RT Journal Article SR Electronic T1 Requirements for Emergent Neurosurgical Procedures among Patients Undergoing Neuroendovascular Procedures in Contemporary Practice JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology SP 465 OP 468 DO 10.3174/ajnr.A2787 VO 33 IS 3 A1 R. Khatri A1 M. Ansar A1 F. Sultan A1 S.A. Chaudhry A1 A.A. Khan A1 G.J. Rodriguez A1 R.P. Tummala A1 A.I. Qureshi YR 2012 UL http://www.ajnr.org/content/33/3/465.abstract AB BACKGROUND AND PURPOSE: Provisions for an emergent neurosurgical procedure have been a mandatory component of centers that perform neuroendovascular procedures. We sought to determine the need for emergent neurosurgical procedures following neuroendovascular interventions in 2 comprehensive stroke centers in settings with such provisions. MATERIALS AND METHODS: Analysis of retrospectively collected data from procedure logs and patient charts was performed to identify patients who required immediate (before the termination of the intervention) or adjunctive (within 24 hours of the intervention) neurosurgical procedures related to a neuroendovascular intervention complication. The types of neurosurgical procedures and in-hospital outcomes of identified patients are reported as an aggregate and per endovascular procedure-type analyses. RESULTS: We reviewed a total of 933 neuroendovascular procedures performed during 3.5 years (2006–2010). A total of 759 intracranial procedures were performed. There was a need for emergent neurosurgical procedures in 8 patients (0.85% cumulative incidence and 1.05% for major intracranial procedures) (mean age, 46 years; 7 were women); the procedures were categorized as 3 immediate and 5 adjunctive procedures. There were 5 in-hospital deaths (62.5%) among these 8 patients. Neurosurgical procedures performed were external ventricular drainage placement in 6 (6 of 8, 75%) patients, decompressive craniectomy in 1 (12.5%) patient, and both surgical procedures in 1 (12.5%) patient. CONCLUSIONS: The need for emergent neurosurgical procedures is very low among patients undergoing intracranial neuroendovascular procedures. Survival in such patients despite emergent neurosurgical procedures is quite low. AISacute ischemic strokeEVDexternal ventricular drainageICHintracranial hemorrhageICPintracranial pressureIPHintraparenchymal hemorrhagemRSmodified Rankin scale