I guess many of you will have seen on the news how scientists have developed a new procedure for treating strokes. It's similar to the coiling procedure, used to stem bleeds on the brain, where the bleed is accessed through an artery in the groin with the appropriate device.
But with a stroke, the device grabs the clot and pulls it back out through the artery, leaving the patient with far less trauma and fewer after effects. I think they said the whole process takes less then 10 minutes and the patient's recovery is rapid. Training will apparently take 3 to 5 years. xx
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cat3
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That's very interesting Cat. I give little attention to the tv now so missed hearing about the new procedure for strokes. Is it actually started to be used in U.K.?
Apparently Caroline it's called a Thrombectomy and is to be rolled out across Britain once enough neurosurgeons are trained in the procedure. A tube is inserted via an artery and is pushed through a stent which has been put in place to grab the blood clot. The tube is then pulled back through the artery together with the stent holding the clot.
Apparently patients are up, and ready to go home, within 48 hours. It's performed on patients at St Georges hospital, London where the procedure is performed daily, around the clock. It's been hailed as a major breakthrough in stroke treatment.............
I actually got goose-bumps listening to this news report tonight ! xx
That's good that it has now been recognized that it will improve the outcome for stroke. A positive start that its already being used daily at St Georges so its just a matter of time before training enables it to happen elsewhere too. So much cutting edge stuff seems to happen in London so I hope it does become accessible for everyone. We don't have any neurosurgeons at my local nhs!
No nor at mine Caroline, which is Trafford, but we have Salford (where I was treated) in Manchester which is quite accessible. We're fortunate in having 6 good hospitals with a half hour distance or less. x
Discussed this with my neuro consultant a couple of years ago - said then was reserved for very rare cases and then only if patients were not responding to other treatment. Good to see it has progressed since then
Yes it's an expensive project, but the argument is that the reduction in hospital stays and aftercare will cover the cost. The only sticking point could be Ms May and co ! xx
hi cat yes indeed a great break through too late for me im afraid but good news for future patientsim still very bitter about the fact when i had my stroke carlisle hospital turned me away no brds available even though i was in an ambulance iwe had to turn around and go to dumfries so my golden hour turned in to two hours but thankfully the paramedic was working on me all the time giving me a monster dose of clot busting injections and a drip.
so a great break through if you can get into a hospital
sorry for the rant ,also how is your trial of mixing your own cbd vape oil coming along
Sorry to hear your story Peter ; really rotten luck & makes me feel fortunate that the first hospital I was taken to scanned me immediately and had me blue-lighted to a specialist neuro hospital just half an hour away. Great to hear about the paramedic and his swift actions though ( those people are brilliant). His intervention will have made all the difference to your eventual outcome !
I haven't mixed the vape oil as I couldn't find reliable information anywhere, and my doctor decided to increase my Diazepam as she wasn't happy about my using the CBD.
Hi saw that yes not sure how many it can help but even 1 would be great my own stroke I had an infarc or mini stroke in the morning then kept in for observation given Asprin in the afternoon then had a massive bleed that night leaving me hemipligic paralysed down my left hand side
That certainly is pants ; I'm so sorry to hear It Jored.
I think the main benefits are the speed of the op and recovery, meaning that the percentage of patients treated would increase dramatically and it's effectiveness more or less guaranteed if the patient reaches hospital with 6 hours.
So there are always some who will slip through the net owing to their own failure to recognise symptoms or misdiagnosis, or a failure of the ambulance service to arrive promptly.
Too late for us of course, but still really exciting. x
I actually saw this procedure taking place on one of the myriad of hospital programs on TV. It looks ground breaking, the patient recovered in minutes, it was quite incredible.
I know, and though it's too late for many it's yet another amazing breakthrough. I remember how, when I was told I'd had a coiling op, I put my hand to my scalp expecting a wound of some kind. When it was explained that the whole procedure had been performed through an artery from my groin I laughed & said 'No, tell me how it was REALLY done'. Clever devils !
Sorry I laughed when you broke your foot BTW ; not funny is it ? Karma maybe. xxx
Really ? Two years............. My life is whizzing past !
I remember a guy where I worked wishing me happy birthday when I was 21 and spoiling it by saying (wistfully) how my life was on a slippery slope from then on, as it flies past like an express train after 21. I got very drunk that night, lamenting my youth. xx
Seriously, time just whistles by in the blink of an eye.
When you're 5, one year is a fifth of your life and seems to last forever, when you're 10, a year is a tenth of your life and still lasts a long time. When you're 50, the years pass by quicker than liquid passes through you...
This is good news for stroke care. I know that for clot you need to present within 4 hours of it forming and know the time of onset or FAST positive for clot busting drugs to be given. If you're outside of the time or you're not sure when you first had symptoms they can only monitor you.
