24/7 mechanical thrombectomy (MT) at University Hospital Southampton (UHS) – local experience and service development in establishing an around the clock service

Marigold, R, Weir, N., Mavrokordatos, C., Evans, S., Battersby Wood, E., Crawford, P., Tjerkstra, E, Macdonald, J., Ghosh, B. and Slaght, S (2025) 24/7 mechanical thrombectomy (MT) at University Hospital Southampton (UHS) – local experience and service development in establishing an around the clock service. International Journal of Stroke, 20 (3S), 16. (doi:10.1177/17474930251379781).

Abstract

Introduction: MT is recognised as a powerful acute intervention in
restoring blood flow to critically occluded large blood vessels in acute
stroke, with expanding indications for patients with large ischaemic cores,
and time windows up to 24hrs from symptom onset. An urgent unmet
need was to expand our current 12hr a day 7 day a week service to provide
24/7 cover.
Method: We describe how we went about setting up a 24/7 MT service
in the face of staffing shortages and the steps we took to establish a
robust and resilient rota and standard operating procedure to maximise
local access to this important treatment. This included engaging with
other stakeholders such as resident doctors neurology and general medicine
and in involved new consultant neurologists contributing to the out
of hours rota.
Results or details of the case: 24/7 MT started at UHS at the beginning
of March 2025 and we have seen a significant rise in cases since.
Regular teaching and training as well as support for our colleagues contributing
to the service have been instrumental in starting 24/7 cover.
Conclusion: We describe the complex processes we went through to
develop a 24/7 MT service, ensuring safe and sustainable staffing levels,
creating a simple pathway that was user friendly and easy to access and
providing referring clinicians with rapid outcomes about transfer decisions.

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