Nagoya University Training System for Neuroendovascular Therapists

Miyachi, Shigeru; Okamoto, Tomoyoshi; Kobayashi, Naoya; Kojima, Tetsuhito; Nakai, Kota; Сузукі, Осаму; Y, Sahara; Hattori, Kenichi; Yoshida, Jun

doi:10.1177/15910199040100s117

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Those institutes without full-time neuroendovascular interventionists (NETists) were unlikely to opt for embolization. This result addressed the pressing issue of meeting the need for more trained NETists 6 . Another factors conspiring to put off early treatment is the dearth of anesthesiologists and assistants.…”

Section: Discussionmentioning

confidence: 91%

The Current Status of Treatment Strategies for Cerebral Aneurysms in Nagoya University and Affiliated Hospitals Based on a Questionnaire Survey

Izumi

Miyachi²,

Hattori

et al. 2007

Interv Neuroradiol

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We investigated differences in the treatment strategies for ruptured aneurysms among 26 hospitals affiliated with Nagoya University and any changes in those strategies based on responses to a questionnaire. We also surveyed the data concerning patients with a ruptured aneurysm collected from our affiliated hospitals between 2001 and 2002. In half of the institutes, angiography is performed immediately after an urgent medical examination, there are only five hospitals (20%) which have a basic policy of terminating the angiography within three to six hours after onset. In half of the institutes, the timing of the treatment also depends on the location of the aneurysm. In particular, the treatment for vertebro-basilar aneurysms tends to be done the next day or later. Low-grade subarachnoid hemorrhage (SAH) patients with mild symptoms tended not to be given any sedative drugs (46%), while patients with SAH in some institutes were sedated without informed consent regardless of the severity. The main treatment method for most anterior circulation aneurysms was clipping. Concerning aneurysms located in the posterior circulation and the origin of the ophthalmic artery, clipping and coiling were equally selected. Almost all the hospitals (92%) responded that their treatment strategy had not changed even after the report of the International Subarachnoid Aneurysm Trial (ISAT). There is a great deal of difference in treatment strategies and indications among institutions. In particular, institutions without neuroendovascular interventionists (NETists) frequently persist in the conventional policy, making it urgently necessary to bring NETists up-to-date on the latest advance in endovascular treatment.

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Section: Discussionmentioning

confidence: 91%

The Current Status of Treatment Strategies for Cerebral Aneurysms in Nagoya University and Affiliated Hospitals Based on a Questionnaire Survey

Izumi

Miyachi²,

Hattori

et al. 2007

Interv Neuroradiol

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“…A task force team (TFT) was organized in August 2010 to develop training programs and certification. TFT members conducted research on programs and systems in other countries 1 , 2 , 3 , 4 , 5 , 6 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21) and conceptualized the programs that would best suit Korea. After 1 year of effort, a rough draft of the ENS training and certification regulations was prepared, and the standard training program title was decided.…”

Section: Preparation Of the Task Force Team And Certification Committmentioning

confidence: 99%

“…This enabled the TFT to gather informative data such as hospital capacities, case experience, ENS constitution, and disease distributions. Then, detailed rules were discussed based on the survey results and regulations in other countries 1 , 3 , 4 , 6 , 9 , 14 , 15) . Much effort was put into designing a program that best suited Korean society, and it took 20 months to complete the final draft.…”

Section: Preparation Of the Task Force Team And Certification Committmentioning

confidence: 99%

“…However, all ENS procedures carry a risk for stroke, indicating that appropriate and acceptable knowledge, procedural training, and case experience are necessary to perform ENS procedures safely. While several other countries have suggested ENS training standards 1 , 3 , 4 , 7 , 9 , 10 , 14 , 15 , 17 , 19) or have begun ENS certification, no ENS training programs or certification systems have been established in Korea. There are two ENS-associated societies in Korea; The Society of Korean Endovascular Neurosurgeons (SKEN) and the Korean Society of Interventional Neuroradiology.…”

Section: Introductionmentioning

confidence: 99%

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Standards for Endovascular Neurosurgical Training and Certification of the Society of Korean Endovascular Neurosurgeons 2013

Shin

Park

Kang

et al. 2014

J Korean Neurosurg Soc

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The need for standard endovascular neurosurgical (ENS) training programs and certification in Korea cannot be overlooked due to the increasing number of ENS specialists and the expanding ENS field. The Society of Korean Endovascular Neurosurgeons (SKEN) Certification Committee has prepared training programs and certification since 2010, and the first certificates were issued in 2013. A task force team (TFT) was organized in August 2010 to develop training programs and certification. TFT members researched programs and systems in other countries to develop a program that best suited Korea. After 2 years, a rough draft of the ENS training and certification regulations were prepared, and the standard training program title was decided. The SKEN Certification Committee made an official announcement about the certification program in March 2013. The final certification regulations comprised three major parts: certified endovascular neurosurgeons (EN), certified ENS institutions, and certified ENS training institutions. Applications have been evaluated and the results were announced in June 2013 as follows: 126 members received EN certification and 55 hospitals became ENS-certified institutions. The SKEN has established standard ENS training programs together with a certification system, and it is expected that they will advance the field of ENS to enhance public health and safety in Korea.

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Morbidity and mortality of patients with endovascularly treated intracerebral aneurysms: does physician specialty matter?

Fennell

Martirosyan

Palejwala

et al. 2016

JNS

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OBJECT Endovascular treatment of cerebrovascular pathology, particularly aneurysms, is becoming more prevalent. There is a wide variety in clinical background and training of physicians who treat cerebrovascular pathology through endovascular means. The impact of clinical training background on patient outcomes is not well documented. METHODS The authors conducted a retrospective analysis of a large national database, the University HealthSystem Consortium, that was queried in the years 2009-2013. Cases of both unruptured cerebral aneurysms and subarachnoid hemorrhage treated by endovascular obliteration were studied. Outcome measures of morbidity and mortality were evaluated according to the specialty of the treating physician. RESULTS Elective embolization of an unruptured aneurysm was the procedure code and primary diagnosis, respectively, for 12,400 cases. Patients with at least 1 complication were reported in 799 cases (6.4%). Deaths were reported in 193 cases (1.6%). Complications and deaths were varied by specialty; the highest incidence of complications (11.1%) and deaths (3.0%) were reported by neurologists. The fewest complications were reported by neurosurgeons (5.4%; 1.4% deaths), with a higher incidence of complications reported in cases performed by neurologists (p < 0.0001 for both complications and deaths) and to a lesser degree interventional radiologists (p = 0.0093 for complications). Subarachnoid hemorrhage was the primary diagnosis and procedure for 8197 cases. At least 1 complication was reported in 2385 cases (29%) and deaths in 983 cases (12%). The number of complications and deaths varied among specialties. The highest incidence of complications (34%) and deaths (13.5%) in subarachnoid hemorrhage was in cases performed by neurologists. The fewest complications were in cases by neurosurgeons (27%), with a higher incidence of complications in cases performed by neurologists (34%, p < 0.0001), and a trend of increased complications with interventional radiologists (30%, p < 0.0676). The lowest incidence of mortality was in cases performed by neurosurgeons (11.5%), with a significantly higher incidence of mortality in cases performed by neurologists (13.5%, p = 0.0372). Mortality rates did not reach statistical significance with respect to interventional radiologists (12.1%, p = 0.4884). CONCLUSIONS Physicians of varied training types and backgrounds use endovascular treatment of ruptured and unruptured intracerebral aneurysms. In this study there was a statistically significant finