Global challenges in the access of endovascular treatment for acute ischemic stroke (global MT access)

作者：Ahmed Nasreldein, W Z Wan Asyraf, Thanh N. Nguyen, Sheila Cristina Ouriques Martins, Vasileios-Arsenios Lioutas, Ahmed Elbassiouny, Ton Duy, Simona Sacco, Mohamed Azlam Mohamed Micdhadhu, Yimin Chen, Rufus Akinyemi, Espen Saxhaug Kristoffersen, Xiaochuan Huo, Zhongrong Miao, Mohamad Abdalkader, Simon Nagel, Volker Puetz, Götz Thomalla, Hiroshi Yamagami, Zhongming Qiu, Jelle Demeestere, Adnan I. Qureshi, Patrik Michel, Daniel Strbian, Bruce Campbell, Bernard Yan, Abdulhakeem Abayomi Olorukooba, Hesham Masoud, Diogo C Haussen, Michael Frankel, Mahmoud Mohammaden · 发表于：International Journal of Stroke · 年份：2025 · DOI：10.1177/17474930251314395 · 被引用次数：14 · 研究领域：Acute Ischemic Stroke Management、Stroke Rehabilitation and Recovery、Peripheral Artery Disease Management

BACKGROUND: Mechanical thrombectomy (MT) is the standard of care for eligible acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) since 2015. AIM: Our aim was to determine the key challenges for MT implementation and access worldwide. METHODS: We conducted an international online survey consisting of 37 questions, distributed through the World Stroke Organization network and as invited by co-authors between December 2022 and March 2023. The survey included a preamble outlining its purpose, questions on respondent demographics, imaging availability, MT service availability, MT selection criteria, barriers to MT, and training status in each country. RESULTS: We received 526 responses from 89 countries distributed across 7 continents. One hundred and sixteen (22.1%) respondents did not have available MT service, 43 (8.2%) had available MT only during working hours, 362 (68.8%) had 24/7 MT availability. Regarding neuroimaging protocols, 13.5% used non-contrast computed tomography (NCCT) only, 40.1% used NCCT/CT angiography, 37.5% used NCCT/CT angiography/CT perfusion), 0.4% used magnetic resonance imaging (MRI) only, and 7.8% used MRI/MR angiography. The most common reasons for not receiving MT were cost, late presentation, and lack of availability of qualified neurointerventional services within reasonable distance. There were 59.1% of respondents who reported having a well-structured MT training program. Lack of qualified trainers, financial support, support ...