A survey of intracranial aneurysm treatment practices among United States physicians.

Autor:	Fargen KM; Department of Neurological Surgery, Wake Forest University, Winston-Salem, North Carolina, USA., Soriano-Baron HE; Department of Neurological Surgery, Wake Forest University, Winston-Salem, North Carolina, USA., Rushing JT; Wake Forest Baptist Medical Center, Wake Forest University, Winston-Salem, North Carolina, USA., Mack W; Department of Neurosurgery, University of Southern California, Los Angeles, California, USA., Mocco J; Department of Neurosurgery, Mount Sinai Hospital, New York, New York, USA., Albuquerque F; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Ducruet AF; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA., Mokin M; Departments of Neurology and Neurosurgery, University of Southern Florida, Tampa, Florida, USA., Linfante I; Miami Cardiac and Vascular Institute, Baptist Neuroscience Center, Miami, Florida, USA., Wolfe SQ; Department of Neurological Surgery, Wake Forest University, Winston-Salem, North Carolina, USA., Wilson JA; Department of Neurological Surgery, Wake Forest University, Winston-Salem, North Carolina, USA., Hirsch JA; Department of Interventional Neuroradiology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	Journal of neurointerventional surgery [J Neurointerv Surg] 2018 Jan; Vol. 10 (1), pp. 44-49. Date of Electronic Publication: 2017 Feb 09.
DOI:	10.1136/neurintsurg-2016-012808
Abstrakt:	Background: Recent surveys have failed to examine cerebrovascular aneurysm treatment practices among US physicians. Objective: To survey physicians who are actively involved in the care of patients with cerebrovascular aneurysms to determine current aneurysm treatment preferences. Methods: A 25-question SurveyMonkey online survey was designed and distributed electronically to members of the Society of NeuroInterventional Surgery, Society of Vascular and Interventional Neurology, and the American Association of Neurological Surgeons/Congress of Neurological Surgeons Combined Cerebrovascular Section. Results: 211 physicians completed the survey. Most respondents recommend endovascular treatment as the first-line management strategy for most ruptured (78%) and unruptured (71%) aneurysms. Thirty-eight per cent of respondents indicate that they routinely treat all patients with subarachnoid hemorrhage regardless of grade. Most physicians use the International Study of Unruptured Intracranial Aneurysms data for counseling patients on natural history risk (80%); a small minority (11%) always or usually recommend treatment of anterior circulation aneurysms of <5 mm. Two-thirds of respondents continue to recommend clipping for most middle cerebral artery aneurysms, while most (51%) recommend flow diversion for wide-necked internal carotid artery aneurysms. Follow-up imaging schedules are highly variable. Neurosurgeons at academic institutions and those practicing longer were more likely to recommend clipping surgery for aneurysms (p<0.05). Conclusions: This survey demonstrates considerable variability in patient selection for intracranial aneurysm treatment, preferred treatment strategies, and follow-up imaging schedules among US physicians. Competing Interests: Competing interests: None declared. (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)
Databáze:	MEDLINE
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