Silva Michael A, Peterson Eric C
Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA
Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
J Neurointerv Surg. 2024 Jul 30;17(5):553-558. doi: 10.1136/jnis-2024-022101.
A growing proportion of percutaneous procedures are performed in outpatient centers. The shift from hospitals to ambulatory surgery centers and office-based laboratories has been driven by a number of factors, including declining reimbursements, increased patient demand, and competition for hospital resources. This transition has been dominated by the interventional radiology, cardiology, and vascular surgery fields. Cerebral angiography, in contrast, is still performed almost exclusively in a hospital-based setting, despite sharing many features with other endovascular procedures commonly performed in outpatient centers. As interest grows in performing cerebral angiography in outpatient endovascular centers, much can be learned from the decades of experience that our interventional colleagues have in the outpatient setting. In this article we examine the outpatient experience of other interventional fields and apply key principles to evaluate the prospect of outpatient neurointervention. The literature suggests that cerebral angiography can feasibly be performed in an outpatient center in both private and academic settings, as some groups have begun to do. Outpatient endovascular centers have helped to improve the patient experience, liberate inpatient resources, and control costs in other interventional fields, and might offer neurointerventionalists an opportunity to do the same.
越来越多的经皮手术在门诊中心进行。从医院转向门诊手术中心和独立实验室是由多种因素推动的，包括报销费用下降、患者需求增加以及对医院资源的竞争。这种转变在介入放射学、心脏病学和血管外科领域最为显著。相比之下，尽管脑血管造影与门诊中心常见的其他血管内手术有许多共同特点，但几乎仍完全在医院环境中进行。随着在门诊血管内中心进行脑血管造影的兴趣日益浓厚，我们可以从介入领域的同事在门诊环境中的数十年经验中学到很多东西。在本文中，我们研究了其他介入领域的门诊经验，并应用关键原则来评估门诊神经介入的前景。文献表明，正如一些团队已经开始做的那样，脑血管造影在私立和学术环境的门诊中心都可以切实可行地进行。门诊血管内中心有助于改善患者体验、释放住院资源并控制其他介入领域的成本，并且可能为神经介入医生提供同样的机会。
