NHS Tayside introduces pioneering new stroke service at Ninewells Hospital 

A new dedicated service providing rapid and effective treatment to remove blood clots in patients who have had a stroke has been introduced at Ninewells Hospital. 

NHS Tayside has received funding from the Scottish Government to carry out a pilot of a mechanical thrombectomy service.

Thrombectomy is a minimally invasive procedure in which blood clots are physically removed from blocked arteries in the brain. It will be performed in NHS Tayside by interventional radiologists, supported by radiographers and the radiology nursing team. Patient care before, during and after the procedure will be provided by the stroke, anaesthesia and intensive care unit teams at Ninewells. 

The initial pilot will see 20 Tayside stroke patients undergo thrombectomy at Ninewells. The plan is to then roll out to patients from the other NHS Boards across the North of Scotland region, with the aim of providing a 24/7 service by April 2023.

NHS Tayside Chief Executive Grant Archibald said, “I am delighted that NHS Tayside is now able to provide a thrombectomy service. This highly effective treatment will be of great benefit to stroke patients across Tayside and beyond.

“Our stroke teams have worked hard to redesign their services over the past 18 months and have already delivered significant improvements for patients. The launch of this new and innovative service is another step in making sure that we can offer the best possible treatment and outcomes for people who have a stroke.”

The Dundee service is the first of its kind in Scotland and will be part of a national network of three regional centres along with Glasgow and Edinburgh, which will provide thrombectomy for the West and East of Scotland regions.

Honorary consultant interventional radiologist Professor Graeme Houston, who leads the North of Scotland thrombectomy service, said, “The launch of the new thrombectomy service at Ninewells is the result of a huge amount of work over the past year to develop the service and train our staff to provide this life-changing treatment.

“Thrombectomy can deliver significantly improved outcomes for patients by reducing disabilities such as paralysis or loss of speech. In those patients who are suitable to receive thrombectomy, the treatment is most effective in the first few hours after a stroke, therefore anyone who has symptoms of a stroke should seek urgent help by dialling 999 to get assessment and treatment as quickly as possible.”

NHS Tayside has appointed Professor Iris Grunwald, a leading thrombectomy interventional neuroradiologist, to train and support the radiology team which will provide the new service. Professor Grunwald also has a training and research role with the University of Dundee.

The new thrombectomy service is among a number of recent improvements to stroke services in Tayside.  A new dedicated Tayside-wide acute stroke unit was created at Ninewells 12 months ago which means that patients from across Tayside now have 24/7 input from stroke specialists and earlier access to specialist treatment.

The percentage of people receiving thrombolysis, which is medication to remove blood clots, has steadily increased from 7% to around 20%. This is at the upper level of what is expected in a highly functioning stroke unit.

There has also been a significant reduction in ‘door to needle time’, which is the time between patients arriving in hospital and receiving thrombolysis. The proportion of those receiving the treatment within 30 minutes of arrival has increased from 13% to 50%, with 75% being treated within one hour. 

The move to a single site for acute stroke admissions has also allowed the new regional thrombectomy service to be developed at Ninewells.

Andrea Cail, Director Scotland for the Stroke Association, said, “Thrombectomy is a game-changing treatment, and it is good to finally have it available in Scotland.

“I want to commend the hard work and innovation of those involved in transforming stroke care in Tayside over the last year. The redesign of the service has led to improvements enabling it to be at the fore in implementing thrombectomy. We look forward to seeing more patients in the area making better recoveries from stroke because of thrombectomy.”