Endovascular treatment of acute ischemic stroke in France: a nationwide survey

J Neuroradiol. 2014 Mar;41(1):71-9. doi: 10.1016/j.neurad.2013.12.002. Epub 2014 Jan 23.

Abstract

Background and purpose: 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.

Materials and 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.

Keywords: Endovascular; Report; Stroke; Survey; Thrombectomy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / epidemiology*
  • Brain Ischemia / surgery*
  • Comorbidity
  • Endovascular Procedures / mortality*
  • Endovascular Procedures / statistics & numerical data*
  • Female
  • France / epidemiology
  • Health Care Surveys
  • Humans
  • Male
  • Middle Aged
  • Neuroradiography / statistics & numerical data*
  • Prevalence
  • Risk Factors
  • Stroke / diagnostic imaging
  • Stroke / mortality*
  • Stroke / surgery*
  • Survival Rate
  • Utilization Review