Cathal John Hannan1, Abdurrahman I Islim2, Andrew F Alalade3, Andrew Bacon4, Anthony Ghosh5, Arthur Dalton6, Ashraf Abouharb7, Daniel Colman Walsh8, Diederik Bulters9, Edward White10, Emmanouil Chavredakis11, George Kounin12, Giles Critchley13, Graham Dow14, Hiren C Patel2, Howard Brydon15, Ian A Anderson16, Ioannis Fouyas17, James Galea18, Jerome St George19, Jarnail Bal20, Krunal Patel21, Mahmoud Kamel22, Mario Teo23, Noel Fanning22, Nitin Mukerji24, Patrick Grover25, Patrick Mitchell26, Peter C Whitfield27, Rikin Trivedi28, Matthew T Crockett29, Paul Brennan29, Mohsen Javadpour30,31,32. 1. Manchester Centre for Clinical Neurosciences, Manchester, UK. cathalhannan@icloud.com. 2. Manchester Centre for Clinical Neurosciences, Manchester, UK. 3. Department of Neurosurgery, Royal Preston Hospital, Preston, UK. 4. Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield, UK. 5. Department of Neurosurgery, Queen's Hospital Romford, Romford, UK. 6. Department of Neurosurgery, Charing Cross Hospital, London, UK. 7. Department of Neurosurgery, Royal Victoria Hospital, Belfast, UK. 8. Department of Neurosurgery, King's College Hospital, London, UK. 9. Department of Neurosurgery, Wessex Neurological Centre, University Hospital Southampton, Southampton, UK. 10. Department of Neurosurgery, Queen Elizabeth Hospital, Birmingham, UK. 11. Department of Neurosurgery, The Walton Centre for Neurology and Neurosurgery, Liverpool, UK. 12. Department of Neurosurgery, Hull Royal Infirmary, Hull, UK. 13. Department of Neurosurgery, University Hospitals Sussex, Brighton, UK. 14. Department of Neurosurgery, Queen's Medical Centre, Nottingham, UK. 15. Department of Neurosurgery, Royal Stoke University Hospital, Stoke, UK. 16. Department of Neurosurgery, Leeds General Infirmary, Leeds, UK. 17. Department of Neurosurgery, Western General Hospital, Edinburgh, UK. 18. Department of Neurosurgery, University Hospital Wales, Cardiff, UK. 19. Department of Neurosurgery, Queen Elizabeth University Hospital, Glasgow, UK. 20. Department of Neurosurgery, Royal London Hospital, London, UK. 21. Department of Neurosurgery, University Hospital Coventry, Coventry, UK. 22. Department of Neurosurgery, Cork University Hospital, Cork, Ireland. 23. Department of Neurosurgery, Southmead Hospital, Bristol, UK. 24. Department of Neurosurgery, James Cook University Hospital, Middlesbrough, UK. 25. Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK. 26. Department of Neurosurgery, Royal Victoria Infirmary, Newcastle, UK. 27. South West Neurosurgery Centre, University Hospitals Plymouth NHS Trust, Plymouth, UK. 28. Department of Neurosurgery, Addenbrookes Hospital, Cambridge, UK. 29. Department of Neuroradiology, Beaumont Hospital, Dublin, Ireland. 30. Department of Neurosurgery, Beaumont Hospital, Dublin, Ireland. 31. School of Medicine, Trinity College Dublin, Dublin, Ireland. 32. Royal College of Surgeons in Ireland, Dublin, Ireland.
Abstract
PURPOSE: Due to the risk of intracranial aneurysm (IA) recurrence and the potential requirement for re-treatment following endovascular treatment (EVT), radiological follow-up of these aneurysms is necessary. There is little evidence to guide the duration and frequency of this follow-up. The aim of this study was to establish the current practice in neurosurgical units in the UK and Ireland. METHODS: A survey was designed with input from interventional neuroradiologists and neurosurgeons. Neurovascular consultants in each of the 30 neurosurgical units providing a neurovascular service in the UK and Ireland were contacted and asked to respond to questions regarding the follow-up practice for IA treated with EVT in their department. RESULTS: Responses were obtained from 28/30 (94%) of departments. There was evidence of wide variations in the duration and frequency of follow-up, with a minimum follow-up duration for ruptured IA that varied from 18 months in 5/28 (18%) units to 5 years in 11/28 (39%) of units. Young patient age, previous subarachnoid haemorrhage and incomplete IA occlusion were cited as factors that would prompt more intensive surveillance, although larger and broad-necked IA were not followed-up more closely in the majority of departments. CONCLUSIONS: There is a wide variation in the radiological follow-up of IA treated with EVT in the UK and Ireland. Further standardisation of this aspect of patient care is likely to be beneficial, but further evidence on the behaviour of IA following EVT is required in order to inform this process.
PURPOSE: Due to the risk of intracranial aneurysm (IA) recurrence and the potential requirement for re-treatment following endovascular treatment (EVT), radiological follow-up of these aneurysms is necessary. There is little evidence to guide the duration and frequency of this follow-up. The aim of this study was to establish the current practice in neurosurgical units in the UK and Ireland. METHODS: A survey was designed with input from interventional neuroradiologists and neurosurgeons. Neurovascular consultants in each of the 30 neurosurgical units providing a neurovascular service in the UK and Ireland were contacted and asked to respond to questions regarding the follow-up practice for IA treated with EVT in their department. RESULTS: Responses were obtained from 28/30 (94%) of departments. There was evidence of wide variations in the duration and frequency of follow-up, with a minimum follow-up duration for ruptured IA that varied from 18 months in 5/28 (18%) units to 5 years in 11/28 (39%) of units. Young patient age, previous subarachnoid haemorrhage and incomplete IA occlusion were cited as factors that would prompt more intensive surveillance, although larger and broad-necked IA were not followed-up more closely in the majority of departments. CONCLUSIONS: There is a wide variation in the radiological follow-up of IA treated with EVT in the UK and Ireland. Further standardisation of this aspect of patient care is likely to be beneficial, but further evidence on the behaviour of IA following EVT is required in order to inform this process.
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