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Early after stroke, emergency mechanical thrombectomy can dramatically increase the chance of a full recovery. Patients, with extensive thrombus, are less likely to respond to conventional intravenous thrombolysis and more likely to experience severe disability. An estimated 800 patients per year are eligible for this intervention which has been the recommended treatment for large vessel occlusion since 2017. Four years on, less than 10% of those who might benefit undergo such a procedure.
THE AIM
Led by Dr Helen Routledge, with the aim to enable 24/7 nationwide equitable access to this highly effective intervention for stroke. This is unlikely to occur soon, or be sustainable, if delivered only by neurointerventional radiologists in the UK. The aim of this focus group is to examine in detail how interventional cardiologists in the UK may contribute to patient care.
THE REMIT OF THE INITIATIVE
To clarify the case for need and come up with proposals for making progress, in collaboration with Radiology and the national clinical teams. Appropriate training and accreditation for interventional cardiologists needs to be agreed upon and access to this training obtained.
PROGRESS
The preliminary activity and a paper written according to the above remit, were presented to BCIS Council in January 2021. The paper and the case for change was presented to the NHSE Thrombectomy Implementation Group and National clinical directors in April 2021. There is steady progress at national meetings move toward acceptance of additional non NIR workforce to bolster the rotas such that all patients UK wide can access this treatment. The solution to the workforce issue will be different in each region and interested cardiologists are encouraged to open up friendly conversation with their local stroke teams and NIRs.
PAPER
Can Interventional Cardiologists Help Deliver the UK Mechanical Thrombectomy Interventional Programme for Patients with Acute Ischaemic Stroke?
A Discussion Paper from the British Cardiovascular Interventional Society (BCIS) Stroke Thrombectomy Focus Group
Attached is a link below to a short video made by colleagues in Royal Stoke University Hospital and their patient charity to promote the importance of ensuring national access to 24/7 mechanical thrombectomy.
We would like to encourage you to watch the film and consider in the context of performance of local services in ensuring rapid diagnosis, referral and access to treatment.
National data shows that there are many more people in England who could benefit from this treatment but unfortunately do not – with lifelong personal and health care impact as demonstrated by the film.
With thanks to the team at Stoke for sharing the video for wider circulation.
Recordings are now available from previous webinars here
The draft guidance Mechanical Thrombectomy delivery in England is now available on the FutureNHS collaboration drive.