Initial experience in establishing an academic neuroendovascular service: program building, procedural types, and outcomes.
OBJECTIVE
To report our initial experience in setting up a neuroendovascular service in a university-based comprehensive stroke center.


METHODS
We determined the rates of referral path, procedural type, and independently adjudicated 1-month outcomes (actual rates) in first 150 procedures (120 patients) and subsequently compared with rates derived from pertinent clinical trials after adjustment for procedural type (predicted rates).


RESULTS
The patients were referred from the emergency department (n= 44), transferred from another hospital (n= 13), or admitted for elective procedures from the clinic (n= 63). The procedures included treatment of acute ischemic stroke (n= 12); extracranial carotid stent placement (n= 33); extracranial vertebral artery stent placement (n= 13); intracranial angioplasty and/or stent placement (n= 12); embolization for intracranial aneurysms (n= 35), arteriovenous malformations (n= 5), and tumors (n= 10); cerebral vasospasm treatment (n= 26); and others (n= 4). The technical success rate was 100% for intracranial aneurysm obliteration and extracranial carotid artery stent placement, and 95% for those undergoing intracranial or vertebral artery stent placements; and partial or complete recanalization was achieved in 72% of patients undergoing intra-arterial thrombolysis. After adjusting for procedural type, the actual adverse event rate of 3% compared favorably with the predicted rate of 7% based on the results of clinical trials.


CONCLUSIONS
We provide estimates of procedure volumes and outcomes observed in the initial phase of setting up a neuroendovascular service with an active training program.
Zeenat Qureshi Stroke Research Center and Departments of Neurology, Neurosurgery, and Radiology, University of Minnesota, Minneapolis, Minnesota 55455, USA. aiqureshi@hotmail.com
Adnan I
AI
Qureshi
Vallabh
V
Janardhan
Muhammad Zeeshan
MZ
Memon
M Fareed K
MF
Suri
Qaisar A
QA
Shah
Jefferson T
JT
Miley
Amy E
AE
Puchta
Robert A
RA
Taylor
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006489:Hemostatic Techniques; D006757:Hospital Units / Q000458:organization & administration*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009937:Organizational Objectives; D010043:Outcome and Process Assessment, Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data; D015607:Stents; D020521:Stroke / Q000628:therapy*; D014656:Vascular Surgical Procedures