Interventional Radiology Societies Call for Expanded Stroke Training

 

October 29, 2018—The Society of Interventional Radiology (SIR) announced that the Cardiovascular and Interventional Radiology Society of Europe and the Interventional Radiology Society of Australasia along with SIR have committed in a joint statement to providing necessary stroke training to interventional radiologists (IRs) in order to alleviate the shortage of physicians trained in endovascular stroke therapies. The societies' joint global position statement was published by David Sacks, MD, et al online ahead of print in the Journal of Vascular and Interventional Radiology.

According to SIR, the ability for patients to access thrombectomy-capable stroke centers (TSCs) remains stymied by geography and a shortage of interventional physicians, despite the American Heart Association’s (AHA) and multiple international stroke organizations’ recommendations that endovascular thrombectomy (EVT) be the standard of care for patients with acute ischemic stroke caused by blocked arteries.

In the announcement, SIR President M. Victoria Marx, MD, commented, “SIR strongly believes IRs have a current and growing role in the care of patients with ischemic strokes. We stand committed to advocate for policy changes and provide the cognitive and technical skills and resources necessary for IRs to provide high-quality care.”

According to SIR, the joint statement advises:

  • Reversing symptoms from these strokes requires rapid and safe removal of the occluding thrombus
  • The stroke neurology community recommend that patients be treated locally rather than having long transfer delays while confirming that there is a shortage of physicians and comprehensive stroke centers (CSCs) providing EVT
  • Appropriately trained IRs can evaluate stroke patients and provide emergent EVT with good outcomes, especially where neurointerventional physicians are not available
  • IRs can also help provide 24/7 care in partnership with neurointerventional physicians where they are available
  • Allowing IRs to join their neurology, neurointerventional, and neurosurgeon colleagues on care teams and allowing them to be part of certified stroke centers will greatly increase access to this critical treatment

SIR noted that the society is revising its current stroke training guidelines to support expanded patient access to interventional stroke treatment. The training pathway will reinforce Joint Commission and AHA requirements for physicians operating in TSCs and CSCs.

In September, the Joint Commission and AHA announced they would hold a dialogue with provider organizations to discuss requirements as the organizations work to update certification criteria for TCSs and CSCs.

Stroke affects 16.9 million worldwide each year. In the United States, there are 795,000 new cases, with approximately 100,000 patients who are eligible for EVT treatment. However, only a fraction of these EVT-eligible patients are treated because of the shortage of TSCs. To meet that volume, the United States would need 500 endovascular stroke centers and 2,000 physicians. Currently, there are 231 TSCs in the United States, noted SIR.

 

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