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<meta name="DC.Title" content="Requirements for Emergent Neurosurgical Procedures among Patients Undergoing Neuroendovascular Procedures in Contemporary Practice" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2787" />
<meta name="DC.Date" content="2012-03-01" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: 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.

MATERIALS AND 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.

AIS
:   acute ischemic stroke
EVD
:   external ventricular drainage
ICH
:   intracranial hemorrhage
ICP
:   intracranial pressure
IPH
:   intraparenchymal hemorrhage
mRS
:   modified Rankin scale" />
<meta name="DC.Contributor" content="R. Khatri" />
<meta name="DC.Contributor" content="M. Ansar" />
<meta name="DC.Contributor" content="F. Sultan" />
<meta name="DC.Contributor" content="S.A. Chaudhry" />
<meta name="DC.Contributor" content="A.A. Khan" />
<meta name="DC.Contributor" content="G.J. Rodriguez" />
<meta name="DC.Contributor" content="R.P. Tummala" />
<meta name="DC.Contributor" content="A.I. Qureshi" />
<meta name="article:published_time" content="2012-03-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Requirements for Emergent Neurosurgical Procedures among Patients Undergoing Neuroendovascular Procedures in Contemporary Practice" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;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.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;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.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;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.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;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.&lt;/p&gt;" />
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<meta name="citation_reference" content="citation_journal_title=American Journal of Neuroradiology;citation_journal_abbrev=Am. J. Neuroradiol.;citation_author=F. Ricolfi;citation_author=C. Le Guerinel;citation_author=J. Blustajn;citation_title=Rupture during treatment of recently ruptured aneurysms with Guglielmi electrodetachable coils;citation_pages=1653-1658;citation_volume=19;citation_year=1998;citation_issue=9;citation_issn=0195-6108;citation_pmid=9802487" />
<meta name="twitter:title" content="Requirements for Emergent Neurosurgical Procedures among Patients Undergoing Neuroendovascular Procedures in Contemporary Practice" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/33/3.cover.gif" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: 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.

MATERIALS AND 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.

AIS
:   acute ischemic stroke
EVD
:   external ventricular drainage
ICH
:   intracranial hemorrhage
ICP
:   intracranial pressure
IPH
:   intraparenchymal hemorrhage
mRS
:   modified Rankin scale" />
<meta name="og-title" property="og:title" content="Requirements for Emergent Neurosurgical Procedures among Patients Undergoing Neuroendovascular Procedures in Contemporary Practice" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/33/3/465" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: 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.

MATERIALS AND 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.

AIS
:   acute ischemic stroke
EVD
:   external ventricular drainage
ICH
:   intracranial hemorrhage
ICP
:   intracranial pressure
IPH
:   intraparenchymal hemorrhage
mRS
:   modified Rankin scale" />
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">R. Khatri</span>, <span class="highwire-citation-author" data-delta="1">M. Ansar</span>, <span class="highwire-citation-author" data-delta="2">F. Sultan</span>, <span class="highwire-citation-author" data-delta="3">S.A. Chaudhry</span>, <span class="highwire-citation-author" data-delta="4">A.A. Khan</span>, <span class="highwire-citation-author" data-delta="5">G.J. Rodriguez</span>, <span class="highwire-citation-author" data-delta="6">R.P. Tummala</span> and <span class="highwire-citation-author" data-delta="7">A.I. Qureshi</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">March 2012,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">33 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">465-468; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2787 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-11810--6884974330" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">R. Khatri </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.%2BKhatri%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Khatri%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.%2BKhatri%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">M. 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<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> 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.</p>
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<p id="p-3"><strong>MATERIALS AND METHODS:</strong> 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.</p>
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<p id="p-4"><strong>RESULTS:</strong> 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.</p>
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<p id="p-5"><strong>CONCLUSIONS:</strong> 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.</p>
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<h2>ABBREVIATIONS:</h2>
<dl id="def-list-1"><dt id="def-item-1">AIS<span class="def-item-dt-sep"></span></dt><dd>acute ischemic stroke<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">EVD<span class="def-item-dt-sep"></span></dt><dd>external ventricular drainage<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">ICH<span class="def-item-dt-sep"></span></dt><dd>intracranial hemorrhage<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">ICP<span class="def-item-dt-sep"></span></dt><dd>intracranial pressure<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">IPH<span class="def-item-dt-sep"></span></dt><dd>intraparenchymal hemorrhage<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">mRS<span class="def-item-dt-sep"></span></dt><dd>modified Rankin scale</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2012 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/33/3/465.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 33</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 3 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Mar 2012 </div></div>
      
      
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      <div class="highwire-cite-title">Requirements for Emergent Neurosurgical Procedures among Patients Undergoing Neuroendovascular Procedures in Contemporary Practice</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Mar 2012, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">33 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">465-468; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2787 </span></div>
  
  
  
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      <div class="highwire-cite-title">Requirements for Emergent Neurosurgical Procedures among Patients Undergoing Neuroendovascular Procedures in Contemporary Practice</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Khatri</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Ansar</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Sultan</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">S.A.</span> <span class="nlm-surname">Chaudhry</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">A.A.</span> <span class="nlm-surname">Khan</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">G.J.</span> <span class="nlm-surname">Rodriguez</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">R.P.</span> <span class="nlm-surname">Tummala</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">A.I.</span> <span class="nlm-surname">Qureshi</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Mar 2012, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">33 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">465-468; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2787 </span></div>
  
  
  
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