More radiologists need training to provide stroke care

Interventional radiologists need training in treating strokes as a critical first step in getting timely care to patients.

There’s limited ability for patients to access stroke centers able to provide thrombectomy services, contend three global interventional radiological groups, highlighting the need to train and empower radiologists to deliver appropriate treatment.

The position statement brings together the Society of Interventional Radiology (SIR), Cardiovascular and Interventional Radiology Society of Europe (CIRSE) and the Interventional Radiology Society of Australasia (IRSA). The groups have committed to providing necessary stroke training to interventional radiologists to alleviate the shortage of physicians trained in endovascular stroke therapies.

“The shortage of physicians and comprehensive stroke centers … has been confirmed by the stroke neurology community, who recommend that patients be treated locally rather than having long transfer delays,” the statement said.

The chief concern is the need to provide patients with endovascular thrombectomy, clot removal treatment known by the acronym EVT. The American Heart Association and several international stroke organizations recommend that EVT be the standard of care for patients with acute ischemic stroke caused by blocked arteries.

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The real-world use of endovascular thrombectomy saves lives and improves outcomes for patients suffering acute ischemic strokes. Patients who undergo these clot-removing treatments not only survive in greater numbers, but also have fewer resulting disabilities and are able to recover functions faster than best medical therapy.

“Appropriately trained interventional radiologists can evaluate stroke patients and provide emergent EVT with good outcomes … especially where neurointerventional physicians are not available,” says the three organizations’ statement. Interventional radiologists also can help provide round-the-clock care in partnership with neurointerventional physicians where they are available, they say.

“Reversing symptoms from these strokes requires rapid and safe removal of the occluding thrombus,” the societies said in the statement. Allowing interventional radiologists to join their neurology, neurointerventional and neurosurgeon colleagues on care teams and allowing them to be part of certified stroke centers will greatly increase access to this critical treatment, they contend.

Stroke affects 16.9 million worldwide each year, with 795,000 new cases in the United States annually. Approximately 100,000 of the U.S. cases are eligible for EVT treatment, but only a fraction are treated because of the shortage of thrombectomy-capable stroke centers. To meet that volume, the U.S. would need 500 endovascular stroke centers and 2,000 physicians. It currently has 231 thrombectomy-capable stroke centers.

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