New eligibility criteria including large-core strokes could boost thrombectomy rates “dramatically”

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A study presented on the first day of the 2023 Society of NeuroInterventional Surgery (SNIS) annual meeting (31 July–4 August, San Diego, USA) has found that US rates of endovascular stroke thrombectomy are projected to increase “dramatically” based on new eligibility criteria.

Recent studies—including the MAGNA meta-analysis and TESLA trial, both of which were disclosed earlier this year at the European Stroke Organisation Conference (ESOC; 24–26 May, Munich, Germany)—have suggested that thrombectomy is a viable option for treating ischaemic stroke patients with large-core infarct volumes, opening up the potential for more people to receive this care.

As stated by an SNIS press release, this is a shift with the potential to affect hospitals across the country and require new planning efforts to accommodate additional patient needs.

Examining the projected increase in thrombectomy volumes based on findings from these large-core trials, researchers reviewed nationwide hospital admission data from 2016–2019 for people who were classified as having an ischaemic stroke in the USA. Using the new eligibility criteria for large-core ischaemic strokes, they then reclassified some patients—who did not receive stroke surgery—as new candidates for a thrombectomy procedure.

According to the study authors’ projections, this new eligibility criteria could increase rates of thrombectomies in the USA by 14–37%. These additional surgeries present new opportunities for patients to get the correct care, but may prove difficult to manage for hospitals without sufficient neurointerventionists on staff to perform them, the SNIS press release also states.

“These outcomes are inspiring, and this information gives us an important opportunity to evaluate current stroke treatment efforts across the country,” said Osman Mir (Texas Stroke Institute, Plano, USA), lead author of the study. “In addition, these numbers clearly show that we need to invest more fully in our capacity to ensure that every stroke patient across the USA can access this high-quality treatment if—or when—they need it.”


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