology Awareness Week last year, he explained how he’d been suddenly struck down with an ischemic stroke in June 2016. Thankfully, a clinical team at Queen’s Hospital in Romford, headed by an Interventional Neuroradiologist was on hand to perform the procedure using a Solitaire stent retriever, restoring the normal blood flow to his brain and enabling him to make a promising recovery. He’s now back at work in the City of London and has campaigned for greater access to the treatment.

As one of 150,000 people in the UK to suffer a stroke each year, Joe was one of the lucky ones. This latest NHS initiative looks set to benefit thousands more patients like him, and according to NHS England chief executive Simon Stevens, it will “put the NHS at the leading edge of stroke care internationally”.

Naturally, the MTG is delighted. It’s not just good for patients. It’s testimony to the value of medical technology to the taxpayer and to wider society.

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