Provocative Idea for Thrombectomy Services in Acute Stroke

In a previous post the CLAHRC WM Director argued that further rationalisation of acute stroke units would be necessary to provide rapid access to thrombectomy, not just clot busting therapy, for acute stroke. But another intriguing idea would be to integrate cardiac and neurological thrombolysis, cutting across tribal lines, as suggested by Apps and colleagues.[1] We think a modelling exercise is needed considering:

  1. Likely patient demand as the number of centres increases or decreases across the country.
  2. The costs of kitting up and staffing integrated versus independent units.

The model may show that more stroke thrombectomy units are cost-effective when they can be integrated with cardiac thrombectomy. Tim Jones, Director of Delivery at the University Hospitals Birmingham NHS Foundation Trust, goes further and thinks a general vascular intervention service should be considered. Our CLAHRC proposes such a modelling study to seek the most efficient and acceptable solution. We seek collaborators.

— Richard Lilford, CLAHRC WM Director


  1. Apps A, Firoozan S, Kabir T. Delivering thrombectomy for acute stroke using cardiology services. BMJ. 2015; 351: h3969.

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