New guide for implementation of mechanical thrombectomy

A ‘how-to’ guide to help accelerate the spread of ‘game-changing’ mechanical thrombectomy (MT) emergency treatment for acute stroke has been launched by national stroke experts.

There is overwhelming evidence that MT for the treatment of ischaemic stroke due to large artery occlusion (blockage of one of the major arteries in the brain, causing a severe stroke) is highly effective and could benefit at least one in ten patients admitted to hospital with an acute stroke.

However, implementation of MT across the UK has been limited, with only 1,200 MT procedures in England and Northern Ireland in 2018/19. That represents just 1.4% of all people with acute stroke or one in 71 stroke patients. In Scotland and Wales, there are no services providing this emergency treatment at all.

Now, for the first time, the best available expertise, evidence, analysis and experience relating to MT have been distilled into a single definitive volume.

Mechanical Thrombectomy for Acute Ischaemic Stroke: an Implementation Guide for the UK has been developed by a group of professors including Phil White, a Consultant Neuroradiologist, at The Newcastle Upon Tyne Hospitals NHS Foundation Trust.

He said: “The evidence base for mechanical thrombectomy for anterior circulation stroke is clear and unequivocal, with 11 randomised controlled trials published since December 2015 demonstrating substantial benefits over best medical therapy. The compelling evidence for MT in patients presenting early after stroke has recently been joined by high-quality evidence for benefit in carefully selected, late-presenting patients. What matters now is putting in place the right infrastructure to make sure as many people as possible can benefit from this intervention.”

Juliet Bouverie, Chief Executive of the Stroke Association, said: “The Stroke Association firmly believes thrombectomy to be a game-changing intervention that could and should act as a catalyst for change and improvement across the whole pathway. I hope this new ‘how-to’ guide will provide the evidence and information the NHS needs to help make thrombectomy a routine option for stroke treatment for the benefit of people affected by stroke across the UK.”

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