Neurointerventional treatment of acute ischemic stroke – Standards of Practice
Intense medical research and technology development have recently produced powerful new techniques to treat acute ischemic stroke. The positive results of multiple randomized thrombectomy trials revolutionized the management of this devastating condition and generated a sudden increase in demand for properly equipped institutions and trained personal.
Due to the temporary shortage of these conditions ESMINT, as a leading medical society of the field in Europe, declares its professional standpoint on the basic requirements for neurointerventional treatment of acute ischemic stroke.
Ischemic stroke is a neurovascular disease. As such, all aspects of its treatment require expertise in the neurovascular field. Hence, it should be treated (either invasively or conservatively) by a trained neurovascular team. In this regard, the invasive treatment itself (thrombectomy, thrombaspiration, etc.) should be exclusively performed in neurointerventional units by properly trained personnel.
The requirements for a neurointerventional unit are set by the Standards of Practice in Interventional Neuroradiology – INR, as approved by UEMS as of 04-02-2011 (https://www.esmint.eu/training-education). An updated version of the Standards is expected to be published by a multisociety working group of ESMINT, ESNR and the UEMS Division of Neuroradiology in the near future.
The increased demand for a round the clock interventional service creates a significant challenge for most neurointerventional sites. ESMINT recommends that sites without a sufficient number of trained neurointerventionists may employ dedicated specialists without full training in neurointerventions as supervised members of the neurointerventional team.
Such individuals need to be trained to collect the necessary knowledge and experience level. ESMINT offers didactic education and certified exams through its ECMINT training course. The practical training needs to be provided by the clinical site. ESMINT strongly discourages practicing neurointerventional treatment of acute ischemic stroke by independent physicians or physician groups not being trained and not belonging to a neurointerventional team.
Background
ESMINT has been established in order to promote the benefits of minimally invasive neurological therapies in Europe through education, training, and support for high-quality scientific research.
ESMINT encourages and supports medical practitioners and scientists working to develop and improve minimally invasive methods for the treatment of neurological diseases. These methods will naturally evolve and currently involve the use of image guidance and medical devices such as endovascular catheters to perform treatments with minimum associated trauma.
The Society promotes the safe application of such techniques and their practice by suitably trained and competent practitioners throughout Europe. ESMINT encourages the setting of international standards for practice and research and encourages their use and appropriate implementation.
The society consists of individuals and groups of members working or training in geographical Europe in the field of minimally invasive neurological therapy. The members determine the organisational structure of the Society and are expected to aspire to the highest standards of ethical and scientific medical practice.