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First Reported Series of Cerebral Angiography Performed at an Outpatient Center: Safety and Satisfaction Results.
Scullen, Tyler A; Lian, Ming X; Jaikumar, Vinay; Gay, Jennifer L; Lai, Pui Man Rosalind; McPheeters, Matthew J; Housley, Steven B; Raygor, Kunal P; Bouslama, Mehdi; Khan, Hamid S; Siddiqui, Adnan H; Davies, Jason M; Moreland, Douglas B; Levy, Elad I.
Affiliation
  • Scullen TA; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
  • Lian MX; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA.
  • Jaikumar V; Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
  • Gay JL; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
  • Lai PMR; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA.
  • McPheeters MJ; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
  • Housley SB; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA.
  • Raygor KP; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
  • Bouslama M; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA.
  • Khan HS; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, New York, USA.
  • Siddiqui AH; Jacobs Institute, Buffalo, New York, USA.
  • Davies JM; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
  • Moreland DB; Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA.
  • Levy EI; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
Neurosurgery ; 2024 Jul 23.
Article in En | MEDLINE | ID: mdl-39041790
ABSTRACT
BACKGROUND AND

OBJECTIVE:

Ambulatory surgery centers (ASCs) are increasingly common venues for same-day neurosurgical procedures, allowing for cost-effective, high-quality patient care. We present the first and largest series of patients undergoing diagnostic cerebral angiography at an ASC to demonstrate the effectiveness, safety, and efficiency of outpatient endovascular care.

METHODS:

We retrospectively reviewed data for consecutive patients who underwent diagnostic cerebral angiography at our ASC between January 1, 2024, and May 29, 2024. Data collected included vascular access approach, procedural duration, turnover time, and periprocedural complications. Using a standardized 2-week postprocedural survey, patients were asked to provide comments and rate their subjective satisfaction from a 1 to 5 scale, with "5" being completely satisfied. All cases were performed with a physician team comprising 1 attending neuroendovascular neurosurgery and 1 neuroendovascular fellow present. Fentanyl and midazolam were administered for conscious sedation in all cases.

RESULTS:

Among the 67 patients included in this series, the mean procedural duration was 29.4 ± 8.6 minutes. The mean turnover time was 13.7 ± 3.6 minutes. Between transradial (46 of 67 [68.7%]) and transfemoral (21 of 67 [31.3%]) access site approaches, there were no statistically significant differences in mean procedural duration (29.4 ± 8.0 vs 29.2 ± 9.9 minutes, respectively; P = .72) or turnover time (14.0 ± 3.9 vs 12.9 ± 2.8 minutes, respectively; P = .4). No complications occurred periprocedurally or within the 2-week follow-up period. A total of 48 (71.6%) of 67 patients responded to the postprocedural survey, all of whom unanimously reported a score of "5."

CONCLUSION:

We found that diagnostic cerebral angiography performed at our ASC was safe and effective for patient care. In addition, all survey respondents (71.6% of those provided the survey) reported highest levels of satisfaction. The integration of neuroendovascular procedures into ASCs potentially offers a cost-effective and highly efficient option in an evolving economic landscape.

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Neurosurgery Year: 2024 Document type: Article Affiliation country: United States Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Neurosurgery Year: 2024 Document type: Article Affiliation country: United States Country of publication: United States