Endovascular Treatment of Cerebral Aneurysms at a Low‐Volume Community Hospital Practice: Management Strategies, Complications, and Outcomes

Abstract

Our institution serves a population of 160,000 and performed 14.4 endovascular cerebral aneurysm interventions annually, averaged over a 5-year period. The purpose of this study was to examine the safety and efficacy of endovascular treatment of cerebral aneurysms at a lowvolume center. Retrospective cohort analysis of 56 patients harboring 64 aneurysms requiring 72 procedures over 62 months. Aneurysm morphology, procedure-related adverse events and clinical outcomes were analyzed. Twenty-two ruptured (34.4%) and 42 unruptured (65.6%) aneurysms were treated in 12 males (mean age 61.1 years), 44 females (mean age 61.8 years). The procedure-related morbidity and mortality was 6.9% (5 of 72) and 1.3% (1 of 72 procedures), respectively. Modified Rankin Scale score was 0 or 1 in 87.9% of all discharges (61.9% in the ruptured group, 100% in the unruptured group). This score was between 2 to 5 in 7.6% (23.8% ruptured, 0% ruptured) and 6 in 4.3% of patients. Seventy-two percent of aneurysms demonstrated complete occlusion initially, 23.0% had residual neck filling, and 4.9% had residual aneurysm filling. Endovascular coil embolization at a small volume nonspecialized community center is feasible with satisfactory procedural risk and clinical outcomes.