Global Stroke Committee Led by UM Neurologist Publishes White Paper to Increase Thrombectomy Care Around the World

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Led by Dileep R. Yavagal, M.D., professor of clinical neurology and neurosurgery at the University of Miami Miller School of Medicine and UM/Jackson Memorial Hospital, the Mission Thrombectomy 2020+ initiative, a global campaign of the Society of Vascular and Interventional Neurology, has just published a report detailing their global initiative to reduce death and disability in stroke patients around the world.

The report, titled “Mechanical Thrombectomy for Acute Stroke. Building Thrombectomy Systems of Care in Your Region: Why and How,” targets health policy and examines the widespread inaccessibility and geographic disparities in receiving mechanical thrombectomy. The procedure is an interventional treatment that has been proven to have overwhelming benefit for a common type of disabling stroke in multiple large studies across many countries since 2015.

Dr. Dileep R, Yavagal

“Large vessel occlusion (LVO) stroke is a longstanding silent global crisis that now has highly effective solutions since the last five years: mechanical thrombectomy,” said Dr. Yavagal, who serves as Mission Thrombectomy 2020+ (MT2020+) global chair and is past president of the Society of Vascular and Interventional Neurology.

“Thrombectomy care isn't widely accessible, with colossal geographic disparities on a global level,” said Dr. Yavagal, who is also UM’s chief of interventional neurology and co-director of endovascular neurosurgery. “We are calling on public health policymakers to increase physical, financial, and diagnostic access to thrombectomy for patients with disabling stroke to prevent a lifetime of suffering and death.”

MT needs to be performed within the first 24 hours of the onset of symptoms of disabling stroke from a large artery being suddenly blocked in the brain (LVO stroke), and its outcomes are highly time-sensitive, especially early on. Released on World Stroke Day, October 29, the White Paper report calls for a sweeping increase in MT awareness, accessibility, and action on a worldwide level.

The United States is a global leader in MT patient care, but the burden of care is 4-5 times greater in many lower- to middle-income countries. According to MT2020+:

  • Each year approximately 13.67 million people suffer from strokes worldwide.
  • 20-30 percent of all ischemic stroke cases are due to LVO strokes, which makes them eligible for highly effective MT treatment
  • Less than 10 percent of eligible LVO stroke patients receive MT, leaving approximately 2 million people in need of this procedure but unable to receive it.

The two main goals of the MT2020+ initiative are:

  • Implement public health interventions to double global access to MT treatments every two years for the next decade.
  • Perform 202,000 MT procedures worldwide by the end of 2020.

The White Paper also provides perspective on:

  • Cost-effectiveness of patient care afforded by successful implementation of MT protocols
  • Tracking metrics and analytics made available through the dedicated MT2020+ Global Thrombectomy Tracking app
  • Educational tools for the community
  • Training initiatives for EMS and health care professionals
  • Building thrombectomy systems of care in the community
  • Improving inter-hospital transfers for MT patients

The White Paper will be disseminated on all six continents by the 82 regional committees of MT2020+. The long-term goal is the emergence and widespread availability of Mechanical Thrombectomy as the standard of care globally. While progress has been made since the formation of MT2020 in 2016, continued efforts are needed.

 

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