Yes it's all pretty uplifting knowing those scientists are working away constantly in the background. I'm assuming there'll be a centre at Salford ; they're pretty cutting edge as it is. And as they've already perfected the arterial access to the brain the surgeons are already well prepared for this type of procedure. Great news. x
Yes, all those scientists doing their research making the world a better place for everyone, they must continue to be valued and their research funded otherwise we're in trouble. The Stroke Association as a charity is brilliant as they even support research initiatives such as the FOCUS trial where they're seeing if an SSRI antidepressant will help stroke recovery. I know this because I volunteer for them and deal with stroke cases. Salford is a place where many people are admitted where possible as it has very good acute care, but then people tend to get transferred to other hospitals in the region for rehab purposes.
Yes, their rehab is pretty basic but the acute care is second to none & apparently attracts people worldwide. I think Walton is the renowned centre for rehab.
The question of whether the funding will be there to facilitate these wonderful, painstakingly developed treatments is quite another matter which grieves me enormously.
The work you're doing for the Stroke association must be very rewarding. I didn't realise that SSRIs are a potential treatment for Stroke recovery ; I've used them since they were introduced and, who knows, they may have aided my recovery from the bleed. x
Well, I was placed on SSRIs when I was 17 by my then psychiatrist and was told I needed to do something to develop the brain and it was suggested I perhaps study something and go to the gym as I liked doing sports. This was so the brain could get the chance to build new pathways and I'm guessing the SSRIs were instrumental in that process. It's not surprising as I'm sure you know, they work by maintaining a strong connection between neurons than would normally be the case which would facilitate the plasticity of the brain to work around the damaged bits.
Hopefully they will have helped you, depression is know to cause the brain to stop making new brain cells which wouldn't help any recovery.
A lot of people seem to be transferred to either Wythenshawe hospital or the MRI on from salford. I think Wythenshawe deals with a lot of the longer term rehab. But again it depends on where you live as to which hospitals you get access to.
It's great news, to be able to reduce the effects of a stroke, for some people is amazing. Like you cat, my neuro centre is Salford Royal, I'm sure it will be in place before long, as does sound very similar to coiling. Xx
I find it so comforting imagining those genius bods constantly searching for solutions to such difficult medical issues. A bit late for me, but I often wish I could've been part of that community. xx
Need to remember that in acute stroke the clock starts ticking from the moment symptoms, even minor ones, present. TIME IS BRAIN! THINK FAST!
The reason thrombolysis (clot busting treatment) isn't given outside 4.5 hrs is due to several reasons
1. When a stroke happens and part of the brain is starved of oxygen the neurons (nerve signal transmitting cells) start to die at a rate of 1.9 million per second (Jeffrey L Saver), so the longer the brain is starved of oxygen, the more cells die and the greater the damage ie more severe symptoms /disabilty. Once cells are dead, restoring blood flow to them doesn't help. It may restore function to cells around the dead area (infarct) that are compromised but not yet dead (the ischaemic penumbra).
2. Dead brain is far more likely to bleed than healthy brain, so if thrombolysis is given once there's a well established infarct, especially a large one, then the risks outweigh the benefits
So- even with this new mechanical thrombectomy treatment, brain cells will die at the same rate and TIME is still totally of the essence.
I suggest that if the thrombectomy patient in the video recovered completely within minutes, they must have been within a perhaps 1-3 hr time window from stroke onset.
The BIG problem with acute stroke care is timing ie patients, for one reason or another, don't get treatment quickly enough. They either don't recognise or ignore the symptoms of stroke, can't summon help or summon inappropriate help eg GP, 111, Family member. Then of course there's delays in ambulance service and failure to recognise a stroke by paramedics or health professionals in hospital.
London actually has some pretty poor stroke care , despite a complete reorganisation to a hub and spoke service about 10 years ago.
There are a lot of non-tertiary referral hospitals (district generals, if you like) outside London that have excellent stroke thrombolysis services set up but they don't have neurosurgery/interventional neuroradiology services available.
Providing this service in London is going to involve a whole new "reshuffle" of acute stroke services at a cost of how much? I'd like to see how many patients actually benefit over the next 5-10 years.
Maybe it would make more sense to improve the acute stroke services we already have and , just as, if not more, importantly-therapy and rehab' services both in hospitals and the community.
"The group of patients that are likely to benefit from mechanical thrombectomy are
those with proximal occlusion of the internal carotid or middle cerebral arteries who
present early after the stroke before there is irreversible ischaemic damage to the
brain. These patients, often with extensive thrombus, are much less likely to respond
to the conventional intravenous thrombolysis and more likely to experience severe
disability. Around 40% of ischaemic strokes are caused by a large artery occlusion
(LAO)"
So of the 40% of LAO patients, based on current figures,less than half will arrive at hospital within the first hour. So we're down to 20%. Then if we subtract those that don't meet the inclusion criteria ( already disabled, uncontrolled diabetes, on blood thinners, other disabling/life threatening conditions etc) we can probably half that again, so maybe 10% 0f all stroke patients who could get the treatment.
"Currently, around 12% of all stroke patients receive intravenous thrombolysis and the majority of patients suitable for thrombectomy will come from this group,....."
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xx 
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Update, just home after craniotomy 
stroke 
Fluid on lungs
Stroke 
