Interdisciplinary management of acute ischaemic stroke: Current evidence training requirements for endovascular stroke treatment. Position Paper from the ESC Council on Stroke and the European Association for Percutaneous Cardiovascular Interventions with the support of the European Board of Neurointervention

Sandor Nardai; Peter Lanzer; Mark Abelson; Andreas Baumbach; Wolfram Doehner; L Nelson Hopkins; Jan Kovac; Martijn Meuwissen; Marco Roffi; Horst Sievert; Dmitry Skrypnik; Jakub Sulzenko; Wim van Zwam; Andreas Gruber; Marc Ribo; Christophe Cognard; Istvan Szikora; Olof Flodmark; Petr Widimsky

doi:10.1093/eurheartj/ehaa833

Interdisciplinary management of acute ischaemic stroke: Current evidence training requirements for endovascular stroke treatment. Position Paper from the ESC Council on Stroke and the European Association for Percutaneous Cardiovascular Interventions with the support of the European Board of Neurointervention

Eur Heart J. 2021 Jan 21;42(4):298-307. doi: 10.1093/eurheartj/ehaa833.

Authors

Sandor Nardai¹, Peter Lanzer², Mark Abelson³, Andreas Baumbach⁴, Wolfram Doehner⁵, L Nelson Hopkins⁶, Jan Kovac⁷, Martijn Meuwissen⁸, Marco Roffi⁹, Horst Sievert¹⁰, Dmitry Skrypnik¹¹, Jakub Sulzenko¹², Wim van Zwam¹³, Andreas Gruber¹⁴, Marc Ribo¹⁵, Christophe Cognard¹⁶, Istvan Szikora¹⁷, Olof Flodmark¹⁸, Petr Widimsky¹²

Affiliations

¹ Department Section of Neurointervention, National Institute of Clinical Neurosciences, Semmelweis University Heart and Vascular Center and Semmelweis University, Budapest, Hungary.
² Mitteldeutsches Herzzentrum, Standort Bitterfeld-Wolfen, Germany.
³ Vergelegen MediClinic, Somerset West, University of Cape Town, South Africa.
⁴ Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
⁵ Berlin Institute of Health Center for Regenerative Therapies (BCRT), and Department of Cardiology (Virchow Klinikum), German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, and Center for Stroke Research Berlin, Charité Universitätsmedizin Berlin, Germany.
⁶ Gates Vascular Institute and Jacobs Institute, Neurosurgery and Radiology, University at Buffalo, USA.
⁷ University Hospitals of Leicester NHS Trust, Leicester, UK.
⁸ Amphia Hospital, Breda, The Netherlands.
⁹ Division of cardiology, University Hospitals, Geneva, Switzerland.
¹⁰ CardioVascular Center Frankfurt, Germany and Anglia Ruskin University, Chelmsford, UK.
¹¹ Department of Interventional Cardiology, Moscow Hospital I. Davydovsky and Moscow State University of Medicine and Dentistry, Russian Federation.
¹² Cardiocenter, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
¹³ Department of Radiology and Nuclear Medicin, Academic Hospital of Maastricht, Maastricht, The Netherlands.
¹⁴ Universitätsklinik für Neurochirurgie, Kepler Universitäts Klinikum, Linz, Austria.
¹⁵ Department of Neurology, Hospital Wall d'Hebron, Barcelona, Spain.
¹⁶ Department of Diagnostic and Therapeutic Neuroradiology Hôpital Purpan, Toulouse, France.
¹⁷ Department Section of Neurointervention, National Institute of Clinical Neurosciences, Semmelweis University, Budapest, Hungary.
¹⁸ Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.

PMID: 33521827
DOI: 10.1093/eurheartj/ehaa833

Abstract

This ESC Council on Stroke/EAPCI/EBNI position paper summarizes recommendations for training of cardiologists in endovascular treatment of acute ischaemic stroke. Interventional cardiologists adequately trained to perform endovascular stroke interventions could complement stroke teams to provide the 24/7 on call duty and thus to increase timely access of stroke patients to endovascular treatment. The training requirements for interventional cardiologists to perform endovascular therapy are described in details and should be based on two main principles: (i) patient safety cannot be compromised, (ii) proper training of interventional cardiologists should be under supervision of and guaranteed by a qualified neurointerventionist and within the setting of a stroke team. Interdisciplinary cooperation based on common standards and professional consensus is the key to the quality improvement in stroke treatment.

Keywords: Thrombectomy; Acute ischaemic stroke; Carotid stenting; Endovascular; Interventional cardiology; Neurointervention; Training requirements.

MeSH terms

Brain Ischemia* / therapy
Endovascular Procedures*
Humans
Ischemic Stroke*
Stroke* / therapy
Thrombectomy
Treatment Outcome