title: Performance and training standards for endovascular ischemic stroke treatment.
abstract: Stroke is the third-leading cause of death in the United States, Canada, Europe, and Japan. According to the American Heart Association and the American Stroke Association, 750,000 new strokes occur each year, resulting in 200,000 deaths (or 1 of every 16 deaths) per year in the United States alone. Endovascular therapy for patients with acute ischemic stroke is an area of intense investigation. The American Stroke Association has given a qualified endorsement of intra-arterial (IA) thrombolysis in selected patients. IA thrombolysis has been studied in 2 randomized trials and numerous case series. Although 2 devices have been granted FDA 3 approval with an indication for mechanical stroke thrombectomy, none of these devices has demonstrated efficacy in improving patient outcomes. This report defines what constitutes adequate training to perform neuroendovascular procedures in patients with acute ischemic stroke and identifies the performance standards that should be adopted to assess outcomes. These guidelines have been written and approved by multiple neuroscience societies that historically have been directly involved in the medical, surgical, and endovascular care of patients with acute stroke, including the Neurovascular Coalition and its participating societies: the Society of NeuroInterventional Surgery; American Academy of Neurology; American Association of Neurological Surgeons, Cerebrovascular Section; and Society of Vascular & Interventional Neurology.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Meyers
authors.forename: H Christian
authors.initials: HC
authors.lastname: Schumacher
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Alexander
authors.forename: Colin P
authors.initials: CP
authors.lastname: Derdeyn
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Furlan
authors.forename: Randall T
authors.initials: RT
authors.lastname: Higashida
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Moran
authors.forename: Robert W
authors.initials: RW
authors.lastname: Tarr
authors.forename: Donald V
authors.initials: DV
authors.lastname: Heck
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Hirsch
authors.forename: Mary E
authors.initials: ME
authors.lastname: Jensen
authors.forename: Italo
authors.initials: I
authors.lastname: Linfante
authors.forename: Cameron G
authors.initials: CG
authors.lastname: McDougall
authors.forename: Gary M
authors.initials: GM
authors.lastname: Nesbit
authors.forename: Peter A
authors.initials: PA
authors.lastname: Rasmussen
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Tomsick
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Wechsler
authors.forename: John R
authors.initials: JR
authors.lastname: Wilson
authors.forename: Osama O
authors.initials: OO
authors.lastname: Zaidat
mesh_terms: D006801:Humans; D002545:Brain Ischemia / Q000150:complications / Q000601:surgery / Q000628:therapy; D002983:Clinical Competence / Q000592:standards; D003406:Credentialing; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000592:standards; D019635:Neurosurgical Procedures / Q000193:education / Q000592:standards; D011787:Quality of Health Care / Q000592:standards; D012955:Societies, Medical; D020521:Stroke / Q000209:etiology / Q000601:surgery / Q000628:therapy; D013647:Task Performance and Analysis; D017131:Thrombectomy / Q000193:education / Q000592:standards; D015912:Thrombolytic Therapy / Q000592:standards; D017410:Practice Guidelines as Topic