# COMAR Title 30 — Maryland Institute for Emergency Medical Services Systems (MIEMSS)

## Subtitle 08 — Designation of Trauma and Specialty Referral Centers

### Chapter 17 — Comprehensive Stroke Center Standards

#### Regulation .08 Endovascular Interventional Services.

*COMAR 30.08.17.08*

The hospital shall have:

A. Interventional services promptly available 24 hours a day with appropriately trained support staff and equipment, including:

  (1) Intra-arterial reperfusion therapy;

  (2) Endovascular treatment of vasospasm;

  (3) Endovascular ablation of arterial venous malformations;

  (4) Stenting/angioplasty of extracranial vessels; and

  (5) Stenting/angioplasty of intracranial vessels;

B. A neurointerventionalist who may be a board-certified/board-eligible neuroradiologist, neurologist, or neurosurgeon on call with a 45-minute arrival time to the hospital;

C. An on-call schedule for primary and back-up neurointerventionalists or neuroradiologists;

D. A written protocol to accept the inter-facility transfer of acute ischemic stroke patients requiring endovascular therapy that includes communication and feedback to the sending facility; and

E. A written protocol to accept the inter-facility transfer of acute stroke patients requiring a higher level of care.