Abstract T P373: Experience with a Multidisciplinary Pediatric Neurovascular Conference for Complex Disease Management

Abstract

Introduction: In 2013 our institution established a multidisciplinary pediatric neurovascular conference (PNVC) for coordination of care. Here we review our initial experience. Hypothesis: Collaboration yields coordinated care for children with complex cerebrovascular disease and treatment protocols for commonly discussed conditions. Methods: Clinical and demographic data were obtained from medical records for patients presented to PNVC from April 2013 to July 2014. Survey data were collected from PNVC participants. Results: The PNVC met 26 times in the study period. Overall, 78 children were presented a total of 112 times, 41% with history of stroke. Of 64 (82%) with a diagnosed vascular lesion, AVM (30%), cavernous malformation (14%), and moyamoya (11%) were most common. Most discussions were for review of imaging (35%), need for additional imaging (27%), or treatment plan (25%) [Table]. Follow-up angiography was performed in 27%. A surgical operation was employed in 22%; 18% received neurointervention; 9% received radiosurgery. Twenty-three patients (29%) were discussed more than once. Standardized care protocols for AVM and moyamoya were developed from discussions among physicians from 7 different specialties [Figure]. Participants cited PNVC’s greatest utility as facilitation of a collaborative approach to patient care. Conclusion: A multidisciplinary conference among a diverse group of providers guides complex care decisions, helps standardize care protocols, promotes faculty collaboration, and supports continuity of care in pediatric neurovascular disease.