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Effect of Operator's Experience on Proficiency in Mechanical Thrombectomy: A Multicenter Study
François Zhu1, Wagih Ben Hassen2, Nicolas Bricout3
1Department of Diagnostic and Therapeutic Neuroradiology, F-54000, CHRU Nancy and IADI, INSERM U1254, F-54000, Université de Lorraine, Nancy, France (F.Z., B.G., R.A.).
Stroke
|July 8, 2021
Summary
Increasing experience in mechanical thrombectomy (MT) improves procedural efficiency and outcomes for interventional neuroradiologists. Performance plateaus around 100 procedures, suggesting new standards for training and recertification.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Stroke Treatment
Background:
- Mechanical thrombectomy (MT) is a standard treatment for ischemic stroke.
- Assessing the impact of operator experience on MT procedural outcomes is crucial.
Purpose of the Study:
- To evaluate if increasing individual experience correlates with improved performance metrics in mechanical thrombectomy (MT).
Main Methods:
- Pooled procedural data from 4516 MT procedures across 7 centers.
- Operator experience defined as cumulative MT procedures performed since 2015.
- Statistical analysis to associate operator experience with procedural metrics.
Main Results:
- Higher operator experience significantly correlated with shorter procedural duration (P<0.001).
- Increased experience was linked to better Thrombolysis in Cerebral Infarction (TICI) scores (P=0.013).
- A potential ceiling effect in performance was observed around 100 procedures.
Conclusions:
- Growing experience in MT by trained interventional neuroradiologists leads to improved procedural duration and reperfusion rates.
- Results suggest establishing experience benchmarks for autonomization and recertification.
- A performance plateau around 100 procedures may inform future training guidelines.
