World Stroke Day protest at threat to thrombectomy equipment vital for stroke treatment

The Irish Heart Foundation and stroke survivors from its national support network held a protest outside Beaumont Hospital in Dublin on World Stroke Day, today (Monday 29 October) over an imminent threat to the national thrombectomy service.

In spite of increasingly urgent calls from doctors at Beaumont Hospital and its own National Stroke Programme, the HSE has failed to fund the replacement of the machine used for the vast majority of thrombectomies in Ireland, even though it has already broken down on several occasions – including during the treatment of stroke patients – and is now so old spare parts will cease to be made for it from the end of next year.

Thrombectomy is a mechanical clot retrieval treatment that restores the blood supply to a stroke patient’s brain. Global evidence shows that it reduces stroke deaths by half and the rate of permanent severe disability among stroke patients by almost as much. Last year, 248 thrombectomies were carried out in Beaumont Hospital on patients from all over Ireland and a further 31 procedures were done in Cork University Hospital, the only other provider of the service nationally.

Speaking at the protest, Mr Chris Macey, Head of Advocacy with the Irish Heart Foundation, said “It is staggering that highly skilled consultants providing the most innovative and effective treatment ever devised for stroke have to work with equipment that is essentially obsolete. When the unit enabling the treatment breaks down they have to switch it off and on again, which takes up to ten minutes. How can this be acceptable in the delivery of life or death treatment of patients for whom every second counts?”

Mr Macey said there was now a real danger that the biplane angiography unit which enables doctors to locate and retrieve stroke-causing clots, would break down for a protracted period of time, or even permanently.

“In that event it’s estimated it would take up to ten months to replace the unit which would inevitably result in significant and wholly preventable loss of life, whilst many more patients would be robbed of the opportunity to recover from their stroke.

“Nobody has died yet, but this has been described to us as an accident waiting to happen.
What makes it even worse is that in this instance health service funding issues cannot be used to justify the failure to invest. A HIQA health technology assessment recommended expanding the service through the provision of a second biplane unit after deeming the treatment to be cost effective. But as things stand even the existing service is under threat.”

The cost of replacing the biplane unit is €1.5 million plus building costs. The same amount, along with additional staffing costs, would be required to provide the recommended second unit that would provide capacity to double the lifesaving impact of the current service.

“We know this treatment saves lives, we know it gives stroke survivors who would otherwise sustain disabilities requiring lifelong institutional care a chance to recover from their stroke, and we know it is cost effective. What we don’t know is why the HSE has failed to fund this service and why they aren’t even required to explain why.”

Mr Macey added that the Irish Heart Foundation had written to Minister for Health Simon Harris in recent weeks to inform him of the crisis and called on him to intervene without delay to ensure the protection of the existing service, as well as its expansion to maximise the lifesaving impact of thrombectomy within the boundaries of cost effectiveness.