Vascular interventional neuroradiology in a country with a small and scattered population. Twenty years' experience in norway.

SUMMARY: Experience with neuroradiological endovascular therapy in a small country is presented. Five Norwegian university hospitals are currently performing coiling of cerebral aneurysms and three are embolizing cerebral arteriovenous malformations. The small number of procedures in most of these institutions may threaten the quality of treatment, education of neuroinradiologists, research and scientific work in this field. An even greater concern might arise in the field of neurosurgery after the reduction in surgical procedures following the increasing takeover by endovascular procedures. The safety during transportation of patients with subarachnoid hemorrhage has been debated and is considered by some as a problem, but earlier experience from Nordic countries does not support this concern. Reducing the number of centres performing these procedures seems necessary to obtain adequate patient safety and an ethical practice.