Endovascular treatment is an effective treatment for large vessel occlusion (LVO) strokes, but it's not available in every hospital for several reasons:
Specialized Equipment and Personnel: Endovascular treatments require specific equipment and personnel with specialized training . Not all hospitals have the necessary infrastructure or trained staff, such as neurointerventional radiologists, to perform these procedures.
24/7 Availability: Endovascular procedures for stroke require around-the-clock availability of a highly specialized team including neurointerventionalists, anesthesiologists, specially trained nursing staff, and technical staff. This not only requires a significant investment in personnel but also necessitates meticulous scheduling and logistical organization to ensure the team is available at all hours.
Cost: The necessary equipment and training can be very expensive, which may not be affordable for all hospitals, especially those in rural or under-resourced areas.
Volume of Patients: The number of LVO stroke patients a hospital sees can also influence whether it's feasible to offer endovascular treatments. Hospitals that don't often see these types of patients might not be able to justify the expense of maintaining the necessary equipment and trained personnel. Also, treating more patients leadss to better qulaity of care.
For these reasons, stroke systems of care often incorporate both primary stroke centers, which can administer intravenous thrombolytics, and comprehensive stroke centers, which can provide endovascular treatment when needed. It is not likely that endovascular treatment will become available in every hospital.