Training interventional radiologists improves patient access to stroke care

Training interventional radiologists how to perform endovascular thrombectomies is an effective way to improve patient care, according to research presented at the Society of Interventional Radiology’s 2019 Annual Scientific Meeting in Austin, Texas. Thrombectomies must be performed quickly, the study’s authors noted, so it is crucial for more providers to be trained in this area.

“With a limited availability of providers, thrombectomy is only available to 2 to 3 percent of eligible patients in the United States,” co-author Kelvin Hong, MD, associate professor and division chief of interventional radiology at Johns Hopkins University in Baltimore, said in a prepared statement. “Patients don’t plan where and when they have a stroke. Our model of training board-certified interventional radiologists can expand access to quality, evidence-based care, and reduce the lifelong disability associated with stroke.”

The researchers developed an interventional radiology stroke team at a single community hospital. The team, which included four interventional radiologists who had undergone six months of training with a neurointerventional radiologist, was available 24 hours a day. The neurointerventional radiologist was then brought to the hospital for each thrombectomy.

“We looked to change the dynamic in stroke care, where instead of transporting medically fragile patients, we brought in a specialist to perform this care and build the infrastructure necessary to provide this treatment to a community with limited stroke care resources,” co-author Ferdinand Hui, MD, associate professor of radiology and radiological science at Johns Hopkins University, said in the same statement. “In a situation where every minute counts, we wanted to design our program to provide the training and organization necessary to bring 24/7 highly trained stroke interventionalists online as quickly as possible.”

So how did the newly trained radiologists do? Quite well, the authors reported. Using the Thrombolysis in Cerebral Infarction scale, the team found “no significant differences” in how interventional radiologists performed during their 35 stroke cases and how other practitioners had performed in a prior study. In addition, the mortality rate in the first 90 days following the procedure was 14 percent, similar to the 15.3 percent achieved by other practitioners. Finally, the median interval from symptom onset to restored blood flow was 325 minutes for the radiologists, longer than the 285 minutes noted in a previous study.

Further research is planned, according to the statement, “with a goal of further reducing the time to treat each patient by improving efficiency and optimization.”