Innovative model improves access to life-saving stroke care while maintaining quality of care

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Apr 02, 2019, 09:00 ET

AUSTIN, Texas, April 2, 2019 /PRNewswire/ -- Training interventional radiologists to perform endovascular thrombectomies results in positive outcomes for patients experiencing stroke, according to a study presented at the Society of Interventional Radiology Annual Scientific Meeting. Expanding access to this treatment provides patients timely access to this gold-standard treatment.

"Depending on your region or geographic area, there are a limited number of thrombectomy providers, making thrombectomy access for all eligible patients is a recognized problem. According to a Wall Street Journal analysis of Medicare data, thrombectomy is only available to 2 to 3 percent of the U.S. population," said Kelvin Hong, MD, FSIR, associate professor and division chief of interventional radiology at Johns Hopkins University. "Patients don't plan where and when they have a stroke. Our model of training board-certified interventional radiologists can expand access to quality, evidence-based care, and reduce the lifelong disability associated with stroke."

Thrombectomy, a treatment that clears a clogged artery in the brain, increases the survival rates among those suffering an acute ischemic stroke, reduces the likelihood of resulting disabilities, and speeds function recovery. However, thrombectomies must be initiated and performed quickly. Many hospitals do not have providers available to perform these treatments and must transfer patients to a facility where they can get this care, losing valuable time.

To determine an efficient and sustainable way to expand access to thrombectomy, researchers from Johns Hopkins University developed an interventional radiology stroke team at Suburban Hospital consisting of four interventional radiologists who were specially trained by a neurointerventional radiologist for six months. The entire team was available 24/7 with the neurointerventional radiologist helicoptered to the hospital for every case during this training period.

"We looked to change the dynamic in stroke care. Instead of transporting medically fragile patients, we brought in a specialist to perform this care and build the infrastructure necessary to provide this treatment to a community with limited stroke care resources," said Ferdinand Hui, MD, associate professor of radiology and radiological science at Johns Hopkins University. "In a situation where every minute counts, we wanted to design our program to provide the training and organization necessary to bring highly trained stroke interventionalists online as quickly as possible."

Researchers measured the technical success of the thrombectomies performed by the newly trained physicians using the Thrombolysis in Cerebral Infarction scale and found no significant differences compared to the 2016 HERMES meta-analysis of outcomes. Additionally, 14 percent mortality in the first 90 days after the procedure was similar to 15.3 percent 90-day mortality among patients at stroke centers.

Abstract 294: Technical Outcomes and Early Experience of a Centrifugally-Trained Interventional Radiology Stroke Service.

SOURCE Society of Interventional Radiology