A new analysis in the Journal of the American College of Radiology suggests many countries face challenges in adhering to the most current standards for radiological stroke care.
Recent neurointerventional trials have changed the way stroke care is provided. Providers have made advancements in stroke care by intervening more quickly and effectively.
“The United States and other regions have adopted updated imaging protocols when dealing with acute stroke patients because many decisions of patient selection are based on imaging,” wrote lead author Bhavya Rehani, MD, of the University of California San Francisco, and colleagues. “With so many new advancements and promising results in stroke care, countries may face challenges adapting to the most current guidelines.”
Rehani and colleagues investigated how different hospitals worldwide provide stroke care, with special emphasis on imaging, to identify and address gaps in stroke care.
A survey was sent to radiologists at hospitals in various areas including Africa, Europe, South Asia, Southeast Asia and Latin America. The most notable findings were:
- 80 percent said their hospital has MRI capabilities, though respondents from Bangladesh, Cameroon and Uganda said they did not have MRI.
- For stroke imaging protocol, non-contrast CT was the most used imaging modality to rule out intracranial hemorrhage. CT angiogram, MRI and MR angiography were also noted as part of imaging protocols.
- About two-thirds of the respondents knew about the new neurointerventional trials that have changed how the U.S. provides stroke care. Of the respondents familiar with the trials, only 20 percent said there was a change in care protocols.
- About two-thirds of respondents stated they have access to at least one neurointerventionalist. Respondents from Bangladesh, Nepal, Bhutan, Uganda and Cameroon said they did not.
- The addition of MRI and vascular imaging were included as part of the updated protocols.
- Approximately 29 percent of respondents were unsure of the door-to-CT time, while 50 percent said it was less than 30 minutes, 14 percent said 30-45 minutes and 7 percent said 60-90 minutes.
“Although standards of care are continuously revised and improved, it seems many countries face challenges in adhering to the most current standards,” Rehani and colleagues wrote. “Certain regions of the world such as Europe, Canada, and South Africa are better resourced to deliver stroke care quickly, with advanced treatment.”
The authors noted that though the information on the neurointerventional trials is available worldwide, countries with fewer resources lagged behind others.
“Improving the delivery of stroke care even in the absence of full resources provides opportunity for improvement in training and education,” the researchers wrote. “There is still a need for specialists in certain regions of the world, thus establishing training programs for neurology or neuroradiology has the potential to improve stroke care.”
As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.