Mechanical Thrombectomy at King’s Health Partners
Following National Stroke Awareness Month, Maria Fitzpatrick shares the three things you should know on a new rapid treatment that’s saving lives.
Ischaemic strokes affects many people
In England and Wales, a total of 80,000 people are admitted to hospital each year with an acute stroke. Around 85% of all stroke patients suffer from an ischaemic stroke – caused by a blood vessel to the brain becoming blocked which leads to damaged tissue or death of brain cells.
King’s College Hospital NHS Foundation Trust is one of eight specialist stroke centres across London. In recent years a new treatment has been offered to patients suffering from an acute ischaemic stroke called a Mechanical Thrombectomy. This is a technique which removes a blood clot from the artery through a catheter.
This life-saving action is offered as an emergency treatment for patients who have suffered an acute ischaemic stroke within the last six hours and is an effective treatment that can reduce brain damage and prevent or limit long term disability. Rapid treatment is essential in minimising the patient’s long term affects after stroke as the benefit from mechanical thrombectomy falls by 5.3% for every hour of delay.
2. The treatment involves the whole body
When a patient arrives at the Hyper Acute Stroke Unit (HASU) they will be assessed to see which treatment will best suit their needs and an evaluation of which treatment pathway is required will be decided. Factors such as the medical background of the patient and the amount of time since the stroke occurred will be considered.
If the patient fits the criteria for this treatment, they are taken to have an angiogram – and x-ray with dye that shows the circulation of blood flow throughout the body. This will identify where the blockage disrupting the blood flow is. A specialist intervention doctor will insert a small wire and tube into an artery from thigh area and will carefully guide a catheter through the patient’s arteries using advanced imaging technology to reach the thrombus forming the blockage in the brain.
If the blockage is unable to be opened and the artery is still blocked, the surgeon will try to remove the clot, either by suction or by pulling it out with a device called a stent retriever – which is an effective treatment that opens the artery in 70% of cases.
Through our pioneering research, 27 patients have successfully received Thrombolysis treatment, and seven patients receiving Endovascular Thrombectomies between October and December 2018.
3. It’s a multidisciplinary, cross-partnership priority
The stroke services within King’s Health Partners are highly multidisciplinary and involve doctors, nurses and a wide range of therapists to support patients on their journey to recovery.
Our researchers and clinicians continue to evolve stroke services as new treatments and techniques are developed. The Hyper Acute Stroke Unit is currently offering thrombectomy treatments from 9am to 5pm Monday to Friday, supported by an excellent out of hours transfer service to St George’s University Hospitals NHS Foundation Trust. Guy’s and St Thomas’ NHS Foundation Trust provides specialist community stroke rehabilitation services in Lambeth and Southwark for up to 12 weeks offering a seamless transfer of care from acute to community setting
Prevention of further stroke: Top tips from a Stroke nurse
There can be multiple causes for a stroke which can make this difficult to prevent. If you have suffered from a Stroke it is important you understand why the Stroke happened and the best method of reducing the risk of further episodes.
The biggest factor that we are in control of is our lifestyle. Healthy eating, weight reduction, smoking and lack of exercise should all be monitored as part of a healthy lifestyle.
Recognise the signs of a Stroke. The quicker professional treatment is given the less significant your brain injury will be.
- Facial weakness - are you able to smile? Has your face fallen to one side?
- Arm weakness - can you raise both arms?
- Speech problems – are you able to speak clearly and are you able to understand what is being said to you?
- Time - call 999 immediately if you see any of these symptoms.
2. Take control of your health
- Manage your blood pressure and regularly have this checked
- Stop smoking
- Look after your heart. Ask your GP to complete a simple pulse check on your next visit
- Monitor your blood sugar if you have diabetes
- Exercise an hour a day if possible
3. Manage what goes into your body
- Eat lots of oily fish like mackerel
- Drink less alcohol (one small glass three times a week is the guideline)
- Reduce your salt intake
Maria Fitzpatrick is Lead Consultant Nurse at King’s College Hospital NHS Foundation Trust.
King’s Health Partners Neurosciences has an ambitious vision to use our collective clinical, research, and educational expertise to deliver world-class patient care and research.