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Original research
A survey of neurointerventionalists on thrombectomy practices for emergent large vessel occlusions
  1. Kyle M Fargen1,
  2. Adam S Arthur2,
  3. Alejandro M Spiotta1,
  4. Jonathan Lena1,
  5. Imran Chaudry3,
  6. Raymond D Turner1,
  7. Aquilla S Turk3
  1. 1Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  2. 2Department of Neurosurgery, University of Tennessee and Semmes-Murphy Clinic, Memphis, Tennessee, USA
  3. 3Department of Radiology, Medical University of South Carolina, Charleston, South Carolina, USA
  1. Correspondence to Dr K M Fargen, Department of Neurosurgery, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 301, Charleston, SC 29425, USA; Fargen{at}musc.edu

Abstract

Background The effect of the five positive randomized controlled trials on thrombectomy practices and procedural volume has yet to be defined. Further, few studies have attempted to define modern thrombectomy practices in terms of selection criteria and devices used.

Methods A 21 question survey of Society of Neurointerventional Surgery (SNIS) physicians was administered using the SurveyMonkey website, addressing current practices as well as changes from before January 1, 2015 to the months after this date.

Results A total of 78 responses were obtained (approximately 10% of SNIS membership). Prior to January 2015, two-thirds of respondents reported performing 1–5 thrombectomies per month (67%), with 31% performing more than 5 per month. Following January 2015, 62% of respondents reported performing more than 5 thrombectomies per month; 45% of respondents reported a higher number of thrombectomies after trial publication. 73% and 80% of respondents indicated that inpatient consultations and hospital to hospital transfers for thrombectomy have increased, respectively. A plurality of respondents reported using A Direct Aspiration First Pass Technique (40%) as the first strategy for revascularization. Most commonly, neurointerventionalists reported using conscious sedation (56%) for anesthesia. 74% of respondents indicated being successful with their primary technique in at least 70% of cases.

Conclusions This survey of predominantly academic SNIS physicians indicates that inpatient consultations, hospital to hospital transfers, and thrombectomy procedural volumes have increased modestly since the publication of the five major stroke trials this year. In addition, many respondents indicated an increase in aggressiveness in pursuing thrombectomy based on selection criteria.

  • Thrombectomy
  • Stroke
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Footnotes

  • Contributors Each author listed above should receive authorship credit based on the material contribution to this article, their revision of this article, and their final approval of this article for submission to this journal.

  • Competing interests None declared.

  • Ethics approval The study was approved by the institutional review board of the Medical University of South Carolina.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Conflicts of interest Fargen: None. Arthur: consultant for Medtronic, Microvention, Penumbra, Sequent, Stryker, Codman and receives research support from Sequent and Siemens. Spiotta: consultant for Microvention, Penumbra, Pulsar Vascular, and Stryker. Lena: consultant for Penumbra. Chaudry: consultant for Covidien, Medina Medical, Microvention, Pulsar Vascular, Stryker, and Three Rivers Medical. Turner: consultant for Blockade Medical, Codman, Covidien, Microvention, Penumbra, and Pulsar Vascular. Turk: consultant for Codman, Covidien, Lazarus Effect, Medina Medical, Microvention, Penumbra, Pulsar Vascular, Siemens, and Three Rivers Medical.

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