Challenges to Widespread Implementation of Stroke Thrombectomy

Johanna Maria Ospel; William K. Diprose; Aravind Ganesh; Sheila Martins; Thanh Nguyen; Marios Psychogios; Ossama Mansour; Fahad Al-Ajlan; Pengfei Yang; Jeyaraj Pandian; Anil Gopinathan; Else Charlotte Sandset; James Kennedy; David Volders; Robert Fahed; Stavropoula Tjoumakaris; Pervinder Bhogal; Martin Kurz; Dileep Yavagal; Violiza Inoa; Michael D. Hill; Mayank Goyal

doi:10.1161/STROKEAHA.124.045889

Challenges to Widespread Implementation of Stroke Thrombectomy

Johanna Maria Ospel
, William K. Diprose
, Aravind Ganesh
, Sheila Martins
, Thanh Nguyen
, Marios Psychogios
, Ossama Mansour
, Fahad Al-Ajlan
, Pengfei Yang
, Jeyaraj Pandian
, Anil Gopinathan
, Else Charlotte Sandset
, James Kennedy
, David Volders
, Robert Fahed
, Stavropoula Tjoumakaris
, Pervinder Bhogal
, Martin Kurz
, Dileep Yavagal
, Violiza Inoa

Michael D. Hill, Mayank Goyal^*

^*Corresponding author for this work

University of Calgary
University of Calgary
Hospital Moinhos de Vento
Boston Medical Center
University of Basel
Faculty of Medicine
King Faisal Specialist Hospital and Research Centre
Naval Medical University
Christian Medical College
MOH Holdings Pte Ltd.
University of Oslo
Oxford University Hospitals NHS Foundation Trust
Dalhousie University
University of Ottawa
Thomas Jefferson University
Barts Health NHS Trust
Stavanger University Hospital
Miller School of Medicine
University of Tennessee Health Science Center

Research output: Contribution to journal › Review article › peer-review

13 Scopus citations

Abstract

Endovascular treatment (EVT) for acute ischemic stroke is one of the most efficacious and effective treatments in medicine, yet globally, its implementation remains limited. Patterns of EVT underutilization exist in virtually any health care system and range from a complete lack of access to selective undertreatment of certain patient subgroups. In this review, we outline different patterns of EVT underutilization and possible causes. We discuss common challenges and bottlenecks that are encountered by physicians, patients, and other stakeholders when trying to establish and expand EVT services in different scenarios and possible pathways to overcome these challenges. Lastly, we discuss the importance of implementation research studies, strategic partnerships, and advocacy efforts to mitigate EVT underutilization.

Original language	English
Pages (from-to)	2173-2183
Number of pages	11
Journal	Stroke
Volume	55
Issue number	8
DOIs	https://doi.org/10.1161/STROKEAHA.124.045889
State	Published - 1 Aug 2024
Externally published	Yes

Keywords

brain ischemia
ischemic stroke
physicians
stroke
undertreatment

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10.1161/STROKEAHA.124.045889

Cite this

Ospel, J. M., Diprose, W. K., Ganesh, A., Martins, S., Nguyen, T., Psychogios, M., Mansour, O., Al-Ajlan, F., Yang, P., Pandian, J., Gopinathan, A., Sandset, E. C., Kennedy, J., Volders, D., Fahed, R., Tjoumakaris, S., Bhogal, P., Kurz, M., Yavagal, D., ... Goyal, M. (2024). Challenges to Widespread Implementation of Stroke Thrombectomy. Stroke, 55(8), 2173-2183. https://doi.org/10.1161/STROKEAHA.124.045889

@article{4a950e94a9f5486e90e582cf5aceb69f,

title = "Challenges to Widespread Implementation of Stroke Thrombectomy",

abstract = "Endovascular treatment (EVT) for acute ischemic stroke is one of the most efficacious and effective treatments in medicine, yet globally, its implementation remains limited. Patterns of EVT underutilization exist in virtually any health care system and range from a complete lack of access to selective undertreatment of certain patient subgroups. In this review, we outline different patterns of EVT underutilization and possible causes. We discuss common challenges and bottlenecks that are encountered by physicians, patients, and other stakeholders when trying to establish and expand EVT services in different scenarios and possible pathways to overcome these challenges. Lastly, we discuss the importance of implementation research studies, strategic partnerships, and advocacy efforts to mitigate EVT underutilization.",

keywords = "brain ischemia, ischemic stroke, physicians, stroke, undertreatment",

author = "Ospel, \{Johanna Maria\} and Diprose, \{William K.\} and Aravind Ganesh and Sheila Martins and Thanh Nguyen and Marios Psychogios and Ossama Mansour and Fahad Al-Ajlan and Pengfei Yang and Jeyaraj Pandian and Anil Gopinathan and Sandset, \{Else Charlotte\} and James Kennedy and David Volders and Robert Fahed and Stavropoula Tjoumakaris and Pervinder Bhogal and Martin Kurz and Dileep Yavagal and Violiza Inoa and Hill, \{Michael D.\} and Mayank Goyal",

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year = "2024",

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doi = "10.1161/STROKEAHA.124.045889",

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Ospel, JM, Diprose, WK, Ganesh, A, Martins, S, Nguyen, T, Psychogios, M, Mansour, O, Al-Ajlan, F, Yang, P, Pandian, J, Gopinathan, A, Sandset, EC, Kennedy, J, Volders, D, Fahed, R, Tjoumakaris, S, Bhogal, P, Kurz, M, Yavagal, D, Inoa, V, Hill, MD & Goyal, M 2024, 'Challenges to Widespread Implementation of Stroke Thrombectomy', Stroke, vol. 55, no. 8, pp. 2173-2183. https://doi.org/10.1161/STROKEAHA.124.045889

TY - JOUR

T1 - Challenges to Widespread Implementation of Stroke Thrombectomy

AU - Ospel, Johanna Maria

AU - Diprose, William K.

AU - Ganesh, Aravind

AU - Martins, Sheila

AU - Nguyen, Thanh

AU - Psychogios, Marios

AU - Mansour, Ossama

AU - Al-Ajlan, Fahad

AU - Yang, Pengfei

AU - Pandian, Jeyaraj

AU - Gopinathan, Anil

AU - Sandset, Else Charlotte

AU - Kennedy, James

AU - Volders, David

AU - Fahed, Robert

AU - Tjoumakaris, Stavropoula

AU - Bhogal, Pervinder

AU - Kurz, Martin

AU - Yavagal, Dileep

AU - Inoa, Violiza

AU - Hill, Michael D.

AU - Goyal, Mayank

PY - 2024/8/1

Y1 - 2024/8/1

N2 - Endovascular treatment (EVT) for acute ischemic stroke is one of the most efficacious and effective treatments in medicine, yet globally, its implementation remains limited. Patterns of EVT underutilization exist in virtually any health care system and range from a complete lack of access to selective undertreatment of certain patient subgroups. In this review, we outline different patterns of EVT underutilization and possible causes. We discuss common challenges and bottlenecks that are encountered by physicians, patients, and other stakeholders when trying to establish and expand EVT services in different scenarios and possible pathways to overcome these challenges. Lastly, we discuss the importance of implementation research studies, strategic partnerships, and advocacy efforts to mitigate EVT underutilization.

AB - Endovascular treatment (EVT) for acute ischemic stroke is one of the most efficacious and effective treatments in medicine, yet globally, its implementation remains limited. Patterns of EVT underutilization exist in virtually any health care system and range from a complete lack of access to selective undertreatment of certain patient subgroups. In this review, we outline different patterns of EVT underutilization and possible causes. We discuss common challenges and bottlenecks that are encountered by physicians, patients, and other stakeholders when trying to establish and expand EVT services in different scenarios and possible pathways to overcome these challenges. Lastly, we discuss the importance of implementation research studies, strategic partnerships, and advocacy efforts to mitigate EVT underutilization.

KW - brain ischemia

KW - ischemic stroke

KW - physicians

KW - stroke

KW - undertreatment

UR - https://www.scopus.com/pages/publications/85198246147

U2 - 10.1161/STROKEAHA.124.045889

DO - 10.1161/STROKEAHA.124.045889

M3 - Artículo de revisión

C2 - 38979609

AN - SCOPUS:85198246147

SN - 0039-2499

VL - 55

SP - 2173

EP - 2183

JO - Stroke

JF - Stroke

IS - 8

ER -

Challenges to Widespread Implementation of Stroke Thrombectomy

Abstract

Keywords

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