In Italy, 300 specialized units for stroke treatment would be needed but there are only 190 of them and 80 percent in the North. Too many patients still fail to access the latest therapies
In Italy there are still too few Stroke Unitthe Units specialized in the therapy of cerebral stroke: to manage the over 100 thousand Italians that every year I am a victim of stroke, about 300 would be needed throughout the national territory, instead there are only 190 and 80 per cent are located in the north of the country. This was denounced by experts from the Italian Society of Interventional Cardiology (Gise), who observe that in this way too many patients still cannot access the most advanced therapies.
stroke there is no time to waste
and to have the best chance of survival without residual disability, it is essential to intervene as soon as possible after the onset of symptoms: if an ischemic stroke occurs, which accounts for about 80 percent of cases and depends on the presence of a thrombus occluding an artery in the brainIn fact, occluded cerebral arteries can be cleared using thrombolysis drugs capable of dissolving it or, when the thrombus is found in larger caliber arteries, a thrombectomy procedure can be used to remove the occlusion mechanically using a catheter. Both intervention possibilities are time-dependent: thrombolysis guarantees results if performed within 4.5-9 hours from the onset of symptoms, thrombectomy has a longer intervention window, up to 16/24 hours. therefore it is essential to arrive in a Stroke Unit on time, so as to be able to undergo the most appropriate intervention quickly and with greater probability of success; unfortunately it does not always happen, quite the contrary.
Few receive the therapies
The lack of Stroke Units, especially in the Center-South, means that many do not arrive within sufficient time to make a specific intervention possible. There thrombectomy has a longer time window in which to intervene than thrombolysis (although it has limits of use because the catheter with which to remove the occlusion requires vessels of a certain caliber, ed), but in Italy it is difficult to guarantee it to the many patients for whom there would be an indication because they are affected by stroke of the internal carotid or middle cerebral artery, who also have a more serious pathology and sequelae of greater disabilities – observes Giovanni Esposito, president Gise -. Across the country, only 37 percent of patients eligible for intracranial thrombectomy undergo intra-arterial treatment and this largely depends on the lack of Stroke Units: the majority of treatments carried out in a few centers, also because the presence of 24-hour specialists is only guaranteed in a minority of the structures. Strengthening the network and allowing all Italians, everywhere, to be able to be subjected to timely and adequate therapies to limit the devastating consequences of a stroke must be an indispensable goal for the near future.
June 24, 2022 (change June 24, 2022 | 10:58)
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