TY - JOUR
T1 - Distribution and current problems of acute endovascular therapy for large artery occlusion from a two-year national survey in Japan
AU - Takagi, Toshinori
AU - Yoshimura, Shinichi
AU - Sakai, Nobuyuki
AU - Iihara, Koji
AU - Oishi, Hidenori
AU - Hirohata, Masaru
AU - Matsumaru, Yuji
AU - Matsumoto, Yasushi
AU - Yamagami, Hiroshi
AU - Menon, Bijoy K.
AU - Almekhlafi, Mohammed
AU - Holodinsky, Jessalyn K.
AU - Kamal, Noreen
AU - Hill, Michael D.
AU - Goyal, Mayank
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study received grants from the Japanese Society of NeuroEndovascular Therapy and the Mihara Cerebrovascular Disorder Research Promotion Fund.
Funding Information:
Data for this study were collected from the Recovery by Endovascular Salvage for Cerebral Ultra-acute Embolism (RESCUE)-Japan Project, a national survey supported by the Japanese Society for NeuroEndovascular Therapy (JSNET). In Japan, JSNET specialist certification or equivalent level of experience is required to perform acute EVT; therefore, almost all acute EVT cases are performed by JSNET specialists. Regarding indications for EVT in Japan from 2016 to 2017, we followed the 2015 American Heart Association/American Stroke Association guidelines. All Japanese citizens are insured under the national insurance, which covers EVT.
Funding Information:
The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Yoshimura received honoraria from Boehringer Ingelheim, Otsuka Pharmaceutical, Bayer, Sanofi K.K., Medtronic, Daiichi Sankyo, and Pfizer. Yoshimura received grant support from Bristol-Myers Squibb and Takeda Pharmaceutical Company Limited. Sakai is a consultant for Achieva, Balt/Century Medical, BiomedicalSolutions/Jimro, Cerenovus/Johnson and Johnson, Medtronic, Microvention/Terumo, NeuroVasc, Penumbra/ Medico’s Hirata, and Stryker. Sakai received grant support from Daiichi-Sankyo and Microvention/Terumo. Iihara received grant support from Otsuka Pharmaceutical, Nihon Medi-Physics Co., Ltd, and AstraZeneca K.K. Matsumaru received honoraria from Medtronic, Stryker, and Johnson and Johnson. Yamagami received honoraria from Stryker, Medtronic, and Medico’s Hirata.
Publisher Copyright:
© 2019 World Stroke Organization.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Background: Endovascular treatment is recommended in clinical practice in Japan. However, its utilization and comprehensiveness are less well described. Aims: To report endovascular treatment utilization and overall geographical coverage in Japan and to analyze regional differences in the number of endovascular treatments, specialists, and endovascular treatment-capable hospitals. Methods: A national survey of members of the Japanese Society for NeuroEndovascular Therapy (JSNET) was conducted in 2017 and 2018. The total number of endovascular treatment cases per year was estimated, and the number of endovascular treatment cases per 100,000 people was calculated using the 2015 census. The distribution of treatment hospitals and JSNET specialists was mapped and the population coverage rate was determined. Results: The total number of endovascular treatment cases in Japan increased by 34.5% from 2016 (7702) to 2017 (10,360). The number of endovascular treatment-capable hospitals in Japan increased from 597 in 2016 to 693 in 2017, with an average annual caseload of 14.9 in 2017. The number of JSNET specialists per hospital decreased from 1.81 in 2016 to 1.76 in 2017 because of the increase in endovascular treatment-capable hospitals. Only 50 (7.2%) hospitals had > 40 endovascular treatment cases annually. The majority (97.7%) of the Japanese population lives within a 60-min drive of any endovascular treatment-capable hospital. However, only 70.4% live within a 60-min drive of a high-volume center (>40 cases annually). Conclusions: Utilization of endovascular treatment in Japan is increasing; however, the number of cases per hospital remains low, as is the number of specialists per endovascular treatment-capable hospital. Increased number of specialists and centralization of endovascular treatment services may improve patient outcomes.
AB - Background: Endovascular treatment is recommended in clinical practice in Japan. However, its utilization and comprehensiveness are less well described. Aims: To report endovascular treatment utilization and overall geographical coverage in Japan and to analyze regional differences in the number of endovascular treatments, specialists, and endovascular treatment-capable hospitals. Methods: A national survey of members of the Japanese Society for NeuroEndovascular Therapy (JSNET) was conducted in 2017 and 2018. The total number of endovascular treatment cases per year was estimated, and the number of endovascular treatment cases per 100,000 people was calculated using the 2015 census. The distribution of treatment hospitals and JSNET specialists was mapped and the population coverage rate was determined. Results: The total number of endovascular treatment cases in Japan increased by 34.5% from 2016 (7702) to 2017 (10,360). The number of endovascular treatment-capable hospitals in Japan increased from 597 in 2016 to 693 in 2017, with an average annual caseload of 14.9 in 2017. The number of JSNET specialists per hospital decreased from 1.81 in 2016 to 1.76 in 2017 because of the increase in endovascular treatment-capable hospitals. Only 50 (7.2%) hospitals had > 40 endovascular treatment cases annually. The majority (97.7%) of the Japanese population lives within a 60-min drive of any endovascular treatment-capable hospital. However, only 70.4% live within a 60-min drive of a high-volume center (>40 cases annually). Conclusions: Utilization of endovascular treatment in Japan is increasing; however, the number of cases per hospital remains low, as is the number of specialists per endovascular treatment-capable hospital. Increased number of specialists and centralization of endovascular treatment services may improve patient outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85071474202&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85071474202&partnerID=8YFLogxK
U2 - 10.1177/1747493019869706
DO - 10.1177/1747493019869706
M3 - Article
C2 - 31409212
AN - SCOPUS:85071474202
SN - 1747-4930
VL - 15
SP - 289
EP - 298
JO - International Journal of Stroke
JF - International Journal of Stroke
IS - 3
ER -