NHS England To Commission Mechanical Thrombectomy For Stroke Treatment
The National Health Service (NHS) in England will soon be commissioning mechanical thrombectomy services at 24 neuro centers around the country, which is expected to expand access to over 8,000 NHS patients in the coming years. According to researchers, this “game-changing” technology can open up blocked blood vessels 80-90 percent of the time, compared with the 30 percent rate offered by pharmaceutical intervention alone.
Mechanical thrombectomy is a minimally invasive procedure wherein an interventional neuroradiologist inserts a catheter, usually beginning at the groin, guides it through the patient’s arteries to where a blood clot is blocking blood flow, and then uses a stent to retrieve the clot. If the treatment is applied within 6 hours of symptom onset, research has shown that the chances of survival and quality of life recovery are significantly improved.
Currently, only one neurocenter in the UK is equipped with specialists capable of offering round-the-clock acute stroke intervention using this procedure. Jeremy Madigan, consultant diagnostic and interventional neuroradiologist at St. George’s University Hospital, said that patients with acute stroke require a range of possible interventions, and expanding access to mechanical thrombectomy “radically improves” options available to NHS clinicians.
NHS is currently evaluating 24 neurocenters across the country, assessing what additional staffing and equipment will be required before they are capable of offering this advanced service. Though an initial investment is necessary, NHS Chief Executive Simon Stevens believes the long-term cost-savings will drive value for taxpayers and NHS patients.
France and Germany already perform between 3,500 and 7,500 of these procedures per year, but despite capabilities in the U.K., only an estimated 600 patients benefit from the treatment annually, reported The Guardian.
“This major national upgrade to stroke services puts the NHS at the leading edge of stroke care internationally,” said Stevens. “It’s another practical example of the NHS quietly expanding innovative modern care that will really benefit patients, but which tends to be invisible in the public debate about the NHS.”
Upgrading acute stroke care is one of the measures included in the NHS’s “Five Year Forward” plan, which aims to drive modernization, but Juliet Bouverie, chief executive of Stroke Association, warned that instituting the “game changing” treatment country wide, and increasing the number of professionals trained in the “complicated procedure,” will take time.
In the U.S., ischemic strokes represent 87 percent of the 795,000 strokes experienced by Americans each year and are a leading cause of long-term disability, according to the Centers for Disease Control and Prevention (CDC). Strokes and their related disabilities cost the U.S. healthcare system and economy approximately $34 billion each year.
Related, the FDA recently expanded indications for Stryker’s clot-retrieving technology, Trevo, to be used alongside clot-dissolving medication. The FDA considered as part of its decision clinical data that showed the combined therapies further reduced the risk of life-long disabilities caused by ischemic stroke.