How 20-minute stroke surgery technique could save thousands of lives

An innovative 20-minute Irish stroke surgery technique could save thousands of later stage stroke patients’ lives and prevent serious disability, a leading surgeon has stated.

he technique, which takes place under general anesthetic, works by reducing the patient’s body temperature, administering intravenous medication and inserting a tube through the neck.

The tube, along with a stent, is placed into the carotid artery – the main artery to the brain. The clot is removed and a hole in the artery is closed with a dissolvable disc.

Professor of vascular and endovascular surgery at NUI Galway, Sherif Sultan, said: “A stroke patient normally has to be treated within 24 hours – the golden hours – but with this treatment, we can save those who’ve gone beyond this timeframe.”

Professor Sultan stated that the first patient to receive the treatment was an Irish-based boss of a famous multinational company.

The businessman had been in a public hospital, where treatment had not worked.

“It was 96 hours before he came to me,” Prof. Sultan said. “The other team had been trying, but so much time had gone by, the patient was not able to move his right hand or right leg.

“But he was still talking and he said ‘Just do anything to help me.’

The patient was referred to Professor Sultan, as word had spread about the treatment. His body temperature was reduced and the procedure was carried out.

“The treatment saved his life,” Prof. Sultan said. “He woke up moving his limbs, as if nothing had happened. It changed everything.

“He sends me Christmas cards, thanking me for saving his life.

“After 24 hours it’s often a case of throwing in the towel, a case of nothing more can be done – but this treatment changes that and offers a higher chance of recovery.

“Within two weeks, this man was driving his car and living his life normally. His daughter now wants to be a vascular surgeon. She sees what this surgery did for her dad. We need more surgeons, we need more young people to read about cases like this, to realize we can really help change lives for the better.”

Prof Sultan and a team at NUI Galway developed the technique and around 100 patients globally have been treated with the method – Transcervical Percutaneous Carotid Angioplasty and Stenting Therapy or (TCAR).

88pc recovered fully and were discharged home within three days. However, 12% of patients did need rehabilitation.

Stroke surgery is normally carried out by inserting a stent through the groin and this is routed up to the brain, to remove a clot.

TCAR offers a “quicker route to the brain” and provides an opportunity to “save those who might have gone beyond the 24 hour period,” Prof Sultan said.

“We started publishing this work because we just want to save patients’ lives, to prevent them from having serious disabilities, if treatment has gone beyond 24 hours.

“We don’t want anyone to throw in the towel because nothing has worked and the golden time period has passed.

“Stroke rehabilitation in Ireland costs approximately €100,000 million. In the UK, it’s close to €2.4bn. This treatment is a paradigm shift in how to treat strokes and the treatment costs around €300.”

The procedure, which is awaiting European, UK and FDA approval, could potentially help thousands of stroke patients, if rolled out.

Prof. Sultan stated that any surgeon trained in vascular surgery could be easily trained on how to use the device.

The procedure, he stated, cut the risk of nerve damage to the brain and also helped the patient avoid a long stay in the hospital.

The professor also stated that the procedure resulted in less pain, fewer side effects and a more rapid recovery.

According to the Irish Heart Foundation, one in six people will have a stroke during their lifetime. Most of these are aged over 65. However, a stroke can occur at any age and even young people and children can be affected.

“This procedure was created and developed in Ireland by an Irish-based team,” Prof Sultan said.

“I want to see it introduced to help patients live normal lives, to reduce disability, to help families and to reduce the cost to the exchequer.

“As well as that, it could potentially create lots of Irish jobs.”

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