European society releases proposal for Standards of Practice in interventional stroke treatment


Intense medical research and technology development have recently produced powerful new techniques to treat acute ischaemic stroke. The positive results of multiple randomised thrombectomy trials (including MR CLEAN, EXTEND-IA, ESCAPE, SWIFT PRIME, and REVASCAT) have revolutionised the management of this devastating condition and generated a sudden increase in demand for properly equipped institutions and trained personnel.

Due to the temporary shortage of these institutions and personnel, the European Society of Minimally Invasive Neurological Therapy (ESMINT), has declared its professional standpoint on the basic requirements for neurointerventional treatment of acute ischaemic stroke.

In a press release issued by the society, ESMINT’s position that the treatment of acute ischaemic stroke should only be carried out by appropriately trained personnel was made plain.

“Ischaemic stroke is a neurovascular disease. As such, all aspects of its treatment require expertise in the neurovascular field. Hence, it should be treated (either invasively or conservatively) by a trained neurovascular team. In this regard, the invasive treatment itself (thrombectomy, thrombaspiration, etc.) should be exclusively performed in neurointerventional units by properly trained personnel.

“The increased demand for a round-the-clock interventional service creates a significant challenge for most neurointerventional sites. ESMINT recommends that sites without a sufficient number of trained neurointerventionalists may employ dedicated specialists without full training in neurointerventions as supervised members of the neurointerventional team. Such individuals need to be trained to collect the necessary knowledge and experience level,” the release states.

As it relates to training, the release indicates that practical training needs to be provided by the clinical site. “ESMINT strongly discourages practicing neurointerventional treatment of acute ischaemic stroke by independent physicians or physician groups not being trained and not belonging to a neurointerventional team. ESMINT offers didactic education and certified exams through its ECMINT training course,” the release states.

Finally, the Society maintained that the requirements for a neurointerventional unit are set by the Standards of Practice in Interventional Neuroradiology, as approved by UEMS in 2011. An updated version of the Standards of Practice is expected to be published by a multisociety working group of ESMINT, ESNR and the UEMS Division of Neuroradiology in the near future.