New criteria could dramatically increase rates of endovascular thrombectomy

A recent study presented today at the Society of NeuroInterventional Surgery's (SNIS) 20th Annual Meeting noted that U.S. rates of endovascular thrombectomy, a lifesaving stroke treatment, are projected to increase dramatically based on new criteria.

In the study, endovascular thrombectomy was shown to improve clinical outcomes in patients with large ischemic strokes. This change has the potential to affect hospitals across the country and require new planning efforts to accommodate these additional patient needs.

A large ischemic stroke occurs when a large or main blood vessel is blocked (often by a blood clot), depriving the brain of oxygen and causing severe damage. Thrombectomy, a minimally invasive procedure that uses a catheter to reopen blocked arteries in the brain, is the gold standard of care for this type of stroke. The faster patients who need this surgery receive it, the better their chances of avoiding death or long-term disability from stroke.

Recent studies have suggested that endovascular thrombectomy is a viable option for treating large ischemic strokes, opening up the potential for more people to receive this care.

Researchers in this study, "Projected Increase in Thrombectomy Volume Based on Large Core Trials," reviewed nationwide hospital admission data from 2016–2019 for people who were classified as having an ischemic stroke. Using the new eligibility criteria for large ischemic strokes, they then re-classified some patients who did not receive stroke surgery as new candidates for the surgery. According to the study authors' projections, this new eligibility criteria could increase rates of thrombectomies in the U.S. by 14%–37%. These additional surgeries present new opportunities for patients to get the correct care, but also may prove difficult to manage for hospitals without sufficient neurointerventionalists on staff to perform these surgeries.

These outcomes are inspiring, and this information gives us an important opportunity to evaluate current stroke treatment efforts across the country. In addition, these numbers clearly show that we need to invest more fully in our capacity to ensure that every stroke patient across the U.S. can access this high-quality treatment if-;or when-;they need it."

Dr. Osman Mir, a vascular and interventional neurologist at Texas Stroke Institute and lead author of the study