ORIGINAL RESEARCH article

Front. Neurol.

Sec. Endovascular and Interventional Neurology

World Stroke Organization Mechanical Thrombectomy Workshops Combined with the Global Stroke Alliance builds regional capacity

  • 1. The University of Tennessee Health Science Center College of Medicine, Memphis, United States

  • 2. Jefferson Einstein Philadelphia Hospital, Philadelphia, United States

  • 3. St Michael's Hospital, Toronto, Canada

  • 4. Jackson North, Miami, FL, United States

  • 5. Leonard M. Miller School of Medicine, University of Miami, Miami, United States

  • 6. Shaio Clinic Foundation, Bogota, Colombia

  • 7. Johns Hopkins University School of Medicine, Baltimore, United States

  • 8. Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia

  • 9. Northwell Health, New York, NY, United States

  • 10. Department of Neurology and Neurosurgery, Division of Neurocritical Care, Emory University School of Medicine, Atlanta, Georgia, United States

  • 11. Hospital Vall d’Hebron, Barcelona, Spain

  • 12. Neurointerventional Unit, Hospital Clinico Universitario San Carlos, Madrid, Spain

  • 13. Department of Radiology (S.G.), IAU Stroke Center, Istanbul Aydin University, Istanbul, Türkiye

  • 14. Department of Radiology (S.G.), IAU Stroke Center, Istanbul Aydin University, Türkiye., Istanbul, Türkiye

  • 15. Department of Neurology, Bakırköy Research and Training Hospital for Psychiatry, Neurology, Neurosurgery, Istanbul, Türkiye

  • 16. Department of Interventional Radiology, Ba¸skent University Dr. Turgut Noyan Application and Research Center, Adana, Türkiye

  • 17. Eskisehir Osmangazi University, Eskişehir, Türkiye

  • 18. Department of Neurointerventional Surgery, Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, India

  • 19. Department of Interventional Neurology, Narayana Health Institute of Neuroscience, Mazumdar Shaw Medical Cente, Narayana Health City, India

  • 20. University of São Paulo, Ribeirão Preto Medical School, Department of Neurosciences and Behavioral Sciences, Ribeirão Preto SP, Brazil

  • 21. Department of Neurointervention surgery, Neurointervention Surgery, Institute of Neurosciences, Medanta, The Medicity Gurugram, Haryana, India

  • 22. Neurology Department, Dr Lutfi Kirdar City Hospital, Istanbul, Türkiye

  • 23. Department of Neurology, Gaziantep University, Gaziantep, Türkiye

  • 24. Departments of Neurology, Neurosurgery, and Radiology, Marcus Stroke and Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, United States

  • 25. Department of Interventional Neuroradiology, Gold Coast University Hospital, Southport, Queensland, Australia

  • 26. Neurological Intervention and Imaging Service of Western Australia (NIISWA), Perth, Western Australia, Australia

  • 27. Paras Health, Gurugram, Haryana, India

  • 28. St Michaels’ Hospital, Toronto, Canada

  • 29. Stroke Center Bach Mai Hospital, Hanoi, Vietnam

  • 30. Department of Neurology, Christian Medical College and Hospital, Ludhiana, PB, India

  • 31. Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

  • 32. University of Miami Miller School of Medicine, Miami, United States

The final, formatted version of the article will be published soon.

Abstract

Introduction: Access to mechanical thrombectomy (MT) remains limited in many low-and middle-income or resource-limited regions because of gaps in trained personnel, procedural experience, public awareness, and stroke-system readiness. The World Stroke Organization paired simulation-based MT workshops with the Global Stroke Alliance to combine hands-on neurointerventional education with regional advocacy, Ministry of Health engagement, public awareness activities, and stakeholder collaboration. This study evaluated the feasibility, scalability, and self-reported educational impact of MT workshops delivered within this broader WSO/GSA capacity-building framework. Methods: A comprehensive 22-hour curriculum was developed, incorporating didactic sessions, hands-on simulations, and complex case studies in collaboration with the Global Stroke Alliance between August 2023 and July 2025. The workshops were designed for neurointerventional physicians and tailored to regional needs. Pre-and post-course assessments measured physician confidence in MT procedures, while a three-month follow-up survey evaluated changes in MT volumes and clinical practice. Data were analyzed using summary statistics, chi-square tests, and McNemar's tests as appropriate. Results: Among 112 participating physicians from 24 countries, 81% completed the pre-test and 72% completed the post-test; 67% had paired pre-and post-test responses. The proportion of participants rating themselves as "very comfortable" increased from 15% pre-workshop to 41% post-workshop (P<0.001), with notable improvements in patient selection for MT (15% to 48%, P<0.001), procedural access knowledge (15% to 46%, P<0.001), thrombectomy technique (9% to 41%, P<0.001), and avoiding harmful maneuvers (7% to 33%, P<0.001). At three months, 32 participants completed follow-up, of whom 37.5% self-reported an increase in overall thrombectomy numbers. Conclusions: Simulation-based MT workshops are feasible and scalable across multiple regions and were associated with improved self-reported procedural confidence and early self-reported changes in clinical practice. These findings support structured hands-on training as one component of broader capacity-building efforts, while highlighting the need for objective procedural volume, patient outcome, and registry-based data to determine the effect of such programs on MT access and stroke care delivery.

Summary

Keywords

hands on simulation, Low to middle income countries, Mechanical thrombectomy, neurointerventional physician education, training

Received

26 April 2026

Accepted

05 August 2026

Copyright

© 2026 Inoa Acosta, Then, Cancelliere, Goyal, Spence, Wells, Fonnegra, Lopez, Gonzalez, Mantilla, Eusebio, Pimentel, Ribo, Moreu Gamazo, Geyik, Mansour, Senadim, Andic, Ozdemir, Gupta, Huded, Pontes-Neto, Goel, Gurkas, Giray, Nogueira, de Villiers, Kabra, Rajsreenivas, Mendes Pereira, Luu, Pandian, Martins and Gordon Perue. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Gillian Gordon Perue

Disclaimer

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Outline

Share article

Article metrics