Endovascular Treatment for Intracranial Aneurysms: A Nationwide Survey in Korea

Purpose In Korea, endovascular treatment (EVT) for intracranial aneurysms (IAs) has increased steadily. We conducted a nationwide survey to evaluate the current status of EVT for IAs and to identify treatment preference in the real world.Materials and Methods A Google online survey was distributed t...

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Main Authors: Jung-Jae Kim, Kwang-Chun Cho, Woo Sang Jung, Sang Hyun Suh
Format: Article
Language:English
Published: Korean Society of Interventional Neuroradiology 2020-03-01
Series:Neurointervention
Subjects:
Online Access:http://neurointervention.org/upload/pdf/neuroint-2019-00157.pdf
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author Jung-Jae Kim
Kwang-Chun Cho
Woo Sang Jung
Sang Hyun Suh
author_facet Jung-Jae Kim
Kwang-Chun Cho
Woo Sang Jung
Sang Hyun Suh
author_sort Jung-Jae Kim
collection DOAJ
description Purpose In Korea, endovascular treatment (EVT) for intracranial aneurysms (IAs) has increased steadily. We conducted a nationwide survey to evaluate the current status of EVT for IAs and to identify treatment preference in the real world.Materials and Methods A Google online survey was distributed to representative clinicians at hospitals treating IAs, where members of Korean Society of Interventional Neuroradiology (KSIN). The data was collected from October 2017 to December 2017. The responding hospitals were divided into 2 groups (tertiary and non-tertiary hospitals). And variable factors involved in decision making for treatment were evaluated. Results In total, 73 hospitals (tertiary: 37, non-tertiary: 36) responded to the survey. Most hospitals that responded had over 100 cases of diagnostic angiography (93%) and over 50 cases of EVT for IAs (74%) performed in 2016. The proportion of EVT for ruptured aneurysms in non-tertiary hospitals was significantly higher than tertiary hospitals (49% vs. 9%). The proportion of EVT for unruptured aneurysms at non-tertiary hospitals was significantly higher than tertiary hospitals (66% vs. 44%). Most physicians tended to make decision for treatment on location, shape, and size of unruptured IAs and patients’ age, more than the results from previous clinical trials for unruptured IAs. Although EVT was preferred for older patients (age >70) with unruptured IAs (99%), surgical clipping was still considered as the first treatment of choice for younger patients (age 30 to 50 years) at considerable rates (56%). Over two-thirds of respondents preferred surgical clipping for middle cerebral artery aneurysms, while EVT was preferred initially at other locations. Conclusion This nationwide survey showed that EVT is considered as the first treatment modality for IAs and there is a discrepancy between current guidelines and real-world practice for decision making of treatment options.
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spelling doaj.art-5b9b97c31d5849e5bcbbcc49a1ceeda72024-02-02T12:52:45ZengKorean Society of Interventional NeuroradiologyNeurointervention2093-90432233-62732020-03-01151182410.5469/neuroint.2019.00157271Endovascular Treatment for Intracranial Aneurysms: A Nationwide Survey in KoreaJung-Jae Kim0Kwang-Chun Cho1Woo Sang Jung2Sang Hyun Suh3 Department of Neurosurgery, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea Department of Neurosurgery, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea Department of Radiology, Ajou University Hospital, Ajou University College of Medicine, Suwon, Korea Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, KoreaPurpose In Korea, endovascular treatment (EVT) for intracranial aneurysms (IAs) has increased steadily. We conducted a nationwide survey to evaluate the current status of EVT for IAs and to identify treatment preference in the real world.Materials and Methods A Google online survey was distributed to representative clinicians at hospitals treating IAs, where members of Korean Society of Interventional Neuroradiology (KSIN). The data was collected from October 2017 to December 2017. The responding hospitals were divided into 2 groups (tertiary and non-tertiary hospitals). And variable factors involved in decision making for treatment were evaluated. Results In total, 73 hospitals (tertiary: 37, non-tertiary: 36) responded to the survey. Most hospitals that responded had over 100 cases of diagnostic angiography (93%) and over 50 cases of EVT for IAs (74%) performed in 2016. The proportion of EVT for ruptured aneurysms in non-tertiary hospitals was significantly higher than tertiary hospitals (49% vs. 9%). The proportion of EVT for unruptured aneurysms at non-tertiary hospitals was significantly higher than tertiary hospitals (66% vs. 44%). Most physicians tended to make decision for treatment on location, shape, and size of unruptured IAs and patients’ age, more than the results from previous clinical trials for unruptured IAs. Although EVT was preferred for older patients (age >70) with unruptured IAs (99%), surgical clipping was still considered as the first treatment of choice for younger patients (age 30 to 50 years) at considerable rates (56%). Over two-thirds of respondents preferred surgical clipping for middle cerebral artery aneurysms, while EVT was preferred initially at other locations. Conclusion This nationwide survey showed that EVT is considered as the first treatment modality for IAs and there is a discrepancy between current guidelines and real-world practice for decision making of treatment options.http://neurointervention.org/upload/pdf/neuroint-2019-00157.pdfaneurystreatmentsurveyshospitalskorea
spellingShingle Jung-Jae Kim
Kwang-Chun Cho
Woo Sang Jung
Sang Hyun Suh
Endovascular Treatment for Intracranial Aneurysms: A Nationwide Survey in Korea
Neurointervention
aneurys
treatment
surveys
hospitals
korea
title Endovascular Treatment for Intracranial Aneurysms: A Nationwide Survey in Korea
title_full Endovascular Treatment for Intracranial Aneurysms: A Nationwide Survey in Korea
title_fullStr Endovascular Treatment for Intracranial Aneurysms: A Nationwide Survey in Korea
title_full_unstemmed Endovascular Treatment for Intracranial Aneurysms: A Nationwide Survey in Korea
title_short Endovascular Treatment for Intracranial Aneurysms: A Nationwide Survey in Korea
title_sort endovascular treatment for intracranial aneurysms a nationwide survey in korea
topic aneurys
treatment
surveys
hospitals
korea
url http://neurointervention.org/upload/pdf/neuroint-2019-00157.pdf
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AT woosangjung endovasculartreatmentforintracranialaneurysmsanationwidesurveyinkorea
AT sanghyunsuh endovasculartreatmentforintracranialaneurysmsanationwidesurveyinkorea