STEMI to stroke: bridging the stroke gap by cross-training interventional cardiologists

Abstract

Acute ischemic stroke remains a major cause of death and disability around the world. Despite the proven efficacy of mechanical thrombectomy (MT) in treating large vessel blockages, many patients, especially those in underserved areas, still cannot access this critical procedure. In this review, we explore whether interventional cardiologists (ICs), with the right training and integration into stroke care, could match or even achieve superior outcomes of neurointerventionalists when performing MT. Some evidence points to ICs especially those with prior carotid stenting experience and high procedural volumes achieving favorable results, including rates of functional independence and successful recanalization similar to those seen in traditional neurointerventional practice. Training strategies - such as simulation-based education, cross-specialty mentorship, and clear institutional protocols - seem to help address the technical and cognitive demands of MT. Bringing ICs into stroke care may, in many cases, help bridge geographic gaps, minimize treatment delays, and improve the overall use of healthcare resources. Nevertheless, these developments must be accompanied by rigorous credentialing processes and open patient communication to maintain ethical and medicolegal standards. Future efforts should explore hybrid training pathways, prospective studies to validate these models, and the role of evolving technology in sustainably expanding MT capacity. With proper supervision, interventional components could serve as an important addition to current neurointerventional teams in the mission to lessen the worldwide impact of stroke.