Performance and training standards for endovascular ischemic stroke treatment
- Writing Group for the American Academy of Neurology, AANS/CNS Cerebrovascular Section, Society of NeuroInterventional Surgery, and the Society of Vascular & Interventional Neurology,
- P M Meyers1,
- H C Schumacher2,
- M J Alexander3,
- C P Derdeyn4,
- A J Furlan5,
- R T Higashida6,
- C J Moran4,
- R W Tarr7,
- D V Heck8,
- J A Hirsch9,
- M E Jensen10,
- I Linfante11,
- C G McDougall12,
- G M Nesbit13,
- P A Rasmussen14,
- T A Tomsick15,
- L R Wechsler16,
- J R Wilson17,
- O O Zaidat18
- 1New York Presbyterian Hospital, Columbia University, College of Physicians & Surgeons, Neurological Institute, New York, New York, USA
- 2Albert Einstein College of Medicine, New York, New York, USA
- 3Cedar Sinai Medical Center, Los Angeles, California, USA
- 4Washington University, St Louis, Missouri, USA
- 5Case Western Reserve University, Cleveland, Ohio, USA
- 6University of California San Francisco, San Francisco, California, USA
- 7University Hospitals Case Medical Center, Cleveland, Ohio, USA
- 8Forsyth Medical Center, Winston-Salem, North Carolina, USA
- 9Harvard University, Boston, Massachusetts, USA
- 10University of Virginia Health Sciences Center, Charlottesville, Virginia, USA
- 11Miami Vascular Institute, Miami, Florida, USA
- 12Barrow Neurological Institute, Phoenix, Arizona, USA
- 13Oregon Health Sciences, Portland, Oregon, USA
- 14Cleveland Clinic, Cleveland, Ohio, USA
- 15University of Cincinnati, Cincinnati, Ohio, USA
- 16University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- 17Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- 18Medical College of Wisconsin, Milwalkee, Wisconsin, USA
- Correspondence to
Philip M Meyers, Associate Professor, Radiology and Neurological Surgery, New York Presbyterian Hospital, Columbia University, College of Physicians & Surgeons, Neurological Institute, 710 West 168th Street, Suite 428, New York, New York 10032, USA; pmm2002{at}columbia.edu
- Received 6 May 2009
- Accepted 15 May 2009
Abstract
Stroke is the third leading cause of death in the USA, Canada, Europe, and Japan. According to the American Heart Association and the American Stroke Association, there are now 750 000 new strokes that occur each year, resulting in 200 000 deaths, or 1 of every 16 deaths, per year in the USA alone. Endovascular therapy for patients with acute ischemic stroke is an area of intense investigation. The American Stroke Association has given a qualified endorsement of intra-arterial thrombolysis in selected patients. Intra-arterial thrombolysis has been studied in two randomized trials and numerous case series. Although two devices have been granted FDA approval with an indication for mechanical stroke thrombectomy, none of these thrombectomy devices has demonstrated efficacy for the improvement of patient outcomes. The purpose of the present document is to define what constitutes adequate training to perform neuroendovascular procedures in patients with acute ischemic stroke and what performance standards should be adopted to assess outcomes. These guidelines have been written and approved by multiple neuroscience societies which historically have been directly involved in the medical, surgical and endovascular care of patients with acute stroke. The participating member organizations of the Neurovascular Coalition involved in the writing and endorsement of this document are the Society of NeuroInterventional Surgery, the American Academy of Neurology, the American Association of Neurological Surgeons/Congress of Neurological Surgeons Cerebrovascular Section, and the Society of Vascular & Interventional Neurology.
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Footnotes
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Competing interests None.
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This article will be co-published in the Journal of Neurosurgery.
