scholarly journals Training System for Young Neurosurgeons on Aneurysm Clipping(Treatment of Cerebral Aneurysms)

2006 ◽  
Vol 15 (12) ◽  
pp. 827-832 ◽  
Author(s):  
Kazuhiro Hongo ◽  
Yuichiro Tanaka ◽  
Jun-ichi Koyama ◽  
Yoshikazu Kusano ◽  
Keiichi Sakai
Keyword(s):  
Cerebral Aneurysms ◽  
Training System ◽  
Special Issue ◽  
Aneurysm Clipping

scholarly journals Unruptured cerebral aneurysm clipping: association of combined open and endovascular expertise with outcomes

2015 ◽  
Vol 8 (9) ◽  
pp. 977-981 ◽  
Author(s):  
Kimon Bekelis ◽  
Dan Gottlieb ◽  
George Bovis ◽  
Yin Su ◽  
Stavropoula Tjoumakaris ◽  
...  
Keyword(s):  
Propensity Score ◽  
Cerebral Aneurysm ◽  
Readmission Rate ◽  
Cerebral Aneurysms ◽  
Postoperative Mortality ◽  
Fee For Service ◽  
Aneurysm Clipping ◽  
Unruptured Cerebral Aneurysm ◽  
Procedural Volume ◽  
Unruptured Cerebral Aneurysms

BackgroundIt is often questioned if one physician can conduct both open and endovascular techniques successfully and safely.ObjectiveTo investigate the association of combined open and endovascular expertise with the outcomes of unruptured cerebral aneurysm clipping.MethodsWe performed a cohort study of 100% of Medicare fee-for-service claims data for elderly patients who underwent surgical clipping for unruptured cerebral aneurysms between 2007 and 2012. To control for confounding we used propensity score conditioning, and controlled for clustering at the physician level.ResultsDuring the study, 3247 patients underwent clipping for unruptured cerebral aneurysms, and met the inclusion criteria. Of these, 766 (23.6%) underwent treatment by hybrid neurosurgeons, and 2481 (76.4%) by proceduralists, who performed only clipping. Multivariable regression analysis with propensity score adjustment demonstrated a lack of association of combined practice with 1-year postoperative mortality (OR=0.81; 95% CI 0.51 to 1.28), discharge to rehabilitation (OR=0.95; 95% CI 0.72 to 1.25), length of stay (adjusted difference 0.85 days; 95% CI −0.31 to 2.00), or 30-day readmission rate (OR=1.05; 95% CI 0.80 to 1.39). Higher procedural volume was independently associated with improved outcomes.ConclusionsIn a cohort of Medicare patients with unruptured aneurysms, we did not demonstrate a difference in mortality, discharge to rehabilitation, or readmission rate between hybrid neurosurgeons and surgeons performing only clipping.

scholarly journals The Choice of Early Treatment on Case-by-case Basis for the Patients with Subarachnoid Hemorrhage : Clipping or Coiling(Treatment of Cerebral Aneurysms)

2006 ◽  
Vol 15 (12) ◽  
pp. 800-806 ◽  
Author(s):  
Shigeki Kobayashi ◽  
Yoshiyuki Watanabe ◽  
Hiromichi Oishi ◽  
Satoshi Ishige ◽  
Akihiro Miyata ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Early Treatment ◽  
Cerebral Aneurysms ◽  
Special Issue ◽  
Case Basis
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