UK NICE Seeks Comments on Draft Guideline for Thrombectomy in Stroke Patients


December 5, 2018—NICE, the United Kingdom's National Institute for Health and Care Excellence, announced an updated draft guideline stating that patients with acute ischemic stroke should be treated with thrombectomy and thrombolytic drugs up to 24 hours after the onset of symptoms if there is potential to salvage brain tissue. Currently, thrombectomy is only offered to patients with stroke up to 12 hours after onset.

The draft guideline, which is open for public consultation until January 11, 2019, updates NICE’s current guideline on treating stroke and transient ischemic attack.

The announcement advised that National Health Services (NHS) organizations should compare their current practice with the final recommendations and consider whether changes need to be made to put them into practice. In considering any changes, they will need to take into account any extra costs and savings involved. The speed at which these recommendations are adopted by local NHS services will depend on the available resources and the other priorities being addressed, noted NICE.

Paul Chrisp, Director for the Center for Guidelines at NICE, stated in the announcement, “New evidence shows that extending the eligibility period of thrombectomy to up to 24 hours can be very cost-effective. There is also a potential benefit for improved quality of life by reducing the level of disability people can experience as a result of a stroke. These recommendations could lead to an increase in referrals to centers that already provide this procedure. Centers will also need to be able to provide or have access to 24-hour care, which will have an impact on NHS resources. However, balanced against this are the positive effects for other aspects of stroke care, such as a decrease in demand for in-patient rehabilitation and a reduction in the need for long-term social care.”

Jason Kendall, MD, Chair of the guideline committee, commented, “Stroke is the single biggest cause of disability in adults, the effects of which can be devastating to patients and their families. Therefore, it’s imperative that we reduce the risk of disability by providing people with the most effective, up-to-date care.”


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