Stroke patients at risk from delays in surgery.

Over 200,000 patients in the UK and throughout Europe, are missing out on the benefits that potentially life-saving surgery could bring because of delays in treatment, research published in The Lancet this week states (20/03/04).

The Stroke Association funded research by the Carotid Endarterectomy Trialists’ Collaboration which examined the factors that determine the extent to which carotid surgery reduces the risk of stroke in patients who have had either a ‘warning stroke’ or a ‘mini stroke’ (transient ischaemic attack or TIA). Carotid endarterectomy is a common surgical procedure that is routinely used to remove the build up of fatty deposits in the main artery between the heart and brain. These deposits could cause blood clots that block the blood supply to the brain, leading to ischaemic strokes.

The study found that the sooner that carotid endarterectomy was performed after patients had their first symptoms, the more beneficial it was in reducing the risk of subsequent, and more serious, strokes. Surgery was particularly effective if performed within two weeks after their initial symptoms.

“The results of our study show that carotid endarterectomy should be performed within the first couple of weeks after patients present with a TIA or “mini-stroke.” explained Dr Peter Rothwell, Coordinator of the research project.

“At the moment, many patients in the UK wait for months for this particular treatment, by which time the benefits are very much reduced or absent. This does a disservice to patients and is also an ineffective use of resources. Sadly, the high risk of stroke without the operation means that many patients have a major disabling stroke before they can be treated.” continued Dr Rothwell. “Current clinical guidelines on the investigation and treatment of patients with TIA or “mini-stroke” should be revised and clinical services should be improved.“

“This study shows that stroke patients do not currently receive the appropriate treatment as quickly as they should to achieve the best outcome,” commented Margaret Goose, Chief Executive of The Stroke Association.

“People who experience minor or mini strokes have a greater likelihood of suffering from a more debilitating stroke later on. Stroke is one of the most common causes of death and a major cause of adult disability. The fact that this could be reduced by the more appropriate use of techniques that currently exist, is something that urgently needs to be addressed. “

Ends

For additional press information please contact the Media team at The Stroke Association on 020 7566 0328/1515 or by e-mail at press@stroke.org.uk
Please note we have an ISDN facility

Dr Peter M Rothwell, Stroke Prevention Research Unit, University Department of Clinical Neurology, Radcliffe Infirmary, Woodstock Road, Oxford OX2 6HE, UK; T) +44 (0)1865 224237 or +44 (0)1865 224639; F) +44 (0)1865 228572; E)peter.rothwell@clneuro.ox.ac.uk (copied to tracey.brock@clneuro.ox.ac.uk to ensure a rapid response).

Notes to editor

1. Each year over 130,000 people in England and Wales have a stroke. Of all people who suffer from a stroke, about a third are likely to die within the first 10 days, about a third are likely to make a recovery within one month and about a third are likely to be left disabled and needing rehabilitation. Stroke has a greater disability impact than any other medical condition. A quarter of a million people are living with long-term disability as a result of stroke in the UK.

2. The Stroke Association is the only national charity solely concerned with combating stroke in people of all ages. It funds research into prevention, treatment and better methods of rehabilitation and helps stroke patients and their families directly through its community services. These include dysphasia support, family support, information services, welfare grants, publications and leaflets. We also campaign, educate and inform to increase knowledge of stroke at all levels of society and we act as a voice for everyone affected by stroke.

3. A stroke happens when the blood supply to the brain is disrupted. Most strokes occur when a blood clot blocks the flow of blood to the brain. Some strokes are caused by bleeding in or around the brain from a burst blood vessel. When the blood supply is disrupted, parts of the brain become damaged or destroyed. Some strokes are fatal whist others can cause permanent or temporary paralysis to one side of the body and loss of the ability to speak, read or write. Recovery may be slow and can vary from person to person.

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