Stroke Thrombectomy

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 MEMBERSHIP

The individuals participating in this focus group include 6 UK interventional cardiologists who have been involved in either the procedure, training issues or the discussions to date (including the Chairman of the ESC Council on Stroke) as well as a key neurointerventional colleague and a stroke clinical lead.

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 FOCUS GROUP

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

Paper as presented to council available here. 

Published version (updated) will be available soon.

REGISTER

A register was launched via this website at ACI where cardiologists can log their interest and intention to seek training so that opportunities are clear to see for all stakeholders. Fill in the form below to register your interest.

Mechanical thrombectomy in England: communities of practice, improving access and quality  

Recordings are now available from recent webinars here

The draft guidance  Mechanical Thrombectomy delivery in England  is now available on the FutureNHS collaboration drive.

GROUP MEMBERS