Van Der Veken Jorn, Van Velthoven Vera, Reuter Gilles, De Vleeschouwer Steven, Menovsky Tomas, Duerinck Johnny, Bruneau Michaël
Department of Neurosurgery, Flinders Medical Centre, Adelaide, South Australia, Australia.
Department of Neurosurgery, Universitair Ziekenhuis Brussel (UZ Brussel) - Vrije Universiteit Brussel (VUB), Laarbeeklaan 101-103, 1090, Brussels, Belgium.
Brain Spine. 2024 Dec 11;5:104158. doi: 10.1016/j.bas.2024.104158. eCollection 2025.
The management of neurovascular pathologies has changed globally over the last few decades. Endovascular treatments are increasing, and fewer surgical procedures are performed.
Evaluate the evolution of vascular neurosurgery in Belgium over the last 30 years and compare with other countries.
Belgian nationwide data was obtained from 1991 to 2021 via the National Institute for Health and Disability Insurance (INAMI-RIZIV). Cost of surgical and endovascular implants used in 2022 was obtained.
Over a 30-year period a total of 37,504 procedures were performed in Belgium, consisting of 13,767 (36.7%) surgeries and 23,737 (63.3%) endovascular treatments (EVT).Adjusted to population per 100000, surgical management peaked at 6.02 in 1996 and gradually dropped below 3.0 in 2019. EVT increased from 1.06 in 1991 to 10.5 in 2021.Important regional differences are seen in terms of total number of procedures as well as ratio of surgery to endovascular surgery.The total cost of surgical implants in 2022 was the equivalent of 1% of the total cost of endovascular implants.
This data confirms a similar trend to other regions in the world: a reduction in surgical management and increase in endovascular management for CNS vascular pathologies.Important regional differences are noted in terms of volume and ratio of endovascular to surgery.A nationwide registry based on patient data and outcomes can help decide whether there should be centralization to manage vascular pathologies.
在过去几十年里，全球范围内神经血管疾病的治疗方式发生了变化。血管内治疗日益增多，而外科手术的实施数量则在减少。
评估比利时过去30年血管神经外科的发展，并与其他国家进行比较。
通过国家健康与残疾保险研究所（INAMI-RIZIV）获取了1991年至2021年比利时全国范围内的数据。获取了2022年使用的外科和血管内植入物的成本。
在30年期间，比利时共进行了37504例手术，其中包括13767例（36.7%）外科手术和23737例（63.3%）血管内治疗（EVT）。按每10万人调整后，外科治疗在1996年达到峰值6.02，并在2019年逐渐降至3.0以下。EVT从1991年的1.06增加到2021年的10.5。在手术总数以及外科手术与血管内手术的比例方面存在重要的地区差异。2022年外科植入物的总成本相当于血管内植入物总成本的1%。
该数据证实了与世界其他地区类似的趋势：中枢神经系统血管疾病的外科治疗减少，血管内治疗增加。在血管内治疗与外科手术的数量和比例方面存在重要的地区差异。基于患者数据和结果的全国性登记可以帮助决定是否应进行集中管理血管疾病。
