Mapping access to endovascular stroke care in the USA and implications for transport models

Jared Aldstadt, National Center for Geographic Information and Analysis and Department of Geography, University at Buffalo - The State University of New York, Buffalo, New York, USA.
Muhammad Waqas, Neurosurgery and Radiology and Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Misa Yasumiishi, National Center for Geographic Information and Analysis and Department of Geography, University at Buffalo - The State University of New York, Buffalo, New York, USA.
Maxim Mokin, Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, USA.
Vincent M. Tutino, Neurosurgery and Radiology and Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Hamid H. Rai, Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Felix Chin, Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Bennett R. Levy, (Medical school student), The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Ansaar T. Rai, Interventional Neuroradiology, West Virginia University Rockefeller Neuroscience Institute, Morgantown, West Virginia, USA.
J Mocco, Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Kenneth V. Snyder, Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA.
Jason M. Davies, Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA.
Elad I. Levy, Neurosurgery and Radiology and Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Adnan H. Siddiqui, Neurosurgery and Radiology and Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA asiddiqui@ubns.com.

Document Type

Journal Article

Publication Date

1-1-2022

Journal

Journal of neurointerventional surgery

Volume

14

Issue

1

DOI

10.1136/neurintsurg-2020-016942

Keywords

economics; statistics; stroke; technology; thrombectomy

Abstract

BACKGROUND: The purpose of this cross-sectional study was to determine the percentage of the US population with 60 min ground or air access to accredited or state-designated endovascular-capable stroke centers (ECCs) and non-endovascular capable stroke centers (NECCs) and the percentage of NECCs with an ECC within a 30 min drive. METHODS: Stroke centers were identified and classified broadly as ECCs or NECCs. Geographic mapping of stroke centers was performed. The population was divided into census blocks, and their centroids were calculated. Fastest air and ground travel times from centroid to nearest ECC and NECC were estimated. RESULTS: Overall, 49.6% of US residents had 60 min ground access to ECCs. Approximately 37.7% (113 million) lack 60 min ground or air access to ECCs. Approximately 84.4% have 60 min access to NECCs. Ground-only access was available to 77.9%. Approximately 738 NECCs (45.4%) had an ECC within a 30 min drive. CONCLUSION: Nearly one-third of the US population lacks 60 min access to endovascular stroke care, but this is highly variable. Transport models and planning of additional centers should be tailored to each state depending on location and proximity of existing facilities.

Department

School of Medicine and Health Sciences Student Works

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