REVIEW ARTICLE Intra-Arterial Stroke Therapy: An Assessment of Demand and Available Work Force

SUMMARY: Intra-arterial therapy is currently applicable to a small subset of patients with ischemic stroke, but it will likely have an expanding role as new devices are introduced. This review evaluates the demand for such therapy and the physician work force available to provide such therapy in the United States. The available literature was reviewed to assess how many patients might need intra-arterial therapy annually and how many skilled neurointerventionalists are available to provide intra-arterial therapy for acute stroke. The number of acute ischemic strokes in the United States that will be amenable to intra-arterial therapy can only be crudely estimated, but it is certainly less than 126,000 per year and will quite likely be no more than 20,000 cases per year. The future demand for intra-arterial reperfusion techniques may change, but the number of patients who require intra-arterial thrombolysis is currently quite low. The overall number of neurointerventionists is currently adequate, though there might be local shortages. Ischemic stroke is a complex disease with many forms andmany corresponding treatments that must be tailored to the patient. The consensus guidelines from the American Heart Association and American Stroke Association regarding acute ischemic stroke treatment mentions intra-arterial therapy a