The Minister of Health, Marcelo Quiroga, announced today (10) the inclusion of thrombectomy in the procedures performed by the Unified Health System (SUS). The highly specialized treatment used in the acute phase of a stroke consists of inserting a catheter into the patient’s blood vessels to remove the blockage and restore blood flow to the affected area. The technology should be fully deployed by the end of the year
The announcement came at the opening of the Global Stroke Alliance – for Stroke Without Borders, a medical conference aimed at discussing cerebrovascular accident (CVA), in the capital, São Paulo.
Health Minister Marcelo Quiroga attends the opening of the 2022 Global Stroke Alliance at Sheraton São Paulo World Trade Center. – Rufina Rosa / Agencia Brasil
According to Queiroga, the logistics of a thrombectomy are complex, but there is already national experience for performing this procedure. Before being approved for entry into SUS, the technology was evaluated by the National Committee for the Integration of Technologies into the Unified Health System (Conitec). The decree was published by the Department of Science, Technology and Strategic Inputs (SCTIE) at the Ministry of Health, with the completion of the third phase, which provides specialized hospitals.
“There are 88 centers in Brazil that offer specialized stroke treatment, but not all of them will have this technology initially. This is done step by step. It can only be provided in those centers where there is technical qualification of qualified teams. Professionals.”
The minister explained that the criteria for selecting places where the technology will be implanted will be indicators of each of the hospitals, such as data on stroke deaths, hospital stays, readmissions, patients being treated with anticoagulants, and doctors’ experience.
According to Quiroga, the challenge of stroke care is so broad that it not only covers specialized care, as it begins in primary care, with control of high blood pressure, diabetes, anti-smoking, and physical inactivity, among others. The minister stressed that cardiovascular diseases are the leading cause of death in the world, affecting 18 million people annually.
“This is the most effective way to reduce deaths from stroke, but those who undergo it need treatment to re-supply the blocked artery leading to stroke. This is done with thrombolytic drugs, which are clot-dissolving drugs, or by ablation of thrombectomy. Like a heart attack, But the logistics of the stroke is more complicated because we have less time.”
Quiroga emphasized that all innovative treatments involve costs that can be additional or that the effectiveness of this treatment is much higher than what already exists, being a diminishing cost. “In the case of thrombectomy, it was evaluated, and the increased cost and effectiveness ratio was within the threshold level supported by the Brazilian system of funding. This issue of costs is not the greatest concern with regard to this treatment. Ensure that results from clinical trials are replicated in practice.”
Until this consolidation, the only clinical treatment available in the general network was thrombolysis, an option not always effective in severe cases. Meanwhile, four public hospitals in Brazil, in São Paulo, Espírito Santo, Santa Catarina and Ceará, already offer thrombectomy, but in these cases, treatment costs are paid for by the hospital itself or by the state health department. Treatment costs range from 15,000 R$ to 20,000 R$.
What is a stroke
A stroke occurs when the blood vessels carrying blood to the brain become blocked or broken, paralyzing an area of the brain that was without blood circulation. It is a disease that affects more men and is one of the leading causes of death, disability and hospitalization worldwide. There are two types of strokes that occur for different reasons: hemorrhagic stroke and ischemic stroke.
A stroke occurs when an artery becomes blocked, preventing the passage of oxygen to brain cells that eventually die. This blockage can be due to a clot (thrombosis) or a blockage (embolism). Ischemic stroke is the most common and accounts for 85% of all cases. Every minute a stroke is not treated results in a patient losing 1.9 million neurons, resulting in serious disabilities that can leave lasting effects, such as reduced movement, memory loss and impaired speech.
A hemorrhagic stroke occurs when a blood vessel in the brain ruptures, causing bleeding. This hemorrhage can occur within brain tissue or on the surface between the brain and the meninges. It is responsible for 15% of all strokes, but it can cause more death than a stroke.
In July 2022 alone, a stroke killed 8,758 Brazilians, equivalent to 11 deaths per hour, according to data from the Transparency Portal of Brazil’s Civil Registry Offices. In the first half of this year, there were 56,320 deaths, higher than the victims of heart attacks (52,665) and COVID-19 (48,865).
According to information received from the Ministry of Health, the main warning signs of any type of stroke are weakness or tingling in the face, arm or leg, especially on one side of the body. muddle; change of speech or understanding; change in vision (in one or both eyes); change in balance or coordination, dizziness, or change in gait; Sudden and severe headache for no apparent reason.
Factors that increase the risk of stroke are high blood pressure, type 2 diabetes, high cholesterol and being overweight. obesity; smoking; excessive use of alcohol; advanced age; sedentary lifestyle; illicit drug use; family history; be male. For prevention, the ideal is to maintain a healthy life, without smoking, consuming alcohol or illegal drugs, as well as maintaining a balanced diet, ideal weight, drinking plenty of water, engaging in regular physical activities, and keeping blood pressure and glucose under control.
* The article has been updated to add information and changed at 5:06 PM to correct the information. It’s not stroke, but cardiovascular disease that kills 18 million people every year.
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