Study Design

Retrospective observational survey-based study.

Introduction

In France, intracranial aneurysm (IA) patients are managed by neurosurgeons and by interventional neuroradiologists. The growth of endovascular treatment led us to reflect on the role of neurosurgeons in the management of patients with IA. The present study aimed to highlight the current organization of IA management in France.

Method

A 60-question survey was sent to the neurosurgeons in 34 hospitals managing IA patients. Thirty-three questions dealt with standards of care, follow-up procedures and the involvement of the specific specialist.

Results

Twenty-seven centers (79.4%) responded to the survey. A Vascular Multidisciplinary Discussion Team was organized, including both surgeons and neuroradiologists, in 92% of responding centers. There were department protocols in 66% of centers, a local registry in 33% and clinical trials in IA in 60%. Patients with unruptured IA were first seen by a neurosurgeon or by an interventional neuroradiologist, with different practices. For ruptured IA, the neurosurgeons were contacted first in 93% of cases, and were systematically involved in initial intensive care unit management. The patients were hospitalized in the neurosurgery department in 89% of the centers. The neurosurgeons took care of initial follow-up in 85% of the centers, and of lifetime follow-up in 36%. In most centers, radiological monitoring of IA was based on MRI angiography for patients who were embolized or under surveillance, and on CT angiography after microsurgery.

Conclusion

Despite the growth of endovascular treatments, the present survey and the literature highlight a major role of neurosurgeons in treatment, follow-up and care coordination.

中文翻译：

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神经外科医生在法国目前颅内动脉瘤治疗中的作用是什么？专业实践分析

学习规划

基于回顾性观察调查的研究。

介绍

在法国，颅内动脉瘤 (IA) 患者由神经外科医生和介入神经放射科医生管理。血管内治疗的发展促使我们反思神经外科医生在 IA 患者管理中的作用。本研究旨在突出法国当前的 IA 管理组织。

方法

向管理 IA 患者的 34 家医院的神经外科医生发送了一项包含 60 个问题的调查。三十三个问题涉及护理标准、后续程序和特定专家的参与。

结果

27 个中心 (79.4%) 对调查做出了回应。在 92% 的响应中心组织了一个血管多学科讨论小组，包括外科医生和神经放射科医师。66% 的中心有部门方案，33% 有本地注册，60% 有 IA 临床试验。未破裂的 IA 患者首先由神经外科医生或介入神经放射科医师诊治，并采用不同的做法。对于破裂的 IA，93% 的病例首先联系神经外科医生，并系统地参与最初的重症监护病房管理。患者在 89% 的中心的神经外科住院。神经外科医生负责 85% 的中心的初始随访和 36% 的终生随访。在大多数中心，

结论

尽管血管内治疗有所增长，但目前的调查和文献强调了神经外科医生在治疗、随访和护理协调中的主要作用。