You Cannot Manage What You Do Not Measure: Advances in Global Stroke Interventions and the Role of the Mechanical Thrombectomy Access Score

Abstract

Global disparities in stroke care, particularly in acute interventions like mechanical thrombectomy (MT), remain profound, with the Mechanical Thombectomy Global Access for Stroke study reporting a median global MT access of just 2.79%. Furthermore, the low- and middle-income countries (LMICs) have been recognized to be disproportionately burdened in this regard as compared with high-income countries. These observed inequities in stroke care impact not only clinical outcomes but also economic productivity and social systems. Recent advancements, such as TeleStroke networks, Mobile Stroke Units, and artificial intelligence-powered tools, have the potential to bridge these gaps. The Mechanical Thrombectomy Access Score (MTAS) offers a novel standardized approach to quantifying barriers to MT access and guiding targeted interventions to mitigate such obstacles. This review explores how MTAS enables the integration of these advancements into global stroke care systems, addressing inequities and optimizing outcomes. Emphasizing the importance of measuring access to manage inequities, we propose strategies to refine and validate MTAS while advocating for systemic investments to enhance global stroke care.