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Current Access to Endovascular Thrombectomy Centers Limited

Increasing number of EVT centers and/or bypassing non-EVT centers could expand access

FRIDAY, March 13, 2020 (HealthDay News) — Less than one in five of the U.S. population has access to endovascular thrombectomy (EVT) centers within 15 minutes, according to a study published online Feb. 12 in Stroke.

Amrou Sarraj, M.D., from the University of Texas at Houston, and colleagues mapped U.S. stroke-treating centers and characterized patients as non-EVT or EVT if they reported one or more acute ischemic stroke thrombectomy code in 2017. Current 15- and 30-minute access was determined both nationwide and at a state level with an emphasis on Texas, New York, California, and Illinois.

The researchers found that 37 percent of stroke centers were EVT-capable. Nearly one in five Americans (19.8 percent) had direct EVT access within 15 minutes, while 30.9 percent had access within 30 minutes. In Texas, there were 65 EVT centers (43 percent), with 22 percent of the population currently within 15-minute access. Access improved to 30.8 percent in Texas by flipping 10 percent of hospitals with top population density from non-EVT to EVT, while bypassing non-EVT centers resulted in 45.5 percent having direct access to EVT centers. Similar results were found in the other three states. Current direct access within 15 minutes was 19.8 percent nationwide but increased by 7.5 percent by flipping the top 10 percent non-EVT to EVT-capable in all states, and bypassing non-EVT centers by 15 minutes resulted in a 16.7 percent gain in coverage.

“National and state efforts should focus on identifying gaps and tailoring solutions to improve EVT access,” the authors write.

Several authors disclosed financial ties to pharmaceutical and scientific companies.

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