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Updated: Jun 17, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Performance and training standards for endovascular ischemic stroke treatment
1Radiology and Neurological Surgery, New York Presbyterian Hospital, Columbia University, College of Physicians & Surgeons, Neurological Institute, New York, New York 10032, USA. pmm2002@columbia.edu
Insights
This document defines essential training and performance standards for neuroendovascular procedures in acute ischemic stroke patients. It aims to improve patient outcomes through standardized, high-quality care.
Area of Science:
- Neuroscience
- Interventional Neurology
- Stroke Medicine
Background:
- Stroke is a leading cause of death globally, with acute ischemic stroke requiring urgent intervention.
- Endovascular therapy for acute ischemic stroke is under intense investigation, but current thrombectomy devices lack proven efficacy for improving patient outcomes.
- Existing guidelines offer qualified endorsement for intra-arterial thrombolysis in select cases.
Purpose of the Study:
- To establish comprehensive guidelines for adequate training in neuroendovascular procedures for acute ischemic stroke.
- To define performance standards for assessing the outcomes of these procedures.
- To ensure consistent and high-quality care for stroke patients undergoing endovascular interventions.
Main Methods:
- Development of guidelines through collaboration among multiple neuroscience societies.
- Involvement of organizations with historical expertise in medical, surgical, and endovascular stroke care.
- Endorsement by the Neurovascular Coalition, including major neurology and neurosurgery associations.
Main Results:
- The document outlines specific training requirements for performing neuroendovascular procedures.
- It proposes performance standards to evaluate the effectiveness and safety of these interventions.
- The guidelines aim to standardize care and improve patient outcomes in acute ischemic stroke.
Conclusions:
- Standardized training and performance metrics are crucial for effective endovascular stroke treatment.
- These guidelines provide a framework for ensuring competence in neuroendovascular procedures.
- Adoption of these standards is expected to enhance patient care and outcomes in acute ischemic stroke management.
Abstract:
Stroke is the third leading cause of death in the USA, Canada, Europe, and Japan. According to the American Heart Association and the American Stroke Association, there are now 750,000 new strokes that occur each year, resulting in 200,000 deaths, or 1 of every 16 deaths, per year in the USA alone. Endovascular therapy for patients with acute ischemic stroke is an area of intense investigation. The American Stroke Association has given a qualified endorsement of intra-arterial thrombolysis in selected patients. Intra-arterial thrombolysis has been studied in two randomized trials and numerous case series. Although two devices have been granted FDA approval with an indication for mechanical stroke thrombectomy, none of these thrombectomy devices has demonstrated efficacy for the improvement of patient outcomes. The purpose of the present document is to define what constitutes adequate training to perform neuroendovascular procedures in patients with acute ischemic stroke and what performance standards should be adopted to assess outcomes. These guidelines have been written and approved by multiple neuroscience societies which historically have been directly involved in the medical, surgical and endovascular care of patients with acute stroke. The participating member organizations of the Neurovascular Coalition involved in the writing and endorsement of this document are the Society of NeuroInterventional Surgery, the American Academy of Neurology, the American Association of Neurological Surgeons/Congress of Neurological Surgeons Cerebrovascular Section, and the Society of Vascular & Interventional Neurology.
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