Nima Kashani1,2, Petra Cimflova1,3, Johanna M Ospel1,4, Manon Kappelhof1,5, Nishita Singh3, Rosalie V McDonough3, Mohammed A Almekhlafi3, Michael Chen6, Nobuyuki Sakai7, Jens Fiehler8, Uzair Ahmed2, Lissa Peeling2, Michael Kelly2, Mayank Goyal9,10. 1. Department of Diagnostic Imaging, Foothills Medical Center, University of Calgary, 1403 29th St.NW, T2N2T9, Calgary, AB, Canada. 2. Department of Neurosurgery, Royal University Hospital, Saskatoon, SK, Canada. 3. Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada. 4. Department of Radiology, University Hospital of Basel, Basel, Switzerland. 5. Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands. 6. Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA. 7. Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan. 8. Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, Germany. 9. Department of Diagnostic Imaging, Foothills Medical Center, University of Calgary, 1403 29th St.NW, T2N2T9, Calgary, AB, Canada. mgoyal2412@gmail.com. 10. Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada. mgoyal2412@gmail.com.
Abstract
BACKGROUND: Endovascular treatment (EVT) for stroke due to medium vessel occlusion (MeVO) can be technically challenging and specific endovascular tools are needed to safely and effectively recanalize these relatively small and fragile vessels. We aimed to gain insight into availability and desired qualities of endovascular devices used in MeVO stroke and examined barriers to adoption of MeVO EVT in clinical practice on a global scale. METHODS: We conducted a case-based international survey among neurointerventionalists. As a part of the survey, participants were asked whether they felt appropriate endovascular tools for MeVO stroke exist and are available to them in their clinical practice. We then examined barriers to adopting MeVO EVT and analyzed them by geographic regions. RESULTS: A total of 263 neurointerventionists participated, of which 178 (67.7%) and 83 (31.6%) provided responses on desired qualities of MeVO EVT tools and on barriers to their adoption in local practice, respectively. The majority 121/178 (68%) felt there was substantial room for improvement regarding existing tools. A large proportion 131/178 (73.6%) felt they had appropriate access to existing tools. The most commonly mentioned barrier for adopting MeVO EVT in North America was "awaiting better tools" (9/28 responses, 32.1%), while "awaiting better evidence" (8/26 responses, 30.8%), and the need for improved "funding" (7/26 responses, 26.9%) were important barriers in Europe. CONCLUSION: The majority of surveyed neurointerventionalists felt that dedicated MeVO EVT tools can be substantially improved upon. Different regions face various challenges in adoption of MeVO EVT, but overall, physicians are mostly awaiting better MeVO EVT tools.
BACKGROUND: Endovascular treatment (EVT) for stroke due to medium vessel occlusion (MeVO) can be technically challenging and specific endovascular tools are needed to safely and effectively recanalize these relatively small and fragile vessels. We aimed to gain insight into availability and desired qualities of endovascular devices used in MeVO stroke and examined barriers to adoption of MeVO EVT in clinical practice on a global scale. METHODS: We conducted a case-based international survey among neurointerventionalists. As a part of the survey, participants were asked whether they felt appropriate endovascular tools for MeVO stroke exist and are available to them in their clinical practice. We then examined barriers to adopting MeVO EVT and analyzed them by geographic regions. RESULTS: A total of 263 neurointerventionists participated, of which 178 (67.7%) and 83 (31.6%) provided responses on desired qualities of MeVO EVT tools and on barriers to their adoption in local practice, respectively. The majority 121/178 (68%) felt there was substantial room for improvement regarding existing tools. A large proportion 131/178 (73.6%) felt they had appropriate access to existing tools. The most commonly mentioned barrier for adopting MeVO EVT in North America was "awaiting better tools" (9/28 responses, 32.1%), while "awaiting better evidence" (8/26 responses, 30.8%), and the need for improved "funding" (7/26 responses, 26.9%) were important barriers in Europe. CONCLUSION: The majority of surveyed neurointerventionalists felt that dedicated MeVO EVT tools can be substantially improved upon. Different regions face various challenges in adoption of MeVO EVT, but overall, physicians are mostly awaiting better MeVO EVT tools.
Authors: Johanna M Ospel; Bijoy K Menon; Andrew M Demchuk; Mohammed A Almekhlafi; Nima Kashani; Arnuv Mayank; Enrico Fainardi; Marta Rubiera; Alexander Khaw; Jai J Shankar; Dar Dowlatshahi; Josep Puig; Sung-Il Sohn; Seong H Ahn; Alexandre Poppe; Ana Calleja; Michael D Hill; Mayank Goyal Journal: Stroke Date: 2020-10-19 Impact factor: 7.914
Authors: Hulin Kuang; Wu Qiu; Anna M Boers; Scott Brown; Keith Muir; Charles B L M Majoie; Diederik W J Dippel; Phil White; Jonathan Epstein; Peter J Mitchell; Antoni Dávalos; Serge Bracard; Bruce Campbell; Jeffrey L Saver; Tudor G Jovin; Marta Rubiera; Alexander V Khaw; Jai J Shankar; Enrico Fainardi; Michael D Hill; Andrew M Demchuk; Mayank Goyal; Bijoy K Menon Journal: Stroke Date: 2020-12-07 Impact factor: 7.914
Authors: Carlos Pérez-García; Santiago Rosati; Carlos Gómez-Escalonilla; Juan Arrazola; Alfonso López-Frías; Eva González; Jon Fondevila; Pedro Vega; Eduardo Murias; Elvira Jimenez-Gomez; Isabel Bravo Rey; Juan Macho; Luis San Roman; Isabel Rodriguez Caamaño; Andres Julián Paipa; Sebastian Remollo; Yeray Aguilar Tejedor; Isabel Bermúdez-Coronel; Sarai Moliner; José Manuel Pumar; Saima Bashir; Josep Puig; Antonio López-Rueda; Jordi Blasco; Raul G Nogueira; Manuel Moreu Journal: J Neurointerv Surg Date: 2021-11-08 Impact factor: 8.572