Societies join to release new training guidelines to help ensure optimal outcomes for ischemic stroke patients

The Society of NeuroInterventional Surgery (SNIS) today joined 14 other neurointerventional medical societies in releasing new training guidelines for endovascular intervention in ischemic stroke patients. The guidelines were developed by an international, multidisciplinary group of neurointerventional medical societies and will be published in seven journals, including the Journal of NeuroInterventional Surgery. This is the first time that such a comprehensive group has come together to define the training requirements for physicians to safely and effectively perform inside-the-artery clot removal in the brain, known as neurointerventional surgery.

Ischemic stroke, which results from a blockage in a vessel supplying blood to the brain, accounts for 87 percent of all strokes in the United States and is a leading cause of death and disability worldwide. The risk of long-term disability is even higher for patients with blockages in large vessels. Until recently, intravenous tissue plasminogen activator (t-PA) was the only proven treatment for large vessel blockages. However, a number of recent clinical trials have provided sufficient evidence to establish neurointerventional surgery as the standard of care for ischemic stroke patients with large vessel blockages.

Given the intricacies of the brain, it is critical that endovascular treatment is administered in a stroke center by an experienced physician with a neuroscience background and dedicated neurointerventional training to ensure the best possible outcomes for the patient.

"Not all vascular systems are the same," said Dr. Karel terBrugge, the Chief of Neuroradiology at Toronto Western Hospital. "These guidelines underscore the importance of a collaborative acute stroke team approach, knowledgeable with respect to the clinical and imaging findings in acute stroke patients and the training needed to acquire the unique technical skills to operate in one of the body's most complex organs."

While treatment standards and training guidelines on various neurointerventional procedures, including endovascular therapy for ischemic stroke, have previously been developed and endorsed by SNIS and other multispecialty groups, these new guidelines are the first to result from the cumulative work of key international neurointerventional medical societies. The guidelines define the basic training and qualifications required of new practitioners who are not currently performing inside-the-artery clot removal in the brain, as well as the requirements of the hospitals where these procedures can be performed.

"These new guidelines represent a major step forward in the field of neurointerventional surgery," said Dr. Donald Frei, a neurointerventional surgeon at Radiology Imaging Associates in Denver and president of SNIS. "While SNIS has long been championing the important role of the neurointerventionalist in ensuring positive outcomes for stroke patients, this consensus among a distinguished group of organizations elevates the importance of appropriate education, training and quality assurance processes to effectively treat a very time-sensitive, life-threatening condition."

In addition to the Journal of NeuroInterventional Surgery, the guidelines will also be published in Interventional Neuroradiology, American Journal of Neuroradiology, Journal of Interventional Neurology, the eJournal of the European Society of Minimally Invasive Neurological Therapy (EJMINT), Journal of Neuroendovascular Therapy, Neuroradiology and Neurosurgery.

The following societies contributed to the development of the training guidelines: American Academy of Neurological Surgeons/Congress of Neurological Surgeons; American Society of Neuroradiology; Asian Australasian Federation of Interventional and Therapeutic Neuroradiology; Australian and New Zealand Society of Neuroradiology - Conjoint Committee for Recognition of Training in Interventional Neuroradiology (CCINR) representing the RANZCR (ANZSNR), ANZAN and NSA; Canadian Interventional Neuro Group; European Society of Neuroradiology; European Society of Minimally Invasive Neurologic Therapy; Japanese Society for Neuroendovascular Therapy; Sociedad Ibero Latino Americana de Neuroradiologica; Society of NeuroInterventional Surgery; Society of Vascular and Interventional Neurology; and the World Federation of Interventional and Therapeutic Neuroradiology.