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SITS opens for thrombectomy

After the first months of 2011 we are approaching 50,000 patients included in the SITS registry. This is all possible thanks to a great work by all participating centres. Besides the role of the SITS data as an instrument for quality development in centres, large numbers of patients are important to enable analyses of the benefit and safety of thrombolysis in subgroups such as in the elderly (recent SITS and SITS-VISTA publications in Lancet Neurology and Stroke) and in a later time window (recently in Lancet Neurology). Read about the publications under Resources/SITS publications.

Within the nearest future, SITS will launch two new protocols, the first is a shorter version of the intravenous thrombolysis protocol (IVTP- minimal) for those centres preferring a minor dataset. The data entry form is shorter, which will reduce the workload. We have tried to keep the data necessary for the most important outcome evaluations, but naturally, it will be a compromise between the workload and what you can get as feed-back. We are just about to open this version for a selected group of test-centres. The second protocol is on thrombectomy.

It is obvious that thrombectomy, mechanical removal of thrombus is an important strategy for further development. It is not yet accepted as a generally applicable routine treatment, although endovascular approaches may be considered as a part of an institutional protocol (see Consensus Statement of Karolinska Stroke Update 2010).

As a consequence, SITS will now provide a registry for thrombectomy, open for all centres using this technique. By checking the 'thrombectomy' box currently available in the patient data entry form, it will be possible to enter data specific for this approach. Importantly, we will accumulate data from clinical routine in the field and centres may compare their experience with others.

In addition to this open registry, centres which meet entry criteria will be invited to join a registry-based controlled study, in which outcomes of treated patients will be compared with prospectively selected control patients from the SITS intravenous thrombolysis register. We believe, that this will be a complement to randomised controlled studies in the field.  A survey will be distributed to SITS centres shortly as an advice on the interest for a registry-based study and for a randomised controlled trial. Both these approaches are being considered with SITS as platform, depending on interest.

These matters will be discussed at separate SITS meetings during the upcoming European Stroke Conference in Hamburg in May. National Coordinators will be invited to a session on the current plans for SITS. Other meeting groups will be arranged for discussions on the thrombectomy registry, an intracerebral haemorrhage registry and a pediatric stroke registry. There will also be meetings with the Steering Committees of SIECV-SITS (Latin America), SITS EAST (East and Central Europe) and SITS-SEARES (SITS South and South East Asia)

We look forward to receiving your input through the survey and if possible, to meet you in Hamburg!

Kind regards

 

Nils e-sign

Nils Wahlgren, Chairman SITS International

 

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