Neurointerventional community moves to “Get Ahead of Stroke”

Donald Frei_main
Donald Frei

In recent years the neurointerventional field has seen many changes, especially in the area of stroke treatment. It is now becoming increasingly important how the community as a whole responds. With his term as president of the Society of NeuroInterventional Surgery now at an end, Donald Frei (Radiology Imaging Associates, Denver, USA) speaks to NeuroNews about what he was able to achieve during his time at the helm of the Society, the future of stroke treatment and the newly-established Get Ahead of Stroke initiative.

Since you took on the role as president of the Society of NeuroInterventional Surgery how has the environment in the field changed? 

In my year of SNIS presidency, we have seen the fruits of our labours in thrombectomy for ELVO (emergent large vessel occlusion) ripen. In the USA, thrombectomy for ELVO will double from 2014–2016. It is paramount that we rapidly develop our systems of care to identify and treat our patients as quickly as possible for the best outcomes.

What do you think are the key issues in the field of neurointerventional surgery that need to be addressed? 

We need to take the lead on establishing state legislation and systems of care to rapidly identify, transport and treat our ELVO patients. This effort includes educating EMS (emergency medical services) on ELVO triage tools, working with our local and state health departments and EMS medical directors and our state legislation to get ELVO patients rapidly to the right hospital for treatment.

What strategies did you implement to secure the future of the Society and the field as a whole? 

The SNIS, along with multiple international neuroInterventional societies, established training guidelines for physicians performing endovascular stroke therapy. Board certification is the next step so that our patients are safely cared for by the most qualified neurointerventional physicians. In the USA, this multidisciplinary effort is being led by the Society of Neurological Surgeons, with input from neurointerventionalists from neuroradiology, neurology and neurosurgical backgrounds. I would encourage all neurointerventionalists to become certified. To start the application, please visit this page

During your presidency the Get Ahead of Stroke initiative was launched. What is the purpose of this initiative and how does it work? 

Every 40 seconds, a patient has a stroke. The right treatment can mean the difference between life and death. The right treatment for ELVO patients is thrombectomy. The SNIS has embarked on an effort to get ELVO patients rapidly to a stroke surgeon for treatment. This effort is called Get Ahead of Stroke. The goal of this effort is to establish EMS triage tools and local and state legislated transport protocols so ELVO patients are identified in the field and rapidly transported to the right place (a neurointerventional capable hospital) for the right treatment (thrombectomy) by the right person (a stroke surgeon—a fellowship-trained neurointerventionalist). We welcome partnership from any group who is interested in improving stroke care. Organisations which have joined our effort include the National Stroke Association and the Joe Kniekro Foundation, a national stroke patient support group.

Why would someone want to be involved with Get Ahead of Stroke and how would they go about this?

Stroke is a leading cause of death and the number one cause of adult disability. Stroke costs the USA US$34 billion each year, with 800,000 people having a stroke every year. This disease affects everyone, either as a patient, a caregiver, family or friend. Everyone should want to be involved in this effort. Who would not want to ensure that every stroke patient gets the best care?  All you need to do is go to and take the pledge. We know that thrombectomy saves lives, gets more patients back to independence and ultimately saves healthcare dollars. All patients should have rapid and equal access to effective treatment. That is what Get Ahead of Stroke is all about.

The Journal of NeuroInterventional Surgery has become increasingly popular and the impact factor was increased this year. To what do you attribute its success?

The efforts of our editor-in-chief, Rob Tarr, and his associate editors need to be recognised. They are responsible for the excellent finished product we read every month. There was a need for a robust peer reviewed journal in the neurointerventional space, and previous leaders of the SNIS also need to be recognised for their vision in establishing the Journal of NeuroInterventional Surgery five years ago. The last group that cannot be overlooked are the neurointerventional physicians worldwide who submit excellent works of research and science to the journal.

The Journal of NeuroInterventional Surgery is recognised as the premier journal in the neurointerventional space, and all who contribute to its success should be applauded.