Endovascular treatment of acute ischemic stroke in France: a nationwide survey.
OBJECTIVE
Developments in endovascular treatment have opened new promising prospects for treating acute ischemic stroke. In France, EVT is increasingly used, especially when intravenous thrombolysis is contraindicated or has failed. However, it has not been documented how neurointerventional centers are organized practically for the treatment of AIS. The present survey aims to address this.


METHODS
The centers in France that are authorized to perform EVT for AIS were invited to participate to an electronic survey. The survey was composed of 33 questions, divided into 6 subheadings: (1) general information, (2) imaging modalities, (3) patient selection, (4) anesthesiology, (5) endovascular procedure and (6) imaging follow-up.


RESULTS
The response rate was high at 93.9%. Neuroradiology centers are organized to perform mechanical thrombectomy around the clock in 80.6% of the institutions. MRI was the most commonly used imaging modality to examine acute stroke, alone in 64.5% or in combination with CT in 22.6%. The median number of neurointerventionalists was 3 per center and the median number of procedures performed in 2012 was 925. Since the medical treatment is complex, an anesthesiologist is often required during the procedure (87.1%). Technical issues are also developed in the manuscript.


CONCLUSIONS
This survey shows that French neuroradiology departments have made important efforts to implement EVT of AIS with a high quality of care for the patients; the majority of the centers used MRI to evaluate the disease and anesthesiologists are involved in order to optimize medical care during EVT.
Department of radiology, hôpital Maison-Blanche, université de Champagne-Ardenne, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims, France.
Sébastien
S
Soize
Inserm U894, department of neuroradiology, université Paris Descartes, Sorbonne Paris Cité, centre hospitalier Sainte-Anne, Paris, France.
Olivier
O
Naggara
Department of neuroradiology, hôpital G.-et-R.-Laënnec, CHU de Nantes, Nantes, France.
Hubert
H
Desal
Department of neuroradiology, hôpital Gui-de-Chauliac, CHU de Montpellier, Montpellier, France.
Vincent
V
Costalat
Department of neuroradiology, CHU de Dijon, Dijon, France.
Frédéric
F
Ricolfi
Department of radiology, hôpital Maison-Blanche, université de Champagne-Ardenne, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims, France. Electronic address: lpierot@gmail.com.
Laurent
L
Pierot
D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D015897:Comorbidity; D057510:Endovascular Procedures / Q000401:mortality* / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009485:Neuroradiography / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D015996:Survival Rate; D014600:Utilization Review
Endovascular; Report; Stroke; Survey; Thrombectomy