‘I was so lucky to have been treated with this life-saving procedure’
A procedure called a thrombectomy reduces the severity of disability caused by stroke and, in some cases, saves lives. Here, the Stroke Association calls for the innovative treatment to be made available across Wales...
It has been described as a “game-changing” treatment which has the potential to save the lives of stroke patients. But campaigners in Wales have voiced concerns about the pioneering thrombectomy treatment which is still not routinely available in Wales.
The procedure involves inserting a catheter into an artery to access a clot in the brain which is then mechanically removed.
It is able to remove clots which are too big to be broken down by clot-busting drugs and is effective in preventing and reducing long-term disability in people with severe strokes.
Experts believe the procedure can offer an 80-90% chance of opening up blocked blood vessels compared to a 30% chance with clotbusting drugs.
Carol Bott, director of the Stroke Association in Wales, says the thrombectomy treatment has the potential to save lives if fully introduced in Wales.
“This is an exciting time to be working in stroke with some real advances in treatment including thrombectomy,” she said.
“This game-changing treatment reduces the severity of the disability caused by stroke and, in some cases, saves lives.
“Although only a relatively small number of patients (around one in 10) is eligible for this treatment, for those that are it’s a powerful intervention.”
Ms Bott said the “very intricate” procedure requires the most skilled of professionals.
She added: “It’s expensive – costing around £9,000-£12,000 per patient – but without this treatment option, stroke patients are more likely to be dependent on others for their daily needs, requiring lifetime care.
“Research shows that over 10 years, the net
monetary benefit of thrombectomy is up to £100,000 per person.
“In other words, you get a lot of extra quality of life for a relatively small amount of investment. This obviously saves money longterm in health, care and welfare costs further down the line.”
In 2016, the National Institute for Health and Care Excellence (NICE) updated its stroke treatment guidance to include mechanical clot retrieval.
It is also recommended by the Royal College of Physicians. However, the treatment still isn’t available routinely in Wales.
Ms Bott added: “There aren’t enough trained medical staff to currently provide this service 24 hours a day, seven days a week, in all areas.
“So you may be lucky and have a stroke when an interventional neuroradiologist is on shift. But you might not.
“We want all eligible patients to be able to access this game-changing treatment whenever stroke strikes.
“For this to happen we need more speciallytrained professionals and well-organised acute stroke services, able to deal with the requirements of a highly specialised service such as thrombectomy.”
She said the NHS in Wales is working to improve the availability of thrombectomy in Wales, but progress is slow.
“We simply cannot afford to delay a process that could save lives,” she added.
“We will continue to work with those in government and across the stroke community, to tackle this, one of the biggest health challenges of our time. The Welsh Government’s Stroke Delivery Plan 2017-2020 is vital to achieving this and we’ll be working with government to ensure stroke remains a priority in Wales after 2020 and beyond.”
Antonio Niro, from Cardiff, counts himself as extremely lucky after receiving a thrombectomy following a stroke at the age of 43.
“I was fit and healthy and hadn’t had any symptoms until I woke up one morning feeling dizzy,” he said.
“I live alone and was able to dial 999 before losing consciousness. Three days later, I woke up in the hospital and was told I’d had a major stroke and they’d done a thrombectomy to remove a clot.
“It was a shock as I hadn’t had any symptoms. But to look at me now, you would never know I’d had a stroke. I do have a bit of weakness on my right side, but it’s nothing too bad.
“I visited a stroke group and had the opportunity to meet other young stroke survivors, who sadly had not been as fortunate as me, and listen to their stories.
“One young man told me that one day, he was playing cricket – the next he was in a wheelchair.
“I was so shocked to see the damage stroke is capable of so quickly. I was so lucky to have been treated with this new and lifesaving procedure so fast.
“Everyone who needs a thrombectomy should be able to have one.”
According to the latest figures, around 7,400 people will have a stroke in Wales each year.
A stroke happens in the brain, the control centre for who we are and what we can do. The condition is the fourth biggest killer in the UK and the largest cause of adult disability.
Last month, First Minister Mark Drakeford said: “The Welsh Health Specialised Services Committee are well advanced in planning a Wales-wide service for thrombectomy here in Wales. It will require recruitment. It will require training. In the meantime, we are commissioning services from across our border where scarce spare capacity exists.
“But the answer, not in the long-term but as soon as we can do it, is to create an all-Wales service with the people we will need and with the coverage that will be required.”