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
- VI
Violiza Inoa Acosta 1
- RT
Ryna Then 2
- NM
Nicole M. Cancelliere 3
- NG
Nitin Goyal 1
- KS
Karelle Spence 4
- MW
Michael Wells 5
- AF
Andres Fonnegra 6
- OL
Omar Lopez 6
- FG
Fernando Gonzalez 7
- DM
Daniel Mantilla 8
- AE
Alex Eusebio 9
- CP
Cedric Pimentel 10
- MR
Marc Ribo 11
- MM
Manuel Moreu Gamazo 12
- SG
Serdar Geyik 13
- OY
Ossama Yassin Mansour 14
- SS
Songul Senadim 15
- CA
Cagatay Andic 16
- AO
Atilla Ozcan Ozdemir 17
- VG
Vipul Gupta 18
- VH
Vikram Huded 19
- OM
Octavio Marques Pontes-Neto 20
- GG
Gaurav Goel 21
- EG
Erdem Gurkas 22
- SG
Semih Giray 23
- RN
Raul Nogueira 24
- LD
Laetitia de Villiers 25
- RK
Ruchi Kabra 26
- PR
Parthasarathy Rajsreenivas 27
- VM
Vitor Mendes Pereira 28
- VD
Vu Dang Luu 29
- JP
Jeyaraj Pandian 30
- SC
Sheila Cristina Ouriques Martins 31
- GG
Gillian Gordon Perue 32
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
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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
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