SIR Announces Multisociety Guidelines for Endovascular Treatment of Stroke

January 29, 2013—The Society of Interventional Radiology (SIR) announced the publication of the first outcome-based guidelines for the interventional treatment of acute ischemic stroke. The document, “Multisociety Consensus Quality Improvement Guidelines for Intraarterial-Catheter-Directed Treatment of Acute Ischemic Stroke,” was created by representatives from the SIR and seven other medical societies to provide a multispecialty and international consensus on the metrics and benchmarks for processes of care and technical and clinical outcomes for stroke patients.

The guidelines will be published first in SIR's Journal of Vascular and Interventional Radiology (2012;24:151–163). Each society will subsequently publish the document, either in its respective journal or on its website.

SIR advised that a joint society document to guide the design and reporting of stroke research was published in 2003 in the Journal of Vascular and Interventional Radiology. The coauthors of the new guidelines, which address clinical care, completed a review of the relevant literature from 1986 through February 2012 as the basis for creating performance metrics and thresholds.

In the society's press release, SIR President Marshall E. Hicks, MD, commented, “These groundbreaking guidelines are the product of 2 years of collaboration among multidisciplinary teams from eight societies. With real progress being made in research and treatment of stroke over the last decade, this distinguished group of international authors from societies whose members perform minimally invasive stroke treatments felt that the time was right for a consensus on how to effectively treat and manage stroke patients.” Dr. Hicks is the head of the division of diagnostic imaging at the University of Texas MD Anderson Cancer Center in Houston, Texas.

The guidelines recommend submission of outcomes to a national registry that will allow for research, as well as comparisons between facilities. Lead author David Sacks, MD, noted that the benchmarks in the paper are intended to be used in a quality assurance program to assess and improve processes and outcomes in acute stroke revascularization, which is the opening of a blocked artery to the brain. Dr. Sacks stated that the guidelines may also be helpful to facilities that are interested in applying for accreditation as a comprehensive stroke center.

“As the field of stroke revascularization evolves, the guidelines will be revised as needed,” added Dr. Sacks. “All society representatives vigorously discussed each issue based on the literature review and personal experience.”

In addition to the lead author, Dr. Sacks, the guidelines were drafted by M.J.B. Stallmeyer, MD, for SIR; Carl M. Black, MD, for the American Society of Neuroradiology; Christophe Cognard, MD, for the European Society of Minimally Invasive Neurologic Therapy; J.J. Connors III, MD, for the American Society of Neuroradiology; Donald F. Frei Jr, MD, for the Society of NeuroInterventional Surgery; Rishi Gupta, MD, for the Society of Vascular and Interventional Neurology; Tudor G. Jovin, MD, for the Society of Vascular and Interventional Neurology; Bryan W. Kluck, DO, for the Society for Cardiovascular Angiography and Interventions; Philip M. Meyers, MD, for the Society of NeuroInterventional Surgery; Kieran J. Murphy, MD, for the Canadian Interventional Radiology Association; Stephen R. Ramee, MD, for the Society for Cardiovascular Angiography and Interventions; and Daniel A. Rufenacht, MD, for the Cardiovascular and Interventional Radiological Society of Europe.

“The one constant in stroke treatment is time,” commented Dr. Sacks, who is a past president of SIR and an interventional radiologist at Reading Hospital and Medical Center in West Reading, Pennsylvania. “Seconds count, from time of admission to treatment. Meeting the outcomes described in these guidelines will ultimately benefit patients by requiring strict adherence to a rapid treatment schedule.”