Among trained specialists who perform mechanical thrombectomies (MTs), more experience with the procedure is associated with shorter duration times and better reperfusion rates, according to a new analysis published in Stroke.
“Technical efficiency has been shown to increase with previous endovascular experience in the cardio-interventionist literature and other neuro-intervention procedures including the endovascular treatment (EVT) of intracranial aneurysms or carotid stenting,” wrote lead author François Zhu, MD, MSc, a neuroradiologist at the University of Lorraine in France, and colleagues. “Yet the impact of individual experience on EVT procedural efficiency remains poorly reported.”
The multicenter study examined more than 4,500 procedures performed by 36 interventional neuroradiologists at seven different stroke centers. An additional 504 procedures were excluded due to missing operator data. All MTs were performed from January 2015 to January 2020. The mean patient age was 70 years old, and 10% were treated under general anesthesia.
Overall, the authors found, higher operator experience was linked to shorter procedures and improved Thrombolysis In Cerebral Infarction scores. Experience had no positive or negative effect on perforation or the rate of reported arterial dissections.
Zhu et al. noted that most training guidelines recommend a user perform 50 EVTs as first operator before they work in autonomy. However, their analysis suggests that improvements are still seen well after 50 procedures—with a the “ceiling” appearing to lie somewhere between 80 and 100.
“These results may inform future training and practice guidelines to set minimal experience standards before autonomization, and to set-up operators’ recertification processes tailored to individual case volume and prior experience,” the authors wrote.
Read the full study here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.