How innovation is transforming stroke care?

  • Posted on 13.10.2021

How innovation is transforming stroke care?

Alenka Brzulja

Alenka Brzulja

Vice President of Cardiovascular & Specialty Solutions EMEA, Johnson & Johnson Medical Devices Companies

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Many of us know someone affected by stroke. It is the second leading cause of death globally and results in 50% of survivors being chronically disabled.[1]

In Europe, the incident of stroke will have increased by 34% by the middle of the next decade. [2]

The impact of stroke

The impact on individuals and families can be profound. Stroke also has serious economic and social consequences. In the EU in 2015, the direct healthcare costs of stroke were €20 billion, with nearly three-quarters of these costs relating to in-hospital care.[3]The total cost of stroke in the EU has been estimated at €45 billion.[2]

Ischaemic stroke is particularly concerning because of its sudden onset and devastating consequences. It accounts for 85% of all strokes and is caused by a blockage cutting off blood supply to the brain or a damaged artery in the brain.[4] Ischaemic stroke is as fast as it is destructive.

With stroke cases, time is brain. Seconds can be the difference between a full, independent life or a life of dependency. The quicker someone is seen and treated by a specialist stroke team, the better their recovery.

Removing clots

A blood clot that blocks or slows blood flow to the brain can lead to stroke. Mechanical thrombectomy (MT)– a minimally invasive procedure – can be used to remove clots from the brain. The procedure requires skilled surgeons and innovative tools to retrieve the clot which caused the stroke. From a patient’s perspective, the outcomes are best if the clot is removed at the first pass as repeated attempts risk complications.

The ARISE II study found that faster and complete resolution of ischemic stroke through manual clot removal is associated with improved outcomes; two thirds of patients in this particular study were functionally independent and one half were disability free at three months.[5] Successful retrieval of the clot at the first attempt is also good news for health systems as it reduces the number of days patients spend in hospital.

While recommended as a first line procedure for ischaemic stroke, mechanical clot removal is often delayed or not performed due to factors including lack of rapid access to specialist centres or delayed stroke diagnosis.

We also know that fewer patients presented during the height of pandemic for fear of COVD-19 – losing precious time which could have been used for treatment. A study in the US, showed approximately 50% drop in ischaemic patients presenting at stroke centres in March 2020 compared with March 2019.[6]

Clot science

The progress we have achieved in recent years should inspire us to continue innovating and sharing knowledge of stroke care. It is built on years of research, investment and collaboration.

The more we discover about blood clots and broaden our understanding, the more exact we can be when designing devices to removing devices to remove challenging clots.

Although mechanical thrombectomy is still a relatively new procedure, its implementation as a treatment option highlights what can be achieved when design, research come together with the physicians at the right time.

MT was incorporated into European stroke guidelines as a Class 1A treatment recommendation as part of the treatment strategy in 2014/2015 following evidence from five big clinical trials. Through collaborating with physicians we can push the boundaries of what’s possible in stroke care to give patients a new lease on life after stroke. 

The future of stroke care

Advances in stroke care are improving patient outcomes and reducing the burden on health systems but there is more to be done. While medical devices and technology like MT can make a difference, further gains could be achieved if healthcare systems across Europe were better positioned to implement optimal approaches.  

When it comes to stroke, the best technical innovations in the world can only make a difference if patients know when to seek treatment and are diagnosed in time.

It is vital, we find ways to accelerate the pace at which new knowledge and technologies are implemented by health systems across Europe and around the world to give patients the best clinical outcome possible. Stroke does not discriminate. It can affect adult men and women of any age – anywhere. In fact, one in four of us over the age of 25 will experience a stroke in our lifetime.[6]

What matters is speed and quality of the response to those strokes. Let’s work together to ensure patients everywhere get the best care we can offer.

 

 



[1] Donker E. Stroke in the 21st Century: A Snapshot of the Burden, Epidemiology, and Quality of Life. Stroke Res Treat. 2018; 2018: 3238165.

[2] Stroke Alliance for Europe. The Economic Burden of Stroke. The Burden of Stroke in Europe Report.

[3] Ischaemic stroke. Stroke Association. Stroke.org.uk. https://www.stroke.org.uk/what-is-stroke/types-of-stroke/ischaemic-stroke. Last accessed July 2020.

[5] Zadiat O, et al. Primary Results of Multicenter Arise II study. Stroke journal. 11 Apr 2018https://doi.org/10.1161/STROKEAHA.117.020125Stroke. 2018;49:1107–1115

 

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