Neurointervention.  2016 Mar;11(1):37-41. 10.5469/neuroint.2016.11.1.37.

Outpatient Day-care Neuroangiography and Neurointervention of Unruptured Intracranial Aneurysms

• Liu H
• Park D
• Hwang SM
• Lee GY
• Lim OK
• Kim M
• Lee DH
• Park W
• Koo HW
• Yang K
• Suh DC

• KMID: 2155717
• DOI: http://doi.org/10.5469/neuroint.2016.11.1.37

Abstract

PURPOSE
Day-care management of unruptured intracranial aneurysms can shorten hospital stay, reduce medical cost and improve outcome. We present the process, outcome and duration of hospital stay for the management of unruptured intracranial aneurysms via a neurointervention clinic in a single center during the past four years.
MATERIALS AND METHODS
We analyzed 403 patients who were referred to Neurointervention Clinic at Asan Medical Center for aneurysm evaluation between January 1, 2011 and December 31, 2014. There were 141 (41%) diagnostic catheter angiographies, 202 (59%) neurointerventional procedures and 2 (0.6%) neurointerventional procedures followed by operation. We analyzed the process, outcome of angiography or neurointervention, and duration of hospital stay.
RESULTS
There was no aneurysm in 58 patients who were reported as having an aneurysm in MRA or CTA (14 %). Among 345 patients with aneurysm, there were 283 patients with a single aneurysm (82%) and 62 patients with multiple aneurysms (n=62, 18%). Aneurysm coiling was performed in 202 patients (59%), surgical clipping in 14 patients (4%), coiling followed by clipping in 2 patients (0.6%) and no intervention was required in 127 patients (37%). The hospital stay for diagnostic angiography was less than 6 hours and the mean duration of hospital stay was 2.1 days for neurointervention. There were 4 procedure-related adverse events (2%) including 3 minor and 1 major ischemic strokes.
CONCLUSION
Our study revealed that day-care management of unruptured intracranial aneurysms could be performed without an additional risk. It could enable rapid patient flow, shorten hospital stay and thus reduce hospital costs.

Keyword

Unruptured intracranial aneurysms; Day-care; Neurointervention

MeSH Terms

Aneurysm
Angiography
Catheters
Chungcheongnam-do
Hospital Costs
Humans
Intracranial Aneurysm*
Length of Stay
Outpatients*
Stroke
Surgical Instruments

Figure

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  Fig. 1 Process diagram of patient flow. Comparison between outpatient daycare and referred procedures. Preadmission study = chest PA, Electrocardiography (ECG), blood test and urine analysis; ★ = consultation for neurointervention; ◇ = Pre-admission study; ⬜ = Admission status

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