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3/2021
vol. 17
abstract:
Review article
Interdisciplinary management of acute ischaemic stroke – current evidence on training requirements for endovascular stroke treatment. Position Paper from the ESC Council on Stroke and the European Association for Percutaneous Cardiovascular Interventions with the support of the European Board of Neurointervention: A step forward
Carlos Alejandro Alvarez
5
,
Panagiotis Papanagiotou
10, 12
,
- Department of Cardiac and Vascular Diseases, Jagiellonian University, John Paul II Hospital, Krakow, Poland
- Accreditation Council, National Centre for Health Quality Assessment, Krakow, Poland
- Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York, United States; Jacobs Institute, Gates Vascular Institute, Kaleida Health, Buffalo, New York, United States
- Department of Cardiology, University of Messina Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, A.O.U. Policlinic “G. Martino”, Messina, Italy
- Hospital Italiano Regional Del Sur, Hospital Privado Del Sur and Hospital Regional Español, Bahia Blanca, Argentina
- Cardiology Department, Ioannina University Hospital, Ioannina, Greece
- Invasive Cardiology Department, Bács-Kiskun County Hospital, Teaching Hospital of the Szent-Györgyi Albert Medical University, Kecskemét, Hungary
- Division of Neurointerventional Radiology, Department of Radiology, University of Masachusetts Medical Center, Worcester, MA, USA
- Acibadem City Clinic Cardiovascular Center, Sofia, Bulgaria
- Department of Diagnostic and Interventional Neuroradiology, Hospital Bremen-Mitte, Germany
- NHS Tayside Interventional Radiology, Dundee, Scotland, United Kingdom
- Areteion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Department of Radiology, University of Münster, Münster, Germany
- CardioVascular Center Frankfurt, Germany
- University of California San Francisco UCSF, San Francisco, California, USA
- Chair of Neuroradiology, Department of Radiology, University of Dundee, Ninewells Hospital, Dundee, Scotland, United Kingdom
Adv Interv Cardiol 2021; 17, 3 (65): 245–250
Online publish date: 2021/10/20
Stroke, a vascular disease of the brain, is the #1 cause of disability and a major cause of death worldwide. Stroke has a major negative impact on the life of stroke-affected individuals, their families and the society. A significant proportion of stroke victims indicate that would have preferred death over their after-stroke quality of life. Mechanical thrombectomy (MT), opening the occluded artery using mechanical aspiration or a thrombus-entrapment device, is a guideline-mandated (class I, level of evidence A) treatment modality in patients with large vessel occlusion stroke. MT clinical benefit magnitude indicates that a universal access to this treatment strategy should be the standard of care. Today there is a substantial geographic variation in MT deliverability, with large-scale disparities in MT implementation. In many countries effective access to MT remains severely limited. In addition, many of the MT-treated patients are treated too late for a good functional outcome because of logistic delays that include transportations to remotely located, scarce, comprehensive stroke centres. Position Paper from the European Society of Cardiology Council on Stroke and European Association for Percutaneous Cardiovascular Interventions on interdisciplinary management of acute ischaemic stroke, developed with the support of the European Board of Neurointervention fills an important gap in systematically enabling interventional cardiologists to support stroke intervention in the geographic areas of unmet needs in particular. We review strengths and weaknesses of the document, and suggest directions for the next steps that are swiftly needed to deliver MT to stroke patients more effectively.
keywords:
acute ischaemic stroke, mechanical thrombectomy, cerebral resuscitation, unmet needs, cardiology cathlab-based treatment, multispecialty team
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