Following the onset of a stroke, getting treatment as fast as possible is critical and in some situations, a case of life or death.
May marks Stroke Awareness Month and we spoke to Dr Hannah Stockley, consultant interventional neuroradiologist at Salford Royal, who tells us more about the life-saving procedures and treatments helping patients get their life back on track.
Since March 2022, Salford Royal has been providing a 24/7 stroke thrombectomy service for the patients of Greater Manchester. This is a revolutionary procedure to remove a clot blocking a blood vessel in the brain, ultimately saving lives. During 2023-2024 the service expanded by 150%, with over 200 thrombectomies performed.
As the tertiary neuroscience centre for Greater Manchester, Salford Royal is the specialist hospital to provide this service and also receives patients from the two primary stroke centres in Fairfield and Stepping Hill hospitals.
Hannah explained: “It’s important to think of stroke like you would a heart attack; it’s a brain attack. If it happens, there is a limited time window to get treatment."
During a thrombectomy, guidewires are inserted through the femoral artery, a major blood vessel in your thigh and an x-ray detectable dye is injected into the arteries to maximise visualisation while an x-ray machine highlights the blood vessels. The neurointerventionalist uses this map to guide wires and tubes up through your body to the location of the clot. Then a small wire stent and a suction device are used to remove the clot and restore blood flow to the affected area.
Hannah added: “Thrombectomy can be a relatively quick procedure, in most cases taking less than an hour, and sometimes less than 15 minutes. It is usually done under general anaesthesia, so patients don’t feel anything.”
The other main treatment for stroke is thrombolysis, where the clot (embolus) gets dissolved by injecting it with medication. Some patients may receive both treatments to maximise the chances of restoring blood flow to the brain.
Both procedures are time critical, meaning it is vital to call 999 or get to a hospital if you think you or your loved one has had a stroke. Thrombolysis can only take place within a four-and-a-half-hour window from the stroke starting, whilst best outcomes for thrombectomy are usually achieved if the procedure is started within six hours. While new evidence is suggesting some patients can benefit beyond these time windows, the best recoveries are seen if the treatments are performed as soon as possible.
Hannah added: “The procedures can help tremendously with recovery and some patients may be up-and-about very quickly, sometimes without the need for too much rehabilitation.
“Also, it’s really important to remember that stroke is not an ‘old person’s disease’. Many cases occur in younger adults and even in children, but there can be a delay in being taken to hospital because people don’t associate stroke with younger age groups.
“I am incredibly proud of the team and the treatment we provide here at Salford. It is important for our service to exist, where stroke care is constantly developing and progressing.”
LtR (Jardel Morris, Ryan Williams, Hannah Stockley, Nunurayi Madzimbamuto, Jacqui Greenhalgh, Sabina Eze, Kemi Oresanya)