Clinicians urge Scottish government to reverse £7 million thrombectomy funding cut

Health charities and National Health Service (NHS) clinicians have united in a call for the Scottish government to reverse a cut to the funding of stroke thrombectomy treatments.

MORE THAN 150 STROKE CLINICIANS HAVE backed a call from charities Chest, Heart and Stroke Scotland (CHSS), and the UK Stroke Association for the reinstatement of £7 million to the national thrombectomy service funding in Scotland.

An open letter to the cabinet secretary for Health and Social Care describes the 50% funding cut and recruitment freeze as a “mistake”.

The letter states that the resulting savings—which amount to less than 0.1% of Scotland’s total health budget—will create far greater costs, with Scottish patients who miss out on this “extraordinarily effective” medical treatment ending up needing longer hospital stays, community rehab and social care services, according to a CHSS media release.

Stroke physician Vera Cvoro (University of Edinburgh, Edinburgh, UK) stated: “Thrombectomy is the single most effective treatment we have for stroke. Many patients that come to our hospitals with a stroke could benefit from this treatment that prevents disability. This can mean being able to walk again, talk again and even going back to work. We have the expertise to deliver such treatment and it should be available to all people living in Scotland.”

The Scottish government had previously committed to rolling out a national thrombectomy service, which would see around 800 stroke patients receive the procedure each year, the media release notes. Such a service is expected to save the health and social care system up to £47,000 per patient in the first five years—with a resulting total saving of £37.6 million to the NHS.

As such, CHSS and the Stroke Association are jointly calling for the Scottish government’s commitment to continuing to fund the service and recruit the staff necessary for a national rollout.

Jane-Claire Judson, CHSS chief executive, said: “CHSS and the Stroke Association are united in our plea to the Scottish government to stand by its commitment to a national thrombectomy service. It is unthinkable that the Scottish government will deny Scots a treatment we know will make a huge difference to their lives for the sake of a small, short-term budget saving. Hundreds of Scots who have a stroke each year should be able to trust they will get the best possible medical attention and chance of making a full recovery.”

John Watson, associate director Scotland at the Stroke Association, added: “Thrombectomy saves brains, money and lives. It can change the course of recovery from stroke in an instant and is one of the most effective medical interventions ever developed. We understand the financial pressure the government is under, but to cut a service that improves patients’ lives while saving money would be a serious mistake. The current resource crisis should lead to thrombectomy being prioritised, not cut.

“That is why we, alongside CHSS and clinicians at the coal face, are calling on the Scottish government to reinstate its funding for a national thrombectomy service.”.

SNIS: Physicians “should not have to choose” between family life and professional career

The Society of NeuroInterventional Surgery (SNIS) has released a position statement advocating pregnancy and parental leave policies in neurointerventional surgery, voicing support for a physician’s ambition to have a family, as well as start, develop and maintain a career in this specialty.

ACCORDING TO THE statement, the SNIS believes that parents in the field—including those who adopt and foster—should not be penalised in any way, and legal and regulatory mandates and family friendly workplace policies should be considered when institutions and individual practitioners approach the issue of childbearing in the context of a career in neurointerventional surgery. Neurointerventionist and SNIS member Amanda Baker (University of California San Francisco [UCSF], San Francisco, USA) led a structured literature review with her peers regarding parental leave policies in neurointerventional surgery and related arenas. This involved evaluating a 2019 survey of those in the field, which included proposed

Synchron announces publication of braincomputer interface clinical trial in JAMA Neurology

SYNCHRON HAS ANNOUNCED that the medical journal JAMA Neurology has published peer-reviewed, long-term safety results from a clinical study in four patients with severe paralysis implanted with the company’s firstgeneration Stentrode neuroprosthesis device. The study found that it is possible to use the neuroprosthesis device to transmit neural signals from inside a blood vessel in the brain over a long-term period without any serious adverse events related to the device.

The SWITCH (Stentrode with thought-controlled digital switch) trial—a first-in-human study— evaluated four patients implanted with Synchron’s Stentrode. Patients completed a 12-month follow-up with no persistent neurological deficits. There were no clots or migrations of the device, a Synchron press release reports, and signal quality remained stable with no significant deterioration.

changes to reduce barriers for women and parents pursuing family life, as well as addressing concerns regarding radiation exposure.

“We are grateful to the leadership of SNIS and the Journal of NeuroInterventional Surgery (JNIS) for supporting all people—all families—in this amazing field,” said Baker. “I would like to personally thank UCSF’s Neuroendovascular Surgery programme for training me as their second female and first pregnant neurointerventionist.”

The recent position statement was developed by the SNIS’ Women in Neurointervention committee, Standards and Guidelines committee, and board of directors, and has been published in JNIS

Other recommendations made in the statement include making the use of vacation time flexible for those undergoing family planning methods or procedures, particularly within training programmes. It also states a belief that fellowship training, career promotion and job security should be maintained during the process of starting a family.

“SNIS believes people should not have to choose between a fulfilling family life or professional career, especially when the nature and urgency of neurointerventional treatments require emotional, physical and mental demands on every person at each experience level,” added SNIS president J Mocco (Mount Sinai, New York, USA). “Things like allowing flexibility for scheduling prenatal appointments, and not penalising those who use family leave, are vital and will have lifelong benefits for those in neurointerventional surgery and their families.

“We want our practitioners to know that we do not believe taking time for family needs is a lack of commitment to the profession.”

In addition, each participant successfully controlled a personal computing device with the braincomputer interface (BCI). They were able to use the implant to generate digital switches under intentional control for routine digital activities, such as texting, emailing, and communication of care needs, the release adds.

The study was led by Peter Mitchell, the neurointerventionist who performed the procedures, and vascular neurologist Bruce Campbell (both University of Melbourne, Melbourne, Australia). The procedures were performed in a neurointerventional angiography suite.“We carefully conducted this first-in-human study with a primary focus on safety. All patients tolerated the procedure well and were typically discharged home within 48 hours,” said Mitchell.

The device is implanted in the motor cortex of the brain via the jugular vein in a minimally invasive endovascular procedure. Once implanted, it detects and transmits motor intent in order to control personal digital devices.In the trial, motor intent was detected using a robust decoder that searches for power changes in certain frequency bands. The digital switches were executed under the volitional control of frequency band shifts by the users.