Background
and purpose:
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. (Survivors don't fucking care about practices, they want to know your results, this told us nothing.)
Materials
and methods:
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.
Results:
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.
Conclusions:
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.
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