In 2015, we proved the efficacy of mechanical thrombectomy. In 2018, we established evidence for mechanical thrombectomy beyond 6 hours in patients with favourable imaging. Moreover, there has been extensive research into dual anti-platelet therapy to prevent recurring stroke in minor stroke patients.
From a technical point of view, there has been an explosion of the number of suction catheters and stent retrievers on the market. This has made mechanical thrombectomy safer & has allowed us to chase distal clots.
So in 2022, it is not just that we are doing thrombectomy, but… we are doing it better.
And as a result, we are improving patient outcomes.Next, Fahad & Greg discuss what the patient journey looks like in 2022 from being out in the community, to receiving treatment. They discuss how we have streamlined the process - including creating general awareness of stroke in the public, implementing screening tests like FAST & coordinating with emergency first responders.
The challenge in modern day stroke treatment is how to determine which patients get thrombectomy, which patients get thrombolysis & which patients are given conservative treatment?
Greg Selkirk suggests that there are five main factors:
- Does the patient have severe cognitive impairment (what is their pre-existing quality of life?)
- What is their functional status?
- Where is the location of the clot and what is the risk of removing it?
- What symptoms does this patient have? Do the symptoms justify the risk?
- How much salvageable parenchyma is there?
Tune in to a #CodaPodcast by Alex Rowell, Fahad Ashraf, Greg Selkirk & Luke Torre. An informative & interesting update on stroke management in 2022.
Finally, for more like this head to our podcast page #CodaPodcast