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Mechanical thrombectomy practices in France: Exhaustive survey of centers and individual operators

2020; Elsevier BV; Volume: 47; Issue: 6 Linguagem: Inglês

10.1016/j.neurad.2020.05.001

1773-0406

Géraud Forestier, Basile Kerleroux, Kévin Janot, François Zhu, Víctor Dumas, Jean-François Hak, Eimad Shotar, Wagih Ben Hassen, Romain Bourcier, Sébastien Soize, Jérôme Berge, Olivier Naggara, Hubert Desal, Grégoire Boulouis, Aymeric Rouchaud, Riyad Hanafi, Vincent L’Allinec, Jean-Baptiste Girot, Guillaume Charbonnier, Alessandra Biondi, Florent Gariel, Gaultier Marnat, Julien Ognard, Jean‐Christophe Gentric, Charlotte Barbier, Emmanuel Chabert, Alexander V. Lebedinsky, Titien Tuilier, Pierre Thouant, Pierre‐Olivier Comby, Mehdi Mejdoubi, Olivier Heck, Adrian Kastler, Vanessa Chalumeau, Jildaz Caroff, Thomas Personnic, Adrien Marchal, Clément Bogey, Omer Eker, Xavier Carle, Cyril Dargazanli, Imad Derraz, Benjamin Gory, Lili Détraz, Jacques Sédat, O. Zurlinden, Simon Escalard, Robert Fahed, Alexis Guédon, Vittorio Civelli, Kévin Premat, Frédéric Clarençon, E. Ducouret, Nicolas Raynaud, Stéphane Velasco, Pierre-François Manceau, Christophe Paya, François Eugène, J. Le Moa, Chrysanthi Papagiannaki, Mohammed Aggour, Marc Bintner, J.-B. Veyrières, Johann Sebastian Richter, Raoul Pop, Arturo Consoli, F. Di-Maria, C. Artéaga, Jean Darcourt, Caterina Michelozzi, Pierre Guédin, Denis Herbreteau, Anthony Le Bras,

Clinical practice guidelines implementation

Mechanical thrombectomy (MT) has dramatically changed the landscape of stroke care as well as stroke care organization. Public health institutions are faced with the challenge of swiftly providing equal access to this high technical level procedure with rapidly broadening indications, and constantly developing techniques. The aim of this study was to present a current nationwide overview of technical MT practices in France as well as local organizations. Thrombectomy capable French stroke centers, and physicians performing MT were invited to participate to a nationwide survey, disseminated through an existing trainee-led research network (the JENI-RC) under the aegis of the French Society of Neuroradiology. The survey was composed of 64 questions to collect both individual practices and general center-based information. All French centers (100%) answered the survey, and 74% (110/148) of active interventional neuroradiologists (INR) performing MT completed individual questionnaires. The mean number of INR per center performing MT was 3.7 ± 1.85, and 85% of the centers were organized for 24/7 continuity of care. MRI was the most commonly used imaging modality for stroke diagnosis and patients’ selection, and perfusion imaging was routinely available in 85% of the centers. Half of centers performed yearly between 100 and 200 MT. Anesthesiologic, and technical considerations are also developed in the manuscript. This nationwide survey highlights the impressive response to the challenge of reorganization of stroke care with regards to mechanical thrombectomy in France. Technical and management disparities remain. Most centers remain understaffed to properly function in the long term, but the inflow of INT trainees is substantial.