Ross Naylor (Leicester, UK), member of the CX Programme Organising Board, discusses the biggest challenges of treating acute stroke and the role of a multidisciplinary team in this setting.
What do you think are the biggest challenges treating acute stroke?
Improving patient awareness about the need to seek urgent medical advice as soon as transient ischaemic attack or stroke-like symptoms happen; persuading health systems of the importance of setting up dedicated daily cerebrovascular clinics for ensuring the rapid treatment of transient ischaemic attack patients and convincing hospitals of the need to have 24/7 access to interventional services who can perform intracranial thrombectomy and/or for ensuring that triage systems exist to enable rapid patient transfer to centres that can.
What is the current role of a multidisciplinary team in treating acute stroke?
As we move towards ultra-rapid treatment of patients with stroke (and transient ischaemic attack), it is no longer appropriate to rely on the traditional weekly carotid/stroke multidisciplinary team, as most interventions are now carried out as emergency or as semi-urgent procedures. This will still require specialties to consult and aid each other, but this will probably now be on a less rigid basis. The key is to develop guidelines for ensuring that patients have rapid access to collaborating specialties, rather than turf wars over who should be doing what. There is still a lesser role for the traditional multidisciplinary team, but this will be for the more complex semi-elective cases which do not require emergency or urgent interventions.
How can physicians who intervene in the aorta, aortic arch and carotid arteries work together with stroke specialists to improve stroke rates and outcomes?
By attending the Charing Cross Symposium to see how interdisciplinary collaboration and knowledge of the latest technologies can help them avoid a potentially devastating complication like stroke.
A debate at the CX Acute Stroke Challenges session will explore the statement “Only neuroradiologists should undertake intra-arterial thrombectomy”; what are your views with regards to this practice?
As with many other aspects of endovascular care, it is more important that our patients have rapid access to a trained and experienced practitioner, rather than the specialty badge he or she wears. Rotas for providing acute intracranial thrombus retrieval will be quite onerous and will require 24-hour service delivery. The more qualified and experienced people that can join these rotas the better.
The CX Acute Stroke Challenges will take place at the Charing Cross Symposium on Friday 29 April – Upper Main Auditorium, Olympia Grand, London, UK
Click here to see the CX Interactive Main Programme – Acute Stroke Challenges
Click here to see the CX Acute Stroke Challenges Abstract Presentations
Click here to register