Cerebral angioplasty practice at major medical centers in the United States.
Concern has been expressed recently regarding the proliferation of angioplasty and/or stenting of cerebral vessels. However, little is known about the volume of angioplasties being performed or the number of experienced interventionalists. A questionnaire was mailed to directors of accredited radiology residency programs in the United States, to define the level of expertise available at teaching hospitals in terms of angioplasty and/or stenting. Of 200 programs surveyed, 111 responded (56 %). Of 111 program directors 47 (42%) indicated that cerebral angioplasty was being performed at their center. The greatest experience is currently for angioplasty of post-subarachnoid hemorrhage vasospasm (mean 16 procedures performed) and the least experience for dilation of basilar artery atherosclerosis (mean five procedures performed). The reported stroke and/or death rate in centers performing angioplasty of the extracranial carotid system is 1.5 %. Comparisons with other medical specialties (e.g., cardiologists, neurologists, neurosurgeons) are necessary to determine the full scope of extracranial neurovascular procedures being performed and the corresponding complication rates.
Chaturvedi
S
S
WSU/DMC Stroke Program, and Department of Neurology, Wayne State University School of Medicine, Detroit Medical Center, MI 48201, USA. SChaturv@med.wayne.edu
St Pierre
M E
ME
Bertasio
B
B
D000800:Angioplasty, Balloon / Q000706:statistics & numerical data*; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D015607:Stents; D014481:United States / Q000453:epidemiology