Stroke Horizon Scanning Bulletin Volume 9 Issue 9

October 11, 2017
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Warrington South MP Faisal Rashid raises ‘serious concerns’ over future of stroke care in letter to Jeremy Hunt

October 11, 2017

Source: Warrington Guardian

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Date of publication: 9th October 2017

Publication type: Local News

In a nutshell:

WARRINGTON South MP Faisal Rashid has written a letter to the secretary of state for health, Jeremy Hunt, in which he raises ‘serious concerns’ over the future of stroke care across the UK. These concerns arise as the national 10-year stroke strategy ends in December.

In the letter, Mr Rashid asked for the assurances for his constituents – and the 1.2m other stroke survivors in the UK – that ministers in the department of health are taking action to replace the national stroke strategy and asked what conversations have been had between the department of health and the NHS in regards to the future of stroke care in the UK.

Length of publication: online article


We’re working with NHS England to develop a national plan for stroke

October 11, 2017

Source: Stroke Association

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Date of publication: 4th October 2017

Publication type: National News

In a nutshell:

The Stroke Association has recently announced that they are working with NHS England, and other partners, to try and develop a new national plan for stroke in England.

It is hoped that this will build on the successes of the current National Stroke Strategy, which ends this year. The Stroke Association also want the new plan to tackle the big issues in stroke treatment and care which stroke survivors and clinicians tell us need to be sorted out.

A working group has already been set up, chaired by Professor Tony Rudd the National Clinical Director for Stroke, which includes experts from across the stroke pathway, a stroke survivor representing a project-specific stroke survivor, and carer reference group.

For updates on the national plan, readers can Sign up to the Campaigns Network.

Length of publication: online article


Stroke patients in Wales ‘could die’ because thrombectomy not available

October 11, 2017

Source: The Guardian

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Date of publication: 1st October 2017

Publication type: News

In a nutshell:

Doctors who specialise in stroke care are warning that the inability of the NHS in south Wales to offer patients what they say is a “game-changing” operation illustrates a chronic UK-wide lack of consultant interventional neuroradiologists (INRs)

INRs perform both thrombectomy and a similar emergency procedure, called endovascular coiling, on patients deemed at imminent risk of suffering a stroke. However, the shortage means a number of hospitals are unable to provide the operation themselves and must send patients elsewhere.

Stroke specialists warn that patients from south Wales could die because they can no longer have a thrombectomy. Efforts by senior NHS officials in Wales to persuade hospitals in England to perform the procedure on patients from south Wales have so far failed to lead to any formal cross-border care agreements.

Twenty stroke patients from Wales have undergone coiling since May in hospitals in Birmingham, Bristol, Oxford, Plymouth and Southampton. The Cardiff service has recruited one new INR, but does not expect to resume offering thrombectomy for some time.

Length of publication: online article


Cost-Effectiveness of thrombectomy in patients with acute ischemic stroke: the THRACE randomized controlled trial

October 11, 2017

Source: Stroke

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Date of publication: October 2017

Publication type: Research Article

In a nutshell:

This trial aimed to analyze whether mechanical thrombectomy combined with intravenous thrombolysis (IVMT) is cost-effective when compared with IVT alone.

Treating acute ischemic stroke with IVMT versus IVT increased the rate of functional independence by 10.9% at an increased cost of $2116, with no significant difference in mortality or symptomatic intracranial hemorrhage. The cost per one averted case of disability was estimated at $19 379. The incremental cost per one quality-adjusted life year gained was $14 881. On sensitivity analysis, the probability of cost-effectiveness with IVMT was 84.1% in terms of cases of averted disability and 92.2% in terms of quality-adjusted life years.

Based on randomized trial data, this study demonstrates that IVMT used to treat acute ischemic stroke is cost-effective when compared with IVT alone.

Length of publication: online article


Group rehabilitation activities improve walking after stroke

October 11, 2017

Source: National Institute for Health Research (NIHR)

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Date of publication: 12th September 2017

Publication type: NIHR Signal

In a nutshell:

One of the big challenges after stroke is ensuring that survivors can regain and maintain their mobility. Circuit class therapy might be delivered to groups of individuals living in the community. A recent Cochrane review has found that it can help stroke survivors to walk further, faster and with more independence and confidence.

Uncertainties remain about whether we can deliver such classes safely and efficiently across the whole country. There are questions around whether it would be practical and appropriate for individuals to attend group sessions, depending on their stroke severity. However, the information available at present looks promising

Length of publication: online article


Stroke in Childhood: Clinical guideline for diagnosis, management and rehabilitation

October 11, 2017

Source: Royal College of Paediatrics and Child Health (RCPCH)

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Date of publication: 20th September 2017

Publication type: Clinical Guideline

In a nutshell:

Stroke in Childhood 2017 is a nationally developed evidence-based clinical guideline for all UK paediatricians and healthcare professionals involved in the regulation or practice of the care of children and young people who have had or are suspected of having a stroke.

Length of publication: online article