Géraud Forestier1, Basile Kerleroux2, Kévin Janot3, François Zhu4, Victor Dumas5, Jean-François Hak6, Eimad Shotar7, Wagih Ben Hassen2, Romain Bourcier8, Sébastien Soize9, Jérome Berge10, Olivier Naggara2, Hubert Desal8, Grégoire Boulouis2, Aymeric Rouchaud11. 1. Neuroradiology department, Dupuytren, university hospital of Limoges, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France. Electronic address: geraudforestier@gmail.com. 2. Inserm UMR 1266, department of neuroradiology, université Paris-Descartes, centre hospitalier Sainte-Anne, Paris, France. 3. Neuroradiology department, university hospital of Tours, Tours, France. 4. University hospital of Nancy, Nancy, France. 5. Department of diagnostic and interventional neuroradiology, La Miletrie hospital, Poitiers, France. 6. University hospital of Marseille, Marseille, France. 7. University hospital, Pitié-Salpêtrière, Paris, France. 8. University hospital of Nantes, Nantes, France. 9. Department of diagnostic and interventional neuroradiology, hôpital Maison-Blanche, université Reims-Champagne-Ardenne, CHU Reims, Reims, France. 10. Department of neuroradiology, hopital Pellegrin, university hospital of Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France. 11. Neuroradiology department, Dupuytren, university hospital of Limoges, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France; XLIM CNRS, UMR 7252, université de Limoges, Limoges, France.
Abstract
BACKGROUND AND PURPOSE: Mechanical thrombectomy (MT) has dramatically changed the landscape of stroke care as well as stroke care organization. Public health institutions are faced with the challenge of swiftly providing equal access to this high technical level procedure with rapidly broadening indications, and constantly developing techniques. The aim of this study was to present a current nationwide overview of technical MT practices in France as well as local organizations. MATERIALS AND METHODS: Thrombectomy capable French stroke centers, and physicians performing MT were invited to participate to a nationwide survey, disseminated through an existing trainee-led research network (the JENI-RC) under the aegis of the French Society of Neuroradiology. The survey was composed of 64 questions to collect both individual practices and general center-based information. RESULTS: All French centers (100%) answered the survey, and 74% (110/148) of active interventional neuroradiologists (INR) performing MT completed individual questionnaires. The mean number of INR per center performing MT was 3.7±1.85, and 85% of the centers were organized for 24/7 continuity of care. MRI was the most commonly used imaging modality for stroke diagnosis and patients' selection, and perfusion imaging was routinely available in 85% of the centers. Half of centers performed yearly between 100 and 200 MT. Anesthesiologic, and technical considerations are also developed in the manuscript. CONCLUSIONS: This nationwide survey highlights the impressive response to the challenge of reorganization of stroke care with regards to mechanical thrombectomy in France. Technical and management disparities remain. Most centers remain understaffed to properly function in the long term, but the inflow of INT trainees is substantial.
BACKGROUND AND PURPOSE: Mechanical thrombectomy (MT) has dramatically changed the landscape of stroke care as well as stroke care organization. Public health institutions are faced with the challenge of swiftly providing equal access to this high technical level procedure with rapidly broadening indications, and constantly developing techniques. The aim of this study was to present a current nationwide overview of technical MT practices in France as well as local organizations. MATERIALS AND METHODS: Thrombectomy capable French stroke centers, and physicians performing MT were invited to participate to a nationwide survey, disseminated through an existing trainee-led research network (the JENI-RC) under the aegis of the French Society of Neuroradiology. The survey was composed of 64 questions to collect both individual practices and general center-based information. RESULTS: All French centers (100%) answered the survey, and 74% (110/148) of active interventional neuroradiologists (INR) performing MT completed individual questionnaires. The mean number of INR per center performing MT was 3.7±1.85, and 85% of the centers were organized for 24/7 continuity of care. MRI was the most commonly used imaging modality for stroke diagnosis and patients' selection, and perfusion imaging was routinely available in 85% of the centers. Half of centers performed yearly between 100 and 200 MT. Anesthesiologic, and technical considerations are also developed in the manuscript. CONCLUSIONS: This nationwide survey highlights the impressive response to the challenge of reorganization of stroke care with regards to mechanical thrombectomy in France. Technical and management disparities remain. Most centers remain understaffed to properly function in the long term, but the inflow of INT trainees is substantial.