Society of Interventional Radiology Training Guidelines for Endovascular Stroke Treatment

Sacks, David; AbuAwad, Mazen K.; Ahn, Sun Ho; Baerlocher, Mark O.; Brady, Paul S.; Cole, John W.; Dhand, Sabeen; Fox, Benjamin D.; Gemmete, Joseph J.; Kee-Sampson, Joanna; McCollom, Vance; Patel, Parag J.; Radvany, Martin G.; Tomalty, R Dana; Vadlamudi, Venu; Webb, Michelle; Wojak, Joan C.

doi:10.1016/j.jvir.2019.08.018

Cited by 8 publications

(4 citation statements)

References 72 publications

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“…The lack of qualified neuro-interventionalists is a barrier for the real-world practice [ 37 , 41 ]. For a physician to become a competent and safe examiner for the carotid and intracranial vasculature, at least 200 diagnostic cerebral angiograms are necessary as the training requirement [ 5 , 42 ]. Thereafter, another 200 selective vascular catheterizations are the prerequisite to becoming qualified in performing the endovascular treatment for acute ischemic stroke [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Patient-Specific 3D-Print Extracranial Vascular Simulators and Infrared Imaging Platform for Diagnostic Cerebral Angiography Training

Weng

Tsui

et al. 2022

Healthcare

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Tortuous aortic arch is always challenging for beginner neuro-interventionalists. Herein, we share our experience of using 3D-printed extracranial vascular simulators (VSs) and the infrared imaging platform (IRIP) in two training courses for diagnostic cerebral angiography in the past 4 years. A total of four full-scale patient-specific carotid-aortic-iliac models were fabricated, including one type I arch, one bovine variant, and two type III arches. With an angiography machine (AM) as the imaging platform for the practice and final test, the first course was held in March 2018 had 10 participants, including three first-year residents (R1), three second-year residents (R2), and four third-year residents (R3). With introduction of the IRIP as the imaging platform for practice, the second course in March 2022 had nine participants, including 3 R1s, 3 R2s, and 3 R3s. The total manipulation time (TMT) to complete type III aortic arch navigation was recorded. In the first course, the average TMT of the first trial was 13.1 min. Among 3 R1s and 3 R2s attending the second trial, the average TMT of the second trial was 3.4 min less than that of the first trial. In the second course using IRIP, the average TMT of the first and second trials was 6.7 min and 4.8 min, respectively. The TMT of the second trial (range 2.2~14.4 min; median 5.9 min) was significantly shorter than that of the first trial (range 3.6~18 min; median 8.7 min), regardless of whether AM or IRIP was used (p = 0.001). Compared with first trial, the TMT of the second trial was reduced by an average of 3.7 min for 6 R1s, which was significantly greater than the 1.7 min of R2 and R3 (p = 0.049). Patient-specific VSs with radiation-free IRIP could be a useful training platform for junior residents with little experience in neuroangiography.

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Section: Discussionmentioning

confidence: 99%

Patient-Specific 3D-Print Extracranial Vascular Simulators and Infrared Imaging Platform for Diagnostic Cerebral Angiography Training

Weng

Tsui

et al. 2022

Healthcare

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Section: Foundational Stroke Center Componentsmentioning

confidence: 99%

“…Formal training and case volume 40 are the 2 main determinates of improved patient outcomes; methods that ensure maintenance of procedural expertise among neurointerventionalists should be prioritized in stroke centers. 41 Telestroke Responders Access to telestroke oversight for acute stroke diagnosis, treatment, and, as needed, ongoing inpatient management plays an important role in ensuring the provision of evidence-based services in acute stroke-ready hospitals, PSCs, and TSCs. 3 Clinicians serving as telestroke responders may come from various backgrounds, including emergency medicine and advanced practice, but should be vascular neurology fellowship trained.…”

Section: Neurointerventionalistsmentioning

confidence: 99%

Ideal Foundational Requirements for Stroke Program Development and Growth: A Scientific Statement From the American Heart Association

Dusenbury¹,

Mathiesen²,

Whaley³

et al. 2023

Stroke

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Stroke center certification has evolved at a rapid pace and is now available at 4 different levels of service in the United States. Although certification standards provide guidance on stroke center process elements, lack of guidance on structural components such as workforce, staffing, and unit operations has resulted in heterogeneous services among hospitals credentialed at the same stroke center level. Such heterogeneity challenges public expectations and transparency about actual service capabilities within American stroke centers and in some cases may foster leniency in credentialing agency certification methods. Standards for other time-dependent diagnoses, including trauma, provide detailed guidance on structural elements that has improved patient triage and resuscitative care while enabling practitioners and administrators to more accurately gauge and plan service development to better support their communities. This scientific statement aims to provide similar structural guidance defined by each level of hospital stroke center services to reduce operational inconsistencies, to foster planning for service development, and to improve the interprofessional care of patients with acute stroke.

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“…Notably, these were the times when MT and intra-arterial thrombolysis were considered rescue therapies for non-responders to IVT and had no supporting evidence from clinical trials in terms of clinical outcome. To ensure the competence of ‘thrombectomists’, several countries and scientific societies have developed dedicated training programs [ 7 , 8 ]. The training is usually scheduled for 24–36 months and distinguishes the educational needs of professionals from different backgrounds (especially radiologists, cardiologists and neurologists).…”

mentioning

confidence: 99%

Designing the future of thrombectomy in Poland: first we must agree on the principles

Karliñski¹,

Kobayashi²,

Karaszewski³

et al. 2022

pwki

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Society of Interventional Radiology Training Guidelines for Endovascular Stroke Treatment

Cited by 8 publications

References 72 publications

Patient-Specific 3D-Print Extracranial Vascular Simulators and Infrared Imaging Platform for Diagnostic Cerebral Angiography Training

Patient-Specific 3D-Print Extracranial Vascular Simulators and Infrared Imaging Platform for Diagnostic Cerebral Angiography Training

Ideal Foundational Requirements for Stroke Program Development and Growth: A Scientific Statement From the American Heart Association

Designing the future of thrombectomy in Poland: first we must agree on the principles

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