Doctors diagnose strokes by X-ray.
Currently, only neuroradiology centers are capable of performing thrombus removal procedures on stroke patients. A new study says that cardiologists with surgical experience can perform the procedure with only a short training period, and the results are no different from the clinical outcomes of neuroradiology center procedures.
Thrombectomy is a particularly important procedure for patients with severe strokes, but many patients go untreated because of the lack of physicians qualified in neurointerventional surgery in many parts of the world. Studies estimate that about 15 percent of stroke patients in Europe are eligible for thrombectomy, but only 2 percent of patients are treated.
The study, published April 12 in the Journal of the American College of Cardiology: Cardiovascular Interventions, reports on a study conducted at the University Hospital Kralovske Vinohrady in Prague, Czech Republic. Vinohrady, Prague, Czech Republic, on a stroke thrombectomy program.
Principal investigator Petr Widimsky said, “Having cardiologists operate this intervention helps address the huge gap in the current demand for stroke thrombectomy.”
The hospital did not establish a joint neurointerventional surgery program consisting of cardiologists, vascular specialists and an interventional radiologist to train cardiologists to operate the thrombus removal procedure until 2012.
This report says that 333 patients with large-vessel occlusive strokes were treated by this program between October 2012 and December 2019.
Of those patients, 47.9% had satisfactory surgical outcomes. 19 patients (5.7%) developed symptomatic brain hemorrhage and 6 patients (1.8%) developed a new embolus in another vascular region, a rate similar to the results of treatment at the neuroradiology center.
Moreover, the report says that the results of the procedure were stable from the beginning of the program and that there was no gradual improvement in clinical outcomes as the operating physicians became more familiar with their skills.
The main message we want to send is that our program outcomes were good from the beginning,” says Wiedimsky. Once the treatment center is ready, cardiologists with experience in interventional surgery, after spending sufficient time getting to know the brain, are able to achieve fairly good results.”
The medical website Medscape reports that while this option seems feasible in Europe, neurointerventional surgeons in the United States are strongly opposed to it.
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