Considering Psychological and Cognitive Factors in Interventional Neuroradiology: A Systematic Literature Review

Abstract

BACKGROUND: Interventional neuroradiology is a relatively recent discipline that diagnoses and treats cerebral vascular diseases. However, specific literature on cognitive and psychological domains of patients undergoing interventional neuroradiology procedures is limited. PURPOSE: Our aim was to review the existent literature on cognitive and psychological domains in patients undergoing interventional neuroradiology procedures to raise clinicians' awareness of their mental status.DATA SOURCES: Articles were searched in PubMed, EMBASE, and Scopus from 2000 to 2022 using terms such as "interventional neuroradiology," "psychology," and "cognition" according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.STUDY SELECTION: Of 1483 articles in English, 64 were included and analyzed. Twelve focused on psychological aspects; 52, on cognitive ones.DATA ANALYSIS: Regarding psychological aspects, it appears that early psychological consultations and "nonpharmacologic" strategies can impact the anxiety and depression of patients undergoing endovascular procedures. Regarding cognitive aspects, it appears that endovascular treatment is safe and generates similar or even fewer cognitive deficits compared with analogous surgical procedures.DATA SYNTHESIS: Among the 12 articles on psychological aspects, 6/12 were retrospective with one, while 6/12 were prospective. Among the 52 articles on cognitive aspects, 7/54 were retrospective, while 45/52 were prospective. LIMITATIONS:The main limitation derives from the inhomogeneity of the cognitive and psychological assessment tools used in the articles included in our analysis. CONCLUSIONS:Our review highlights the need to include cognitive and psychological assessments in clinical practice in case patients eligible for interventional neuroradiology procedures. In the future, much more research of and attention to cognitive and psychologic aspects of neurovascular disease is needed. Systematic incorporation of strategies and tools to access and address pre, peri-, and postprocedural psychological and cognitive components could have major benefits in patient satisfaction, recovery, and the success of endovascular practice.ABBREVIATIONS: CAS ¼ carotid artery stent placement; DAVF ¼ dural arteriovenous fistula; EC ¼ endovascular coiling; INR ¼ interventional neuroradiology; QoL ¼ quality of life; RCT ¼ randomized control trial; RIA ¼ ruptured intracranial aneurysm; SC ¼ surgical clipping; UIA ¼ unruptured intracranial aneurysm