The global challenge of stroke and pathways to better outcomes

One of the key challenges in stroke care is the limited window available for treatment once symptoms arise.

GlobalData October 02 2024

Stroke remains one of the leading causes of death and disability worldwide, affecting millions each year. Acute ischemic stroke (AIS), responsible for 85% of all strokes, poses a critical challenge due to its narrow treatment window. With less than 10% of patients fully recovering, stroke-related disabilities also impose significant strain on healthcare systems. The rising availability of advanced medical devices - particularly in diagnostic imaging and thrombectomy tools - is central to improving stroke diagnosis and expanding access to timely care.

One of the main challenges in stroke care is the limited time available for treatment. Thrombolysis is most effective within 4.5 hours of symptom onset, while mechanical thrombectomy can extend the window to 6 hours in certain cases. However, only 20-30% of patients qualify for these interventions, often due to delays in symptom recognition, misdiagnosis, or insufficient access to specialised care. Enhancing public education, emergency response systems, and expanding treatment accessibility, especially in underserved areas, are essential to improving patient outcomes.

Advancements in diagnostic imaging are also crucial for stroke management. Computed tomography and magnetic resonance imaging scans are used to determine stroke type and severity and enable timely decision-making while perfusion imaging assesses salvageable brain tissue, with the potential to extend treatment to viable patients outside of eligibility windows. Mobile stroke units equipped with imaging technologies have also emerged, reducing treatment delays by 20-30 minutes and significantly improving recovery chances. However, widespread adoption of these technologies is hindered by logistical and financial barriers, especially in regions with limited healthcare infrastructure.

Mechanical thrombectomy has seen major improvements with tools such as stent retrievers and aspiration catheters, expanding treatment to a broader range of stroke types. Some emerging studies use thrombectomy up to 24 hours after symptom onset or in patients with medium vessel occlusions, suggesting the potential for up to 60% of AIS patients to benefit despite current limited usage. According to leading data and analytics company GlobalData, the global neurovascular thrombectomy market is expected to rise from $0.9bn in 2024 to $2bn by 2034, driven by rising demand, increasing stroke incidence, and the potential for expanded treatment eligibility. However, broader adoption of these techniques will require more clinical trials, physician training, and infrastructural improvements.

Haemorrhagic strokes, though less common, also present significant challenges. Early intervention to limit bleeding is critical. The recent INTERACT-4 trial demonstrated substantial benefits from early blood pressure management, highlighting the need for all hospitals - not just specialised centres - to be equipped to handle both ischemic and haemorrhagic strokes for comprehensive care.

With World Stroke Day approaching on 29 October, it serves as a reminder of the pressing need to expand treatment options, improve diagnostic capabilities, and address care disparities. Investments in advanced imaging, treatment options, and physician training can significantly reduce stroke-related deaths and disabilities. Through innovation, awareness, and equitable access, the healthcare sector can make substantial strides in improving stroke outcomes globally.

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