A survey of neurointerventionalists on thrombectomy practices for emergent large vessel occlusions
A survey of neurointerventionalists on thrombectomy practices for emergent large vessel occlusions
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DOI：
10.1136/neurintsurg-2015-012235
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发表时间：
2017-02-01
影响因子：
4.8
通讯作者：
Turk, Aquilla S.
中科院分区：
文献类型：
--
作者：
Fargen, Kyle M.;Arthur, Adam S.;Turk, Aquilla S.
背景：五项阳性随机对照试验对取栓方法和取栓量的影响尚未明确。此外，很少有研究试图从选择标准和使用的设备方面定义现代取栓实践。方法通过SurveyMonkey网站对神经介入外科学会（SNIS）医生进行21个问题的调查，了解目前的做法以及从2015年1月1日之前到该日期之后的变化。结果共获得78份回复（约占SNIS成员的10%）。在2015年1月之前，三分之二的受访者报告每月进行1-5次血栓切除术（67%），31%的受访者每月进行5次以上的血栓切除术。2015年1月之后，62%的受访者报告每月进行5次以上的血栓切除术；45%的应答者在试验发表后报告了更高数量的血栓切除术。73%和80%的答复者分别表示，为取栓而进行的住院会诊和医院到医院的转诊有所增加。多数应答者报告使用直接抽吸第一次通道技术（40%）作为血运重建术的第一策略。最常见的是，神经介入医师报告使用清醒镇静（56%）进行麻醉。74%的应答者表示，在至少70%的病例中，他们的主要技术是成功的。这项主要针对学术SNIS医生的调查表明，自今年5项主要卒中试验发表以来，住院会诊、医院到医院转诊和取栓手术量略有增加。此外，许多受访者表示，在选择标准的基础上，追求血栓切除术的积极性有所增加。
Background The effect of the five positive randomized controlled trials on thrombectomy practices and procedural volume has yet to be defined. Further, few studies have attempted to define modern thrombectomy practices in terms of selection criteria and devices used.Methods A 21 question survey of Society of Neurointerventional Surgery (SNIS) physicians was administered using the SurveyMonkey website, addressing current practices as well as changes from before January 1, 2015 to the months after this date.Results A total of 78 responses were obtained (approximately 10% of SNIS membership). Prior to January 2015, two-thirds of respondents reported performing 1-5 thrombectomies per month (67%), with 31% performing more than 5 per month. Following January 2015, 62% of respondents reported performing more than 5 thrombectomies per month; 45% of respondents reported a higher number of thrombectomies after trial publication. 73% and 80% of respondents indicated that inpatient consultations and hospital to hospital transfers for thrombectomy have increased, respectively. A plurality of respondents reported using A Direct Aspiration First Pass Technique (40%) as the first strategy for revascularization. Most commonly, neurointerventionalists reported using conscious sedation (56%) for anesthesia. 74% of respondents indicated being successful with their primary technique in at least 70% of cases.Conclusions This survey of predominantly academic SNIS physicians indicates that inpatient consultations, hospital to hospital transfers, and thrombectomy procedural volumes have increased modestly since the publication of the five major stroke trials this year. In addition, many respondents indicated an increase in aggressiveness in pursuing thrombectomy based on selection criteria.