Standards of Practice in Acute Ischemic Stroke Intervention International Recommendations

Pierot L 1 , Jarayaman M 2 , Szikora I 3 , Hirsch J 4 , Baxter B 5 , Miyachi S 6 Show all authors , Mahadevan J 7 , Chong W 8 , Mitchell PJ 9 , Coulthard A 10 , Rowley HA 11 , Sanelli PC 12 , Tampieri D 13 , Brouwer P 14 , Fiehler J 15 , Kocer N 16 , Vilela P 17 , Rovira A 18 , Fischer U 19 , Caso V 20 , van der Wort B 21 , Sakai N 22 , Matsumaru Y 23 , Yoshimura SI 24 , Biscoito L 25 , Pumar M 26 , Diaz O 27 , Fraser J 28 , Lifante I 29 , Liebeskind DS 30 , Nogueira RG 31 , Hacke W 32 , Brainin M 33 , Yan B 34 , Soderman M 14 , Taylor A 35 , Pongpech S 36 , Terbrugge K 37

Affiliations 

  • 1 Hôpital Maison-Blanche,Université Reims-Champagne-Ardenne (URCA)Reims,France
  • 2 Warren Alpert School of Medicine at Brown University,Rhode Island,USA
  • 3 National Institute of Clinical Neurosciences,Budapest,Hungary
  • 4 Massachusetts General Hospital,Harvard Medical School,Boston,USA
  • 5 Tennessee Interventional and Imaging Associates/Erlanger,Chattanooga,USA
  • 6 Neuroendovascular Therapy Center,Aichi Medical University,Aichi,Japan
  • 7 Pantai Hospital,Kuala Lumpur,Malaysia
  • 8 Monash University,Clayton,Australia
  • 9 The Royal Hospital of Melbourne,The University of Melbourne,Parkville, Victoria,Australia
  • 10 University of Queensland,Royal Brisbane and Women's Hospital, Brisbane,Australia
  • 11 University of Wisconsin,Madison,USA
  • 12 Northwell Health,Manhasset,USA
  • 13 Queen's University,Kingston,Canada
  • 14 Karolinska University Hospital,Stockholm,Sweden
  • 15 University Medical Center Hamburg-Eppendorf,Hamburg,Germany
  • 16 Cerrahpasa Medical School, Istanbul,Istanbul University,Turkey
  • 17 Hospital Garcia de Orta,Hospital da Luz,Lisbon,Portugal
  • 18 Hospital Univesitari Vall d'Hebron,Barcelona,Spain
  • 19 University of Bern,Bern,Switzerland
  • 20 University of Perugia,Perugia,Italy
  • 21 University Medical Center,Utrecht,The Netherlands
  • 22 Comprehensive Stroke Center and Center for Clinical Research and Innovation,Kobe City Medical Center General Hospital,Kobe,Japan
  • 23 University of Tsukuba,Tsukuba,Japan
  • 24 Gifu University,Gifu-Shi,Japan
  • 25 Hospital Universitário Santa Maria,Lisbon,Portugal
  • 26 Hospital Clinico Universitário,Santiago de Compostela,Espana
  • 27 The Methodist Hospital,Houston, Texas,USA
  • 28 University of Kentucky,Lexington,USA
  • 29 Wertheim College of Medicine,Florida International University, Miami Cardiac and Vascular Institute, Baptist Hospital,Miami,USA
  • 30 UCLA,Los Angeles,USA
  • 31 Marcus Stroke and Neuroscience Center,Grady Memorial Hospital, Emory University School of Medicine,Atlanta,USA
  • 32 University of Heidelberg,Heidelberg,Germany
  • 33 Danube University Krems,Krems,Austria
  • 34 Melbourne Brain Centre at Royal Melbourne Hospital,University of Melbourne,Parkville, Victoria,Australia
  • 35 Groote Schuur Hospital,University of Cape Town,Cape Town,South Africa
  • 36 Ramathibodi Hospital,Mahidol University,Bangkok,Thailand
  • 37 University of Toronto, Toronto Western Hospital,Toronto,Canada
Can J Neurol Sci, 2019 05;46(3):269-274.
PMID: 30890199 DOI: 10.1017/cjn.2019.1

Abstract

After five positive randomized controlled trials showed benefit of mechanical thrombectomy in the management of acute ischemic stroke with emergent large-vessel occlusion, a multi-society meeting was organized during the 17th Congress of the World Federation of Interventional and Therapeutic Neuroradiology in October 2017 in Budapest, Hungary. This multi-society meeting was dedicated to establish standards of practice in acute ischemic stroke intervention aiming for a consensus on the minimum requirements for centers providing such treatment. In an ideal situation, all patients would be treated at a center offering a full spectrum of neuroendovascular care (a level 1 center). However, for geographical reasons, some patients are unable to reach such a center in a reasonable period of time. With this in mind, the group paid special attention to define recommendations on the prerequisites of organizing stroke centers providing medical thrombectomy for acute ischemic stroke, but not for other neurovascular diseases (level 2 centers). Finally, some centers will have a stroke unit and offer intravenous thrombolysis, but not any endovascular stroke therapy (level 3 centers). Together, these level 1, 2, and 3 centers form a complete stroke system of care. The multi-society group provides recommendations and a framework for the development of medical thrombectomy services worldwide.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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