Experience-driven differences in acute ischemic stroke management: A nationwide study.

Area of Science:

• Neurology
• Interventional Neurology
• Public Health

Background:

• Endovascular thrombectomy (EVT) and trial evidence have transformed acute ischemic stroke care.
• Gaps exist between guidelines and real-world practice, influenced by operator experience.

Purpose of the Study:

• To investigate physician experience-based differences in acute ischemic stroke management strategies.
• To identify variations in technical preferences and resource allocation.

Main Methods:

• A national survey with 53 questions was distributed to physicians.
• Data collected on thrombectomy, thrombolysis, anesthesia, and access site preferences.

Main Results:

• 1,289 responses from 883 hospitals were analyzed.
• Senior physicians favored thrombectomy; junior physicians preferred thrombolysis-centric approaches.
• Junior physicians were more likely to use Balloon-guide catheters (BGC), post-thrombectomy thrombolysis, local anesthesia, and radial access.

Conclusions:

• Significant heterogeneity in acute ischemic stroke management exists among Chinese physicians.
• Experience-based differences drive practice variations.
• Stratified training, standardized protocols, and collaboration are needed to harmonize care and improve evidence translation.