Tribhuvan University Teaching Hospital (TUTH), a prominent public hospital in Nepal, has commenced 24-hour mechanical thrombectomy services for acute ischemic stroke patients. The hospital recently announced the successful treatment of a 42-year-old woman using this procedure.
Dr. Subash Fuyal, a radiology and neuro-intervention specialist at TUTH, stated that the woman’s blood circulation was obstructed by a clot in the middle cerebral artery (left M1 MCA) on the left side of her brain. The modern mechanical thrombectomy procedure successfully removed the clot, restoring blood flow. The hospital confirmed that blood flow in the obstructed vessel was fully re-established after the treatment.
Mechanical thrombectomy is a minimally invasive modern treatment method. It involves inserting a thin catheter through a blood vessel in the arm or thigh to reach the obstructed vessel in the brain and remove the blood clot. This procedure does not require opening the skull.
Dr. Fuyal explained that a stroke can interrupt blood circulation to the brain, leading to damage to brain cells. He emphasized that timely mechanical thrombectomy in suitable patients can help restore blood circulation and reduce the risk of disability. However, he noted that this treatment is not appropriate for all stroke patients. The decision for treatment is based on the patient’s condition, brain scans, and other medical factors.
Stroke in Nepal: A Major Health Concern
An estimated 50,000 people suffer from strokes in Nepal annually, with 15,000 deaths. Stroke is the third leading cause of death in Nepal, accounting for approximately 7.6 percent of all fatalities. Ischemic stroke is the most common type, affecting 87 percent of patients. The “golden hour,” or the first few hours after a stroke, is crucial for treatment. About 90 percent of patients who reach the hospital within four hours of a stroke can regain their independence after treatment.
According to Dr. Fuyal, key symptoms of a stroke include facial drooping, weakness in the arms or legs, paralysis on one side of the body, slurred speech, or difficulty speaking and understanding. Immediate hospitalization is essential if these symptoms appear, and they should not be ignored even if they disappear on their own. Although precise data on stroke patients in Nepal is unavailable, stroke is the second most common reason for patients seeking neurological care.
National Protocol and Future Plans
The Ministry of Health and Population, Nepal, approved the “National Stroke Treatment Management Protocol, 2082” on Shrawan 30 (BS). This protocol clarifies the roles of basic, primary, and specialized hospitals, providing clear guidelines for treatment. The Ministry stated that essential infrastructure development and capacity building for doctors and health workers will be undertaken based on this protocol to improve service delivery.
