Study design

Observational retrospective survey-based study.

Introduction

Intracranial aneurysms (IA) can be treated with microsurgery or by endovascular treatments (EVT). EVT have taken an increasingly important part in IA management; the ability of neurosurgical teams to perform such surgery as well as the quality of their training is being questioned. We therefore wanted to assess the proportion of IA treated by microsurgery in France, the demography and caseload of surgeons trained in vascular neurosurgery.

Methodology

A 60-question survey was sent to the 34 French neurosurgical centers treating IA. Twenty-seven questions dealt with the demography of neurovascular surgeons and caseload. Descriptive data are reported here.

Results

Twenty-seven centers answered, giving us a response rate of 79.4%. A total of 209 neurosurgeons worked in these centers. Forty-six neurosurgeons were designated as referents in vascular neurosurgery, 47% of them were under 45 years old. Among the centers, 96.3% had at least one surgeon that was a referent in neurovascular surgery. A total of 88 surgeons performed IA surgery, but only 11 operated more than 20 IA per year. Two thousand four hundred and thirty seven unruptured IA were treated every year in these centers, 25% of which by microsurgery. A total of 2727 ruptured IA were treated in these centers, of which 15% were treated by microsurgery. The most common indications for microsurgical treatment of IA were: middle cerebral artery aneurysms, wide-neck intracranial aneurysms, and giant intracranial aneurysms, as well as aneurysms associated with a hematoma for the ruptured ones.

Conclusion

Demography of vascular neurosurgeons remains favorable, with a referent neurosurgeon in most centers, who, in half of the cases, is a young practitioner. The percentage of microsurgery in the treatment of IA is low, especially for ruptured ones. The most frequently operated types of intracranial aneurysm correspond to good practice recommendations.

中文翻译：

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法国颅内动脉瘤的治疗：显微外科和血管神经外科医生的人口统计学

学习规划

基于观察性回顾性调查的研究。

介绍

颅内动脉瘤 (IA) 可以通过显微手术或血管内治疗 (EVT) 进行治疗。EVT 在 IA 管理中发挥着越来越重要的作用；神经外科团队进行此类手术的能力以及他们的培训质量受到质疑。因此，我们想评估法国显微外科治疗 IA 的比例、接受过血管神经外科培训的外科医生的人口统计学和病例量。

方法

向治疗 IA 的 34 个法国神经外科中心发送了一项包含 60 个问题的调查。27 个问题涉及神经血管外科医生的人口统计学和病例数。此处报告了描述性数据。

结果

27 个中心回答了，我们的回答率为 79.4%。共有 209 名神经外科医生在这些中心工作。46名神经外科医生被指定为血管神经外科的参考对象，其中47%的人年龄在45岁以下。在这些中心中，96.3% 的中心至少有一名外科医生是神经血管手术的代表。共有 88 名外科医生进行了 IA 手术，但只有 11 名外科医生每年进行 20 次以上的 IA。这些中心每年治疗 2437 例未破裂的 IA，其中 25% 是通过显微外科手术进行的。这些中心共治疗了 2727 例破裂的 IA，其中 15% 接受了显微手术治疗。IA显微外科治疗最常见的适应症是：大脑中动脉瘤、宽颈颅内动脉瘤和巨大颅内动脉瘤，

结论

血管神经外科医生的人口统计学仍然有利，大多数中心都有一名神经外科医生，在一半的病例中，他是一名年轻的从业者。显微外科治疗IA的比例很低，尤其是破裂的。最常手术的颅内动脉瘤类型符合良好实践建议。