eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
1/2023
vol. 19
 
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abstract:
Guidelines/recommendations

World Federation for Interventional Stroke Treatment (WIST) multispecialty training guidelines for endovascular stroke intervention

Iris Q. Grunwald
1, 2, 3
,
Klaus Mathias
4
,
Stefan Bertog
3, 5
,
Kenneth V. Snyder
6
,
Horst Sievert
3
,
Adnan Siddiqui
6
,
Piotr Musialek
7
,
Marius Hornung
3, 8
,
Panagiotes Papanagiotou
9, 10
,
Simone Comelli
11
,
Sanjay Pillai
1
,
Helen Routledge
12
,
Rafal T. Nizankowski
13
,
Ian Ewart
14
,
Klaus Fassbender
15
,
Anna L. Kühn
16
,
Carlos A. Alvarez
17
,
Bagrat Alekyan
18
,
Dimitry Skrypnik
19
,
Maria Politi
9
,
Lukasz Tekieli
7
,
Thomas Haldis
20
,
Shailesh Gaikwad
21
,
John Graeme Houston
2
,
Helen Donald-Simpson
2
,
Paul Guyler
14
,
Ivo Petrov
22
,
Christine Roffe
23
,
Mark Abelson
24
,
David Hargroves
25
,
Sunithi Mani
26
,
Anna Podlasek
2, 27
,
Adam Witkowski
28
,
Kolja Sievert
3
,
Krzysztof Pawlowski
29
,
Artur Dziadkiewicz
30
,
Nelson L. Hopkins
6

1.
Department of Radiology, NHS Tayside, Dundee, UK
2.
Tayside Innovation MedTech Ecosystem (TIME), Division of Imaging Science and Technology, School of Medicine, University of Dundee, UK
3.
Cardiovascular Center Frankfurt, Frankfurt, Germany
4.
Asklepios Clinik St. Georg – Klinische und Interventionelle Angiologie, Hamburg, Germany
5.
Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA
6.
Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo New York, USA; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, New York, USA; Jacobs Institute, Buffalo, New York, USA
7.
Department of Cardiac and Vascular Diseases, Jagiellonian University, John Paul II Hospital, Krakow, Poland
8.
SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Germany
9.
Department of Diagnostic and Interventional Neuroradiology, Hospital Bremen-Mitte/Bremen-Ost, Bremen, Germany
10.
First Department of Radiology, School of Medicine, National & Kapodistrian University of Athens, Areteion Hospital, Athens, Greece
11.
S. C. Neuroradiologia ed Interventistica Vascolare, Ospedale S. Michele, Cagliari, Italy
12.
Worcestershire Royal Hospital, Cardiology Department, Worcester, United Kingdom
13.
Accreditation Council, National Centre for Health Quality Assessment, Krakow, Poland
14.
Mid and South Essex NHS Foundation Trust, Southend-on-Sea, United Kingdom
15.
Department of Neurology, Saarland University Medical Center, Homburg, Germany
16.
New England Center for Stroke Research, Department of Radiology, University of Massachusetts, Worcester, USA
17.
Hospital Italiano Regional Del Sur, Hospital Privado Del Sur and Hospital Regional Español, Bahia Blanca, Argentina
18.
A.V. Vishnevsky Institute of Surgery, Moscow, Russia
19.
I.V. Davidovsky City Hospital, Moscow State University and Dentistry, Moscow, Russia
20.
Sanford Medical Center, Fargo North Dakota, USA
21.
Department of Neuroimaging and Interventional Neuroradiology, Neurosciences Center, Ansari Nagar, All India Institute of Medical Sciences (A.I.I.M.S), New Delhi, India
22.
Department of Cardiology and Angiology, Acibadem City Clinic-Cardiovascular Center, Sofia, Bulgaria
23.
University Hospital of North Midlands, Keele University, Stoke-on-Trent, UK
24.
Vergelegen MediClinic, Somerset West, University of Cape Town, South Africa
25.
East Kent Hospitals University NHS Foundation Trust, Ashford, United Kingdom
26.
Jerudong Park Medical Centre, Brunei
27.
Precision Imaging Beacon, Radiological Sciences, University of Nottingham, Nottingham, United Kingdom
28.
Deptartment of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland
29.
Department of Cardiology and Interventional Angiology, Kashubian Center for Heart and Vascular Diseases, Pomeranian Hospitals, Wejherowo, Poland
30.
Department of Neurology and Stroke, Pomeranian Hospitals, Wejherowo, Poland
Adv Interv Cardiol 2023; 19, 1 (71): 6–13
Online publish date: 2023/04/01
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Introduction:
Today, endovascular treatment (EVT) is the therapy of choice for strokes due to acute large vessel occlusion, irrespective of prior thrombolysis. This necessitates fast, coordinated multi-specialty collaboration. Currently, in most countries, the number of physicians and centres with expertise in EVT is limited. Thus, only a small proportion of eligible patients receive this potentially life-saving therapy, often after significant delays. Hence, there is an unmet need to train a sufficient number of physicians and centres in acute stroke intervention in order to allow widespread and timely access to EVT.

Aim:
To provide multi-specialty training guidelines for competency, accreditation and certification of centres and physicians in EVT for acute large vessel occlusion strokes.

Material and methods:
The World Federation for Interventional Stroke Treatment (WIST) consists of experts in the field of endovascular stroke treatment. This interdisciplinary working group developed competency – rather than time-based – guidelines for operator training, taking into consideration trainees’ previous skillsets and experience. Existing training concepts from mostly single specialty organizations were analysed and incorporated.

Results:
The WIST establishes an individualized approach to acquiring clinical knowledge and procedural skills to meet the competency requirements for certification of interventionalists of various disciplines and stroke centres in EVT. WIST guidelines encourage acquisition of skills using innovative training methods such as structured supervised high-fidelity simulation and procedural performance on human perfused cadaveric models.

Conclusions:
WIST multispecialty guidelines outline competency and quality standards for physicians and centres to perform safe and effective EVT. The role of quality control and quality assurance is highlighted.

keywords:

stroke, acute stroke, ischaemic stroke, mechanical thrombectomy, acute stroke intervention

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