“MR CLEAN.” “SWIFT PRIME.” No, these are not your household cleaning supplies. These are clinical trials that are shaping the public’s perception of interventional stroke treatment. While these studies found interventional stroke treatments to be safe and effective, other federally funded trials have found no benefits to adding interventional treatments to the current standard of care, IV-tPA.
With conflicting evidence and opinions in the stroke community, it seems the jury is still out regarding the effectiveness of interventional treatment for stroke. Some programs are eagerly embracing these treatments as an exciting frontier, while others have shied away from them out of the fear that they are ineffective or dangerous. Our team has combed through the existing research on interventional stroke to determine three key takeaways for your stroke program.
Further research is needed
As with all research, critics have poked numerous holes in the existing interventional stroke literature: patient selection criteria, stroke severity, device inclusion, you name it.
Our team thinks it is important to note the dynamic nature of stroke treatment—each patient and situation is different. For example, much of the existing research fails to highlight those patients for whom interventional stroke treatment is the only option. Hospitals with well-established stroke programs and regionalized networks should by no means shy away from these treatment offerings and should instead consider the potential role of interventional stroke care in their programs.
Interventional devices extend the time window of stroke care
One of the biggest challenges to stroke care is patients arriving outside of the time window to receive IV-tPA. The majority of newly developed interventional devices have been found to extend the time window for stroke care and improve outcomes, especially for those patients who do not qualify for IV-tPA. These patients may be rare and low in volume traditionally, but with our aging population and the rising occurrence of stroke, they are becoming more and more common.
Large, wide-reaching programs are opting to provide these new interventional treatments for patients who don’t qualify for IV-tPA or require more advanced care. Smaller programs in rural areas are developing strict transfer protocols with more progressive providers to ensure access to fast, adequate stroke care. However, regardless of your size, improving the time window for stroke care should be a top priority for your program. Discuss these treatment options and devices with your stroke team to determine how they fit into the scope of your program and ways to improve the timely delivery of stroke care.
Data tracking is essential
Given the importance of standardized protocols for stroke, data tracking is vital towards perfecting your program, regardless of your scope of services. While the research regarding treatment efficacy is not yet 100% conclusive, there’s one thing we can all agree on: time is brain. Tracking door-to-CT, tPA, and endovascular treatment times aids in care improvement initiatives. Especially for patients being transferred, providers on both ends of the transition should track metrics to evaluate transfer protocols. Additionally, tracking long-term outcomes for patients and submitting this data to national databases will help improve your program’s and the industry’s understanding of best practices for interventional stroke care.
Whether you’re just beginning to develop a stroke program, or you are already offering advanced interventional treatments, this body of research has impacts for your strategic approach to stroke. Our team expects that further research and advances in device development will continue to refine the stroke standard of care and we will continue to provide the most up-to-date results relevant to your strategic growth.