NHS England has announced its intention to expand the use of a new treatment for stroke victims. The treatment, known as a ‘mechanical thrombectomy’ involves the mechanical removal of a blood clot in the stroke patient’s brain.
Currently, strokes involving a blood clot in the brain (known as ischaemic strokes) are often treated using clot-busting (or thrombolytic) drugs. The new treatment, which would be performed by an interventional neuroradiologist, would be offered to patients who have not responded to the clot-bursting drugs.
During a mechanical thrombectomy, a doctor inserts a thin tube into an artery (usually in the patient’s groin) and then feeds the tube up through the body to the brain. A stent (basically a wire mesh tube) is then wrapped around the clot. When the wire is retracted, the clot is pulled out.
The procedure is intended to restore normal blood flow to the stroke victim’s brain. If successful, it greatly reduces damage to brain tissue which is the cause of the long-term impairment to the physical and mental functions of the stroke victim.
St George’s Hospital in London is currently the only UK hospital that offers thrombectomies on a 24/7 basis. The outcomes from St George’s show that the mechanical thrombectomy gives an 80/90% chance of opening up blocked vessels compared with a 30% chance with clot-busting drugs. An article in The Guardian said that stroke experts consider the procedure ‘can produce remarkable results, with patients who would otherwise have ended up in a wheelchair instead able to walk out of hospital within 48 hours…’
The plan is to make mechanical thrombectomy widely available in England. NHS England’s chief executive Simon Stevens said that ‘this major national upgrade to stroke services puts the NHS at the leading edge of stroke care internationally’. Juliet Bouvierie, chief executive of the Stroke Association, believes that ‘thrombectomy is a real gamechanger which can save lives and reduce the chances of someone being severely disabled after a stroke’.
Camilla Wonnacott, associate in the clinical negligence team at Penningtons Manches and a specialist in cardiology claims, said: “We welcome the plans to roll out this treatment across the UK. It is set to benefit thousands of stroke patients, increasing recovery chances and giving patients a greater opportunity to take control of their lives through living independently in their own homes.
“Nevertheless, stenting procedures require considerable skill; the training doctors receive will need to be rigorous and comprehensive. Our cardiology team already deals with claims for injury to patients following the use of stents, usually, but not exclusively, involving the practice of interventional cardiologists. These claims can be complex and require specialist support.”