Differences in Physician Experience and Practice Area Shown to Affect Decision-Making for Endovascular Treatment

July 24, 2019—A study presented at the Society of NeuroInterventional Surgery’s (SNIS) 16th annual meeting held July 22–25 in Miami Beach, Florida, found significant differences in decision-making for endovascular treatment when the physician’s experience with endovascular treatment (EVT) use and practice area were taken into consideration.

According to SNIS, this web-based global study of 607 clinicians and interventionalists had participants respond to randomly selected acute stroke case scenarios and state how they would treat the patient. Participants also indicated how they would treat patients both within the constraints of their practice and in ideal settings. The study was conducted by the University of Calgary in Calgary, Alberta, Canada, and supported by an unrestricted research grant from Stryker.

The study, "Factors Associated With the Decision-making on Endovascular Thrombectomy for the Management of Acute Ischemic Stroke," found that endovascular treatment decisions significantly differed between regions and specialties under current local resources but not under assumed ideal conditions.

Additionally, it found that the National Institutes of Health Stroke Scale score (34.9%), level of evidence (30.2%), ASPECTS or ischemic core volume (22.4%), patient’s age (21.6%), and clinician's experience in EVT use (19.3%) are the most important factors for EVT decisions.

In the SNIS announcement, the study's lead author Mayank Goyal, MD, commented, “Physicians of different specialties and practicing in different geographic regions make decisions based on different external variables. While it is promising to see acceptance of EVT as the standard of care for patients with acute ischemic stroke, it is clear that more work needs to be done to standardize decision-making for the benefit of all patients.” Dr. Goyal is Professor of Radiology and Clinical Neurosciences and the Director of Imaging and Endovascular Treatment at the University of Calgary.