Successful Endovascular Neurosurgical Practice in Resource-poor Exclusive Rural Neuro-hospital Setup.
OBJECTIVE
The aim of this study to evaluate the feasibility of establishing endovascular neurosurgery in remote resource-poor neuro-hospital setup and evaluate its outcome.


METHODS
Retrospective analysis of diagnostic and therapeutic endovascular neurosurgical procedures performed during September 2013-June 2016.


RESULTS
A total of 174 diagnostic cerebral and spinal digital subtraction angiograms and 70 major endovascular neurosurgeries were performed during the period. The endovascular neurosurgical procedures included 54 aneurysms coiled, 4 cerebral arteriovenous malformation embolization, 2 dural arteriovenous fistulas embolization, 2 cerebral tumor embolizations, 2 intracranial stentings, 5 extracranial carotid stentings, 1 transverse sinus stenting. No complications were seen during diagnostic procedures. Operation related morbidity of 1.4% and mortality of 1.4% seen, with a procedural success rate of 97.2%.


CONCLUSIONS
Endovascular neurosurgery is feasible in resource-poor remote rural exclusive neuro-hospital setup with procedural success rate and outcomes comparable to existing literature.
Department of Endovascular Neurosurgery, Indo American Hospital, Brain and Spine Centre, Vaikom, Kerala, India.
Kamble Jayaprakash
KJ
Harsha
Aneurysm coiling; digital subtraction angiogram; endovascular neurosurgery; rural hospital