Advanced

AJNR - American Journal of Neuroradiology

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Friedman, D. P. Articles by Maitino, A. J. Search for Related Content PubMed PubMed Citation Articles by Friedman, D. P. Articles by Maitino, A. J.

American Journal of Neuroradiology 24:1772-1777, October 2003
© 2003 American Society of Neuroradiology

INTERVENTIONAL

Endovascular Interventional Neuroradiologic Procedures: Who Is Performing Them, How Often, and Where? A Survey of Academic and Nonacademic Radiology Practices

David P. Friedman^a and Andrea J. Maitino^a

^a From the Jefferson Medical College and Thomas Jefferson University Hospital, Philadelphia, PA

Address reprint requests to David P. Friedman, MD, Department of Radiology, Jefferson Medical College and Thomas Jefferson University Hospital, 132 South 10th Street, Suite 1072, Main Building, Philadelphia, PA 19107

BACKGROUND AND PURPOSE: In this report, the authors assess practice patterns at both academic and nonacademic centers regarding the treatment of aneurysms with Guglielmi detachable coils (GDCs), thrombolysis of the carotid-vertebral arteries, and stent placement with angioplasty of the carotid arteries.

METHODS: A neurovascular radiology survey was sent to 102 directors of neuroradiology fellowship programs in the United States and Canada ("academic centers"). The survey was also sent to senior members of the American Society of Neuroradiology (three per state) who were not affiliated with fellowship programs ("nonacademic centers").

RESULTS: Fifty-seven surveys from academic practices and 70 surveys from nonacademic practices were returned. A total of 4361 procedures (2283 GDC; 949 thrombolysis; 1129 stent placement) were performed; 84% were performed at academic centers and 16% at nonacademic centers. Ninety percent of GDC, 71% of thrombolysis, and 82% of stent placement procedures were performed at academic centers. Seven academic and three nonacademic centers performed 48% of all GDC procedures; eight academic and four nonacademic centers performed 45% of all thrombolysis procedures; eight academic centers performed 50% of all stent placement procedures. A total of 544/4361 (12%) procedures were performed by nonradiologists. At academic centers, 14% of procedures were performed by nonradiologists; participation by nonradiologists was greatest for carotid stent placement (24% of procedures). At nonacademic centers, only 5% of procedures were performed by nonradiologists.

CONCLUSION: According to this survey, most endovascular interventional neuroradiologic procedures are performed at academic centers; given the survey population, this study likely identifies the lower limit of participation by nonradiologists (12%). Performance of these procedures is concentrated in relatively few centers, and these data raise questions about the overall use of intraarterial thrombolytic therapy for acute infarction.

This article has been cited by other articles:

				J. L. Brisman, J. K. Song, and D. W. Newell Cerebral aneurysms. N. Engl. J. Med., August 31, 2006; 355(9): 928 - 939. [Full Text] [PDF]

				S. C. Johnston Who belongs inside the carotid arteries? Neurology, January 25, 2005; 64(2): 188 - 189. [Full Text] [PDF]