title: Requirements for emergent neurosurgical procedures among patients undergoing neuroendovascular procedures in contemporary practice.
abstract: OBJECTIVE
  Provisions for an emergent neurosurgical procedure have been a mandatory component of centers that perform neuroendovascular procedures. We sought to determine the need for emergent neurosurgical procedures following neuroendovascular interventions in 2 comprehensive stroke centers in settings with such provisions.
  
  
  METHODS
  Analysis of retrospectively collected data from procedure logs and patient charts was performed to identify patients who required immediate (before the termination of the intervention) or adjunctive (within 24 hours of the intervention) neurosurgical procedures related to a neuroendovascular intervention complication. The types of neurosurgical procedures and in-hospital outcomes of identified patients are reported as an aggregate and per endovascular procedure-type analyses.
  
  
  RESULTS
  We reviewed a total of 933 neuroendovascular procedures performed during 3.5 years (2006-2010). A total of 759 intracranial procedures were performed. There was a need for emergent neurosurgical procedures in 8 patients (0.85% cumulative incidence and 1.05% for major intracranial procedures) (mean age, 46 years; 7 were women); the procedures were categorized as 3 immediate and 5 adjunctive procedures. There were 5 in-hospital deaths (62.5%) among these 8 patients. Neurosurgical procedures performed were external ventricular drainage placement in 6 (6 of 8, 75%) patients, decompressive craniectomy in 1 (12.5%) patient, and both surgical procedures in 1 (12.5%) patient.
  
  
  CONCLUSIONS
  The need for emergent neurosurgical procedures is very low among patients undergoing intracranial neuroendovascular procedures. Survival in such patients despite emergent neurosurgical procedures is quite low.
authors: Zeenat Qureshi Stroke Research Center, University of Minnesota, Minneapolis, Minnesota 55455, USA. rakeshk10@gmail.com
authors: R
authors: R
authors: Khatri
authors: M
authors: M
authors: Ansar
authors: F
authors: F
authors: Sultan
authors: S A
authors: SA
authors: Chaudhry
authors: A A
authors: AA
authors: Khan
authors: G J
authors: GJ
authors: Rodriguez
authors: R P
authors: RP
authors: Tummala
authors: A I
authors: AI
authors: Qureshi
mesh_terms: D002543:Cerebral Hemorrhage / Q000401:mortality* / Q000601:surgery*; D015897:Comorbidity; D003422:Critical Care / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D019635:Neurosurgical Procedures / Q000401:mortality*; D011183:Postoperative Complications / Q000401:mortality*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000401:mortality* / Q000601:surgery*; D016019:Survival Analysis; D015996:Survival Rate