title: Performance and training standards for endovascular acute 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, there are now 750,000 new strokes that 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 thrombolysis in selected patients. Intra-arterial thrombolysis has been studied in 2 randomized trials and numerous case series. Although 2 devices have been granted FDA phase 3 approval with an indication for mechanical stroke thrombectomy, none of these thrombectomy devices has demonstrated efficacy for the improvement of patient outcomes. The purpose of the present document is to define what constitutes adequate training to perform neuroendovascular procedures in patients with acute ischemic stroke and what performance standards 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. These organizations include the Neurovascular Coalition and its participating societies, including the Society of NeuroInterventional Surgery (SNIS), American Academy of Neurology (AAN), American Association of Neurological Surgeons/Cerebrovascular Section (AANS/CNS), and Society of Vascular & Interventional Neurology (SVIN).
authors.affiliation: New York Presbyterian Hospital, Columbia University, College of Physicians & Surgeons, Neurological Institute, New York, NY, USA.
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: D000068:Accreditation / Q000379:methods / Q000592:standards; D002545:Brain Ischemia / Q000175:diagnosis / Q000628:therapy*; D002983:Clinical Competence / Q000592:standards*; D004503:Education, Medical, Graduate / Q000379:methods / Q000592:standards*; D057510:Endovascular Procedures / Q000379:methods / Q000592:standards*; D006801:Humans; D020521:Stroke / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome