Forestier Géraud, Hanning Uta, Kaesmacher Johannes, Boulouis Grégoire, Zeleňák Kamil, Januel Anne-Christine, Kulcsár Zsolt, Fiehler Jens, Rouchaud Aymeric
Neuroradiology Department, University Hospital of Limoges, Dupuytren, France.
Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf Hamburg, Hamburg, Germany.
Eur Stroke J. 2024 Oct 10:23969873241286000. doi: 10.1177/23969873241286000.
Mechanical thrombectomy (MT) has revolutionized the prognosis of acute ischemic stroke. Indications for MT are constantly expanding across countries, presenting healthcare professionals, and institutions with the challenge of offering MT to the entire population despite geographic constraints, while also training enough interventional neuroradiologists (INR) for this highly technical-level procedure. We aimed to provide an overview of current European MT practices and organizations in 2021.
Members of the European Society of Minimally Invasive Neurological Therapy (ESMINT) were invited to complete two different online surveys from March to November 2021 to collect data on MT practice.
A total of 240 individual responses from INR (from 33 European countries) were received. These included information from 56 thrombectomy-capable stroke centers (TCSC) data (across 26 European countries). The mean number of INR per center was 3.8 ± 1.43, median 4 (IQR, 3-4.5). Half of the centers (28/56, 50.00%) performed less than 150 MT per year. Most INR used a balloon guide catheter in less than 50% of cases (160/240, 66.67%), and limited the number of recanalization attempts to six passes to restore flow (209/240, 87.08%). Additionally, 37.92% of the respondents (91/240, 37.92%) indicated that they already performed MT for distal occlusions (M3, M4) as part of their routine practice. Other details of the MT procedure, anesthetic management, and patient selection are also presented and discussed.
This European survey emphasizes the differences between TCSC and INR in modern thrombectomy practices. Even if most centers remain understaffed to meet current and future MT needs, most European TCSCs are actively training young INR.
机械取栓术（MT）彻底改变了急性缺血性卒中的预后。MT的适应证在各国不断扩大，这给医疗保健专业人员和机构带来了挑战，即尽管存在地理限制，仍要为全体人群提供MT，同时还要为这一高技术水平的手术培训足够数量的介入神经放射科医生（INR）。我们旨在概述2021年欧洲当前的MT实践和组织情况。
邀请欧洲微创神经治疗学会（ESMINT）成员在2021年3月至11月期间完成两项不同的在线调查，以收集MT实践的数据。
共收到来自33个欧洲国家的INR的240份个人回复。其中包括来自56个具备取栓能力的卒中中心（TCSC）的数据（分布在26个欧洲国家）。每个中心INR的平均数量为3.8±1.43，中位数为4（四分位间距，3 - 4.5）。一半的中心（28/56，50.00%）每年进行的MT手术少于150例。大多数INR在不到50%的病例中使用球囊导引导管（160/240，66.67%），并将再通尝试次数限制在6次以恢复血流（209/240，87.08%）。此外，37.92%的受访者（91/240，37.92%）表示他们已经将对远端闭塞（M3、M4）进行MT作为常规实践的一部分。还介绍并讨论了MT手术的其他细节、麻醉管理和患者选择。
这项欧洲调查强调了现代取栓实践中TCSC和INR之间的差异。即使大多数中心人员配备不足，无法满足当前和未来的MT需求，但大多数欧洲TCSC仍在积极培训年轻的INR。
