Commentary

An Endovascular Approach to Stroke Care

In recent months, we have seen in rapid succession the presentation and publication of a number of contemporary trials that demonstrate the great value of an endovascular approach to stroke care. The trials are concordant in terms of supporting, in carefully selected patients, use of initial thrombolysis followed by an endovascular approach.

In the Clinical News section on page 16, read more about detailed results from the ESCAPE, EXTEND-IA and SWIFT PRIME studies, presented at the International Stroke Conference in February.

Deepak L. Bhatt, MD, MPH

Deepak L. Bhatt

My prediction is that interventional cardiologists may soon play a larger role than we currently do in the treatment of patients with acute stroke. Current involvement of interventional cardiologists varies across institutions, and appears to be the exception rather than the norm. The reality is that there are not enough neurointerventionalists in the United States to scale up for the number of stroke patients who could benefit from these interventional approaches. Practically speaking, for cath labs doing acute MI that also have experience in peripheral and cerebrovascular intervention, with carotid stenting, for example, this may be a logical transition to be involved in the care of patients with acute stroke. For this approach to be to be successful, it has to be in the right patients, with institutional support, and requires a close working relationship between the neurologists and the interventional cardiologists.

Let us know your thoughts on the changing role of interventional cardiologists in stroke care by emailing the editor at cardiology@healio.com.

Deepak L. Bhatt, MD, MPH

Chief Medical Editor, Cardiology Today’s Intervention

In recent months, we have seen in rapid succession the presentation and publication of a number of contemporary trials that demonstrate the great value of an endovascular approach to stroke care. The trials are concordant in terms of supporting, in carefully selected patients, use of initial thrombolysis followed by an endovascular approach.

In the Clinical News section on page 16, read more about detailed results from the ESCAPE, EXTEND-IA and SWIFT PRIME studies, presented at the International Stroke Conference in February.

Deepak L. Bhatt, MD, MPH

Deepak L. Bhatt

My prediction is that interventional cardiologists may soon play a larger role than we currently do in the treatment of patients with acute stroke. Current involvement of interventional cardiologists varies across institutions, and appears to be the exception rather than the norm. The reality is that there are not enough neurointerventionalists in the United States to scale up for the number of stroke patients who could benefit from these interventional approaches. Practically speaking, for cath labs doing acute MI that also have experience in peripheral and cerebrovascular intervention, with carotid stenting, for example, this may be a logical transition to be involved in the care of patients with acute stroke. For this approach to be to be successful, it has to be in the right patients, with institutional support, and requires a close working relationship between the neurologists and the interventional cardiologists.

Let us know your thoughts on the changing role of interventional cardiologists in stroke care by emailing the editor at cardiology@healio.com.

Deepak L. Bhatt, MD, MPH

Chief Medical Editor, Cardiology Today’s Intervention