Kyle M Fargen1, Hector E Soriano-Baron1, Julia T Rushing2, William Mack3, J Mocco4, Felipe Albuquerque5, Andrew F Ducruet5, Maxim Mokin6, Italo Linfante7, Stacey Q Wolfe1, John A Wilson1, Joshua A Hirsch8. 1. Department of Neurological Surgery, Wake Forest University, Winston-Salem, North Carolina, USA. 2. Wake Forest Baptist Medical Center, Wake Forest University, Winston-Salem, North Carolina, USA. 3. Department of Neurosurgery, University of Southern California, Los Angeles, California, USA. 4. Department of Neurosurgery, Mount Sinai Hospital, New York, New York, USA. 5. Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA. 6. Departments of Neurology and Neurosurgery, University of Southern Florida, Tampa, Florida, USA. 7. Miami Cardiac and Vascular Institute, Baptist Neuroscience Center, Miami, Florida, USA. 8. Department of Interventional Neuroradiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Abstract
BACKGROUND: Recent surveys have failed to examine cerebrovascular aneurysm treatment practices among US physicians. OBJECTIVE: To survey physicians who are actively involved in the care of patients with cerebrovascular aneurysms to determine current aneurysm treatment preferences. METHODS: A 25-question SurveyMonkey online survey was designed and distributed electronically to members of the Society of NeuroInterventional Surgery, Society of Vascular and Interventional Neurology, and the American Association of Neurological Surgeons/Congress of Neurological Surgeons Combined Cerebrovascular Section. RESULTS: 211 physicians completed the survey. Most respondents recommend endovascular treatment as the first-line management strategy for most ruptured (78%) and unruptured (71%) aneurysms. Thirty-eight per cent of respondents indicate that they routinely treat all patients with subarachnoid hemorrhage regardless of grade. Most physicians use the International Study of Unruptured Intracranial Aneurysms data for counseling patients on natural history risk (80%); a small minority (11%) always or usually recommend treatment of anterior circulation aneurysms of <5 mm. Two-thirds of respondents continue to recommend clipping for most middle cerebral artery aneurysms, while most (51%) recommend flow diversion for wide-necked internal carotid artery aneurysms. Follow-up imaging schedules are highly variable. Neurosurgeons at academic institutions and those practicing longer were more likely to recommend clipping surgery for aneurysms (p<0.05). CONCLUSIONS: This survey demonstrates considerable variability in patient selection for intracranial aneurysm treatment, preferred treatment strategies, and follow-up imaging schedules among US physicians. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
BACKGROUND: Recent surveys have failed to examine cerebrovascular aneurysm treatment practices among US physicians. OBJECTIVE: To survey physicians who are actively involved in the care of patients with cerebrovascular aneurysms to determine current aneurysm treatment preferences. METHODS: A 25-question SurveyMonkey online survey was designed and distributed electronically to members of the Society of NeuroInterventional Surgery, Society of Vascular and Interventional Neurology, and the American Association of Neurological Surgeons/Congress of Neurological Surgeons Combined Cerebrovascular Section. RESULTS: 211 physicians completed the survey. Most respondents recommend endovascular treatment as the first-line management strategy for most ruptured (78%) and unruptured (71%) aneurysms. Thirty-eight per cent of respondents indicate that they routinely treat all patients with subarachnoid hemorrhage regardless of grade. Most physicians use the International Study of Unruptured Intracranial Aneurysms data for counseling patients on natural history risk (80%); a small minority (11%) always or usually recommend treatment of anterior circulation aneurysms of <5 mm. Two-thirds of respondents continue to recommend clipping for most middle cerebral artery aneurysms, while most (51%) recommend flow diversion for wide-necked internal carotid artery aneurysms. Follow-up imaging schedules are highly variable. Neurosurgeons at academic institutions and those practicing longer were more likely to recommend clipping surgery for aneurysms (p<0.05). CONCLUSIONS: This survey demonstrates considerable variability in patient selection for intracranial aneurysm treatment, preferred treatment strategies, and follow-up imaging schedules among US physicians. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Cathal John Hannan; Abdurrahman I Islim; Andrew F Alalade; Andrew Bacon; Anthony Ghosh; Arthur Dalton; Ashraf Abouharb; Daniel Colman Walsh; Diederik Bulters; Edward White; Emmanouil Chavredakis; George Kounin; Giles Critchley; Graham Dow; Hiren C Patel; Howard Brydon; Ian A Anderson; Ioannis Fouyas; James Galea; Jerome St George; Jarnail Bal; Krunal Patel; Mahmoud Kamel; Mario Teo; Noel Fanning; Nitin Mukerji; Patrick Grover; Patrick Mitchell; Peter C Whitfield; Rikin Trivedi; Matthew T Crockett; Paul Brennan; Mohsen Javadpour Journal: Acta Neurochir (Wien) Date: 2022-10-11 Impact factor: 2.816
Authors: Rishab Belavadi; Sri Vallabh Reddy Gudigopuram; Ciri C Raguthu; Harini Gajjela; Iljena Kela; Chandra L Kakarala; Mohammad Hassan; Ibrahim Sange Journal: Cureus Date: 2021-12-17