When an interventional cardiology center, where interventional cardiology specialists work alongside neurologists and radiologists, start a thrombectomy program in acute stroke, results achieved are similar to those at an interventional neurology center.
Mechanical thrombectomy has proven to be the best treatment option for acute ischemic stroke. However, it is not widely available, mainly due to logistic difficulties.
An endovascular treatment program for acute stroke was initiated in 2012 at a cardiac cath lab.
The decision to perform the procedure was taken by neurologists based on symptoms and tomographic findings. The primary endpoint was functional result (Modified Rankin Scale score) of patients 3 months after the procedure.
From the beginning of the program in 2012 until the end of enrollment in 2019, 333 patients were treated.
Clinical results did not change significantly during this period of time and almost half the population achieved a modified Rankin Scale score of 0-2 (47.9%).
Symptomatic intracerebral hemorrhage was observed in 5.7% of patients, while embolization of new vascular territory was informed in 1.8%.
Read also: Experts Reach Consensus on Post TAVR Pacemaker Indication.
The clinical results were as desired from the beginning of the program without the effect of a learning curve.
These data support the potential for interventional cardiologists to treat acute stroke in regions where therapy is not available due to a lack of interventional neurologists.
Conclusion
An interventional cardiology center with experienced staff working as a team with neurologists and radiologists can begin an endovascular treatment program for acute stroke with results comparable to those of a center with interventional neurologists. These results can be obtained from the start without a learning curve.
Original Title: Stable Clinical Outcomes When a Stroke Thrombectomy Program Is Started in an Experienced Cardiology Cath Lab.
Reference: Jakub Sulženko et al. JACC Cardiovasc Interv. 2021 Apr 12;14(7):785-792. doi: 10.1016/j.jcin.2021.01.025.
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