Stroke Treatment Standards Published
July 29, 2009—Philip M. Myers, MD, et al have published performance and training standards for endovascular treatment of ischemic stroke treatment in the Journal of Neurointerventional Surgery (2009;1:10–12). According to the writing group, the purpose of the 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. The guidelines have been written and approved by multiple neuroscience societies that 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 and Interventional Neurology.
The document's introduction notes that 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 US Food and Drug Administration approval with an indication for mechanical stroke thrombectomy, none of these thrombectomy devices have demonstrated efficacy for the improvement of patient outcomes, the document states.