Opinion: Interventional vascular neurology

Abstract

Simultaneously published in the Journal of Stroke and Cerebrovascular Diseases and the Journal of Neurosurgery ,1,2 “Performance and training standards for endovascular ischemic stroke treatment” by Meyers et al. proposes guidelines for training requirements to achieve cognitive and technical qualifications in interventional treatment of acute stroke patients, thus ensuring quality of care and safety. Recommendations for cognitive training include at least 6 months of documented training in cerebrovascular disease within an ACGME approved residency program (neurology, radiology, or neurosurgery) and additional experience in a 1-year endovascular surgical neuroradiology fellowship. The cognitive part of the latter training was undefined and will likely vary among fellowships. Technical requirements focus on the minimum quantity of cases. They were defined as documented training in 100 diagnostic cerebral arteriograms, training in intracranial microcatheter and microguidewire navigation (or 30 cases as primary operator with supervision by a neurointerventionalist), and 10 endovascular stroke procedures. A grandfathering option was proposed for all endovascular specialists not specifically trained and not yet credentialed in the clinical neurosciences, and recommends 6 months of cognitive training and documentation of supervised cerebral angiography in the aforementioned amount. No recommendation was made as to how the …