Neurology Trainee Attitudes Toward Neurointervention: Results From an International Survey

Background The rapidly changing treatment landscape for large vessel occlusion acute ischemic stroke, now more than ever, has added to the complexity of emergent decision making and the demand for neurointerventionists. Ensuring exposure of neurology trainees to neurointervention and the availability of well‐defined pathways for those interested in this career is crucial. Here we report the results from our large survey of neurology trainee attitudes toward neurointervention training. Methods An online survey targeting trainee impressions on the current state of vascular neurology, neurocritical care, and neurointervention training was conducted as a mandatory requirement for trainee registration in the Society for Vascular and Interventional Neurology Break meeting in April 2020. Quantitative results are reported in proportions, and qualitative results are described. Chi‐square test was used to determine association between categorical variables. Results Of the 725 respondents from 49 countries who participated in this conference, 450 (62%) were trainees. A total of 30% of trainees did not have access to neurointervention training, and 40% believed that neurology residency, vascular neurology, or neurocritical care fellowship do not adequately prepare them for a career in neurointervention. A total of 237/321 (73%) trainees whose institutional neurointervention practice included neurologists or a mix of subspecialty backgrounds including a neurologist had an opportunity to spend elective time in a neurology–angiography suite compared with 49/89 (55%) if the institutional neurointervention practice consisted of neurosurgeons or radiologists alone (P=0.001). A total of 49% of trainees each preferred the introduction of a mandatory or an elective neurointervention module during residency. A total of 60% of trainees preferred no to minimal exposure at the medical student level. Conclusions This international survey of trainees reinforces the existing gap in neurointervention exposure for neurology trainees. Inclusion of neurointervention faculty that come from a neurology training background and exposure to neurointervention will be crucial to support trainees interested in a neurointervention career pathway

Call to Action: SARS-CoV-2 and CerebrovAscular DisordErs (CASCADE)

BACKGROUND AND PURPOSE: The novel severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), now named coronavirus disease 2019 (COVID-19), may change the risk of stroke through an enhanced systemic inflammatory response, hypercoagulable state, and endothelial damage in the cerebrovascular system. Moreover, due to the current pandemic, some countries have prioritized health resources towards COVID-19 management, making it more challenging to appropriately care for other potentially disabling and fatal diseases such as stroke. The aim of this study is to identify and describe changes in stroke epidemiological trends before, during, and after the COVID-19 pandemic. METHODS: This is an international, multicenter, hospital-based study on stroke incidence and outcomes during the COVID-19 pandemic. We will describe patterns in stroke management, stroke hospitalization rate, and stroke severity, subtype (ischemic/hemorrhagic), and outcomes (including in-hospital mortality) in 2020 during COVID-19 pandemic, comparing them with the corresponding data from 2018 and 2019, and subsequently 2021. We will also use an interrupted time series (ITS) analysis to assess the change in stroke hospitalization rates before, during, and after COVID-19, in each participating center. CONCLUSION: The proposed study will potentially enable us to better understand the changes in stroke care protocols, differential hospitalization rate, and severity of stroke, as it pertains to the COVID-19 pandemic. Ultimately, this will help guide clinical-based policies surrounding COVID-19 and other similar global pandemics to ensure that management of cerebrovascular comorbidity is appropriately prioritized during the global crisis. It will also guide public health guidelines for at-risk populations to reduce risks of complications from such comorbidities