Revised Multisociety Guidelines Address Endovascular Therapy for Acute Ischemic Stroke

April 4, 2018—The Society of Interventional Radiology (SIR) announced the publication of revised guidelines for the nonsurgical, image-guided interventional treatment of acute ischemic stroke that will ensure patients receive the right treatment at the right time. The document, "Multisociety Consensus Quality Improvement Revised Consensus Statement for Endovascular Therapy of Acute Ischemic Stroke," was published by David Sacks, MD, et al in SIR's Journal of Vascular and Interventional Radiology (2018;29:441–453).

The updated guidelines are endorsed by SIR and 11 other medical societies: the American Association of Neurological Surgeons, American Society of Neuroradiology, Canadian Association for Interventional Radiology, Cardiovascular and Interventional Radiological Society of Europe, Congress of Neurological Surgeons, European Society of Minimally Invasive Neurologic Therapy, European Society of Neuroradiology, European Stroke Organization, Society for Cardiovascular Angiography and Interventions, Society of NeuroInterventional Surgery, and World Stroke Organization.

According to SIR, this revision updates standards of practice first published in 2013 and establishes 15 metrics of patient care and outcomes based on findings of recent scientific studies about interventions such as thrombectomy and revascularization. The 2018 guidelines cover important factors in selecting patients for interventional treatments and ensuring optimal outcomes, such as the time since the patient was “last known well,” preprocedural imaging, and clot location.

The benchmarks set in this revised guidelines are intended for use in quality improvement programs to assess and improve processes and outcomes and may also help facilities meet the criteria for accreditation as a comprehensive stroke center, advised SIR.

In the SIR announcement, Dr. Sacks commented, “The one constant in stroke treatment is time to opening the artery. Seconds count from time of admission to successful treatment. Meeting the outcomes described in these guidelines will ultimately benefit patients by requiring strict adherence to a rapid treatment schedule.”

SIR President M. Victoria Marx, MD, added, “We know from recent studies that rapid access to interventional treatments increases the odds of survival and decreases the occurrence of disability in patients who suffered an acute ischemic stroke. Now is the time for these guidelines to be adopted and applied to save lives.”