Dr Tufail Patankar says thousands of stroke patients are currently unable to access a game-changing treatment that could save them from lifelong disability.
A consultant interventional neuroradiologist at Leeds General Infirmary, Dr Patankar says delays in extending the treatment to patients across England are unacceptable and should be addressed immediately.
“It is wrong that a stroke patient can walk from one hospital soon after suffering a stroke, while a patient in another 20 miles down the road is left disabled for life,” he says. “We cannot allow this to continue.”
Dr Patankar is calling for all stroke patients to have access to a procedure called thrombectomy, which uses a mechanical device to remove disabling and potentially fatal blood clots.
Currently only a few hundred patients a year receive the treatment and just a small number of hospitals in England offer it, despite its proven effectiveness. The procedure can produce remarkable results, with patients able to walk out of hospital within 48 hours of having it.
The treatment has been widely available in a number of countries, including Germany, France and Spain, for several years. But in England its availability has been curtailed for a wide number of reasons and although the National Institute for Health and Care Excellence (NICE) eventually approved the treatment in February 2016, it was only in April 2017 that NHS England announced plans to extend it to around 8,000 patients a year.
Dr Patankar welcomes the proposal but says he is concerned there will be further delay in its implementation. “I am delighted that NHS England has accepted the need for change. But I am concerned about the lack of clarity about how this is going to be achieved.
“The NHS England announcement is vague about detail, with no clear timetable. To do this requires significant upfront investment, although the savings will be huge, in terms of the longer-term care that is required.
All stroke patients should have access to a procedure called thrombectomy, which uses a mechanical device to remove disabling and potentially fatal blood clots
“We also must invest in training, to have the specialists we need to be able to provide this treatment across the country. At present, we don’t have enough specialists and it will take time to address this. We have already lost so much time. We can’t afford to delay any longer.
“Stroke care has not benefited from the support and investment that has been given to cancer care, for example, and we need to put this right.”
Dr Patankar pays tribute to Leeds General Infirmary, which continued to offer stroke patients thrombectomies, even before NICE approved the treatment. “We always believed in its effectiveness and value. We learnt from practice in comparable countries, including Germany and Spain, and believed in what we were doing.”
He has been carrying out between 40 to 50 thrombectomy procedures a year. In Germany, a consultant in a similar hospital, serving a similar population, would carry out between 200 and 250 procedures a year.
NHS England can take advantage of technological advances which have made thrombectomies safer and easier to carry out. In the early days, a thrombectomy was a major operation which took place under general anaesthetic. Today most of the procedures can take just about ten minutes and the patient is usually awake, so the recovery is also quicker.
The quality of the mechanical devices used to remove blood clots has also improved, with manufacturers such as Germany’s Phenox applying the latest technology for the benefit of patient care.
“Speed is critical in treating stroke,” says Dr Patankar. “We used to say ‘time is brain’, because every minute we gained meant we saved more of the brain. Now for me ‘brain is brain’, because we know that even 20 per cent of the saved brain makes a profound difference to quality of life.”
For more information please visit www.phenox.net
