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1/2023
vol. 19
abstract:
Guidelines/recommendations
World Federation for Interventional Stroke Treatment (WIST) multispecialty training guidelines for endovascular stroke intervention
Iris Q. Grunwald
1, 2, 3
,
Panagiotes Papanagiotou
9, 10
,
Rafal T. Nizankowski
13
,
- Department of Radiology, NHS Tayside, Dundee, UK
- Tayside Innovation MedTech Ecosystem (TIME), Division of Imaging Science and Technology, School of Medicine, University of Dundee, UK
- Cardiovascular Center Frankfurt, Frankfurt, Germany
- Asklepios Clinik St. Georg – Klinische und Interventionelle Angiologie, Hamburg, Germany
- Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo New York, USA; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, New York, USA; Jacobs Institute, Buffalo, New York, USA
- Department of Cardiac and Vascular Diseases, Jagiellonian University, John Paul II Hospital, Krakow, Poland
- SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Germany
- Department of Diagnostic and Interventional Neuroradiology, Hospital Bremen-Mitte/Bremen-Ost, Bremen, Germany
- First Department of Radiology, School of Medicine, National & Kapodistrian University of Athens, Areteion Hospital, Athens, Greece
- S. C. Neuroradiologia ed Interventistica Vascolare, Ospedale S. Michele, Cagliari, Italy
- Worcestershire Royal Hospital, Cardiology Department, Worcester, United Kingdom
- Accreditation Council, National Centre for Health Quality Assessment, Krakow, Poland
- Mid and South Essex NHS Foundation Trust, Southend-on-Sea, United Kingdom
- Department of Neurology, Saarland University Medical Center, Homburg, Germany
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts, Worcester, USA
- Hospital Italiano Regional Del Sur, Hospital Privado Del Sur and Hospital Regional Español, Bahia Blanca, Argentina
- A.V. Vishnevsky Institute of Surgery, Moscow, Russia
- I.V. Davidovsky City Hospital, Moscow State University and Dentistry, Moscow, Russia
- Sanford Medical Center, Fargo North Dakota, USA
- Department of Neuroimaging and Interventional Neuroradiology, Neurosciences Center, Ansari Nagar, All India Institute of Medical Sciences (A.I.I.M.S), New Delhi, India
- Department of Cardiology and Angiology, Acibadem City Clinic-Cardiovascular Center, Sofia, Bulgaria
- University Hospital of North Midlands, Keele University, Stoke-on-Trent, UK
- Vergelegen MediClinic, Somerset West, University of Cape Town, South Africa
- East Kent Hospitals University NHS Foundation Trust, Ashford, United Kingdom
- Jerudong Park Medical Centre, Brunei
- Precision Imaging Beacon, Radiological Sciences, University of Nottingham, Nottingham, United Kingdom
- Deptartment of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland
- Department of Cardiology and Interventional Angiology, Kashubian Center for Heart and Vascular Diseases, Pomeranian Hospitals, Wejherowo, Poland
- Department of Neurology and Stroke, Pomeranian Hospitals, Wejherowo, Poland
Adv Interv Cardiol 2023; 19, 1 (71): 6–13
Online publish date: 2023/04/01
Introduction:
Today, endovascular treatment (EVT) is the therapy of choice for strokes due to acute large vessel occlusion, irrespective of prior thrombolysis. This necessitates fast, coordinated multi-specialty collaboration. Currently, in most countries, the number of physicians and centres with expertise in EVT is limited. Thus, only a small proportion of eligible patients receive this potentially life-saving therapy, often after significant delays. Hence, there is an unmet need to train a sufficient number of physicians and centres in acute stroke intervention in order to allow widespread and timely access to EVT.
Aim:
To provide multi-specialty training guidelines for competency, accreditation and certification of centres and physicians in EVT for acute large vessel occlusion strokes.
Material and methods:
The World Federation for Interventional Stroke Treatment (WIST) consists of experts in the field of endovascular stroke treatment. This interdisciplinary working group developed competency – rather than time-based – guidelines for operator training, taking into consideration trainees’ previous skillsets and experience. Existing training concepts from mostly single specialty organizations were analysed and incorporated.
Results:
The WIST establishes an individualized approach to acquiring clinical knowledge and procedural skills to meet the competency requirements for certification of interventionalists of various disciplines and stroke centres in EVT. WIST guidelines encourage acquisition of skills using innovative training methods such as structured supervised high-fidelity simulation and procedural performance on human perfused cadaveric models.
Conclusions:
WIST multispecialty guidelines outline competency and quality standards for physicians and centres to perform safe and effective EVT. The role of quality control and quality assurance is highlighted.
keywords:
stroke, acute stroke, ischaemic stroke, mechanical thrombectomy, acute stroke intervention
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