Journal article
Mechanical Thrombectomy Access Score: A Systematic Review and Modified Delphi of Global Barriers to Endovascular Therapy
Stroke (1970), Vol.56(1), pp.158-167
01/2025
DOI: 10.1161/STROKEAHA.124.047805
PMID: 39450508
Abstract
BACKGROUND: The availability of mechanical thrombectomy (MT) for acute ischemic stroke is limited, and vast disparities exist between countries. We aim to create a MT access score to measure the drivers of access to help quantify and accelerate treatment worldwide. METHODS: We used a systematic review complemented by a modified Delphi method. In the first of 3 rounds, 4 independent investigators performed a systematic literature review using key search terms that drive MT access, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In the second round, a panel of 6 anonymous international experts selected key attributes needed for scoring. In the final round, a total of 12 attributes were selected on consensus, each given a score on a 0 to 3 scale. An ultimate MT access score (range, 0–36) was proposed as a new tool to use in identifying barriers to MT access and assist in providing an initial framework for public health interventions. RESULTS: Of 2864 abstracts screened, 121 studies were included in the final systematic review. A total of 34 attributes that potentially drive MT access were initially identified. In the final round, 12 attributes were selected by the expert panel: public awareness, emergency medical services transportation, prehospital large vessel occlusion screening, interhospital transfer policy, emergency department protocols, stroke imaging protocols, emergency department stroke expertise or telestroke availability, interventionalists, MT-capable centers, device availability, and insurance coverage. These attributes were weighted as part of the final score of 0 to 36. CONCLUSIONS: The MT access score represents the first tool to quantify barriers to global MT access. Its implementation stands not just as an academic achievement but as a beacon of hope for improving stroke care and outcomes worldwide, bringing us a step closer to bridging the gap in stroke treatment disparities.
Details
- Title: Subtitle
- Mechanical Thrombectomy Access Score: A Systematic Review and Modified Delphi of Global Barriers to Endovascular Therapy
- Creators
- Sushanth R. Aroor - The University of Texas Health Science Center at HoustonCynthia B. Zevallos - University of IowaKaiz S. Asif - AscensionNishita Singh - University of ManitobaJennifer Potter-Vig - University of Illinois at SpringfieldAaron Rodriguez-Calienes - Universidad Científica del SurBijoy K. Menon - University of CalgaryAravind Ganesh - University of CalgaryJeffrey L. Saver - University of California, Los AngelesHooman Kamel - Weill Cornell MedicineAnne W. Alexandrov - University of Tennessee Health Science CenterEdward C. Jauch - Mountain Area Health Education CenterZhongrong Miao - Beijing Tian Tan HospitalXiaochuan Huo - Beijing Anzhen HospitalPankajavalli Ramakrishnan - Riverside Regional Medical CenterShashvat M. Desai - HonorHealthKaustubh Limaye - Indiana UniversityMohammad El-Ghanem - University of HoustonGabor Toth - Cleveland ClinicChetan V. Rao - Baylor College of MedicineHesham E. Masoud - SUNY Upstate Medical UniversityQingliang Tony Wang - State University of New YorkNabeel A. Herial - Thomas Jefferson UniversityKunakorn Atchaneeyasakul - Virginia Mason Medical CenterViktor Szeder - University of California, Los AngelesKrishna Amuluru - Indiana Spine GroupVictor C. Urrutia - Johns Hopkins MedicineFawaz Al-Mufti - New York Medical CollegeDileep R. Yavagal - University of MiamiSantiago Ortega-Gutierrez - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Stroke (1970), Vol.56(1), pp.158-167
- DOI
- 10.1161/STROKEAHA.124.047805
- PMID
- 39450508
- NLM abbreviation
- Stroke
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Grant note
- Society of Vascular and Interventional Neurology
The study was funded by the Society of Vascular and Interventional Neurology.
- Language
- English
- Electronic publication date
- 10/25/2024
- Date published
- 01/2025
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984740857702771
Metrics
6 Record Views