title: Endovascular treatment of cerebral aneurysms at a low-volume community hospital practice: management strategies, complications, and outcomes.
abstract: OBJECTIVE
  Our institution serves a population of 160,000 and performed 14.4 endovascular cerebral aneurysm interventions annually, averaged over a 5-year period. The purpose of this study was to examine the safety and efficacy of endovascular treatment of cerebral aneurysms at a lowvolume center.
  
  
  METHODS
  Retrospective cohort analysis of 56 patients harboring 64 aneurysms requiring 72 procedures over 62 months. Aneurysm morphology, procedure-related adverse events and clinical outcomes were analyzed.
  
  
  RESULTS
  Twenty-two ruptured (34.4%) and 42 unruptured (65.6%) aneurysms were treated in 12 males (mean age 61.1 years), 44 females (mean age 61.8 years). The procedure-related morbidity and mortality was 6.9% (5 of 72) and 1.3% (1 of 72 procedures), respectively. Modified Rankin Scale score was 0 or 1 in 87.9% of all discharges (61.9% in the ruptured group, 100% in the unruptured group). This score was between 2 to 5 in 7.6% (23.8% ruptured, 0% ruptured) and 6 in 4.3% of patients. Seventy-two percent of aneurysms demonstrated complete occlusion initially, 23.0% had residual neck filling, and 4.9% had residual aneurysm filling.
  
  
  CONCLUSIONS
  Endovascular coil embolization at a small volume nonspecialized community center is feasible with satisfactory procedural risk and clinical outcomes.
authors.affiliation: Central Illinois Neurosciences Institute, Bloomington, Illinois, USA.
authors.forename: Darbi
authors.initials: D
authors.lastname: Invergo
authors.forename: Ajeet
authors.initials: A
authors.lastname: Gordhan
mesh_terms: D000328:Adult; D057510:Endovascular Procedures / Q000401:mortality*; D005260:Female; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000401:mortality*; D015995:Prevalence; D011379:Prognosis; D011859:Radiography; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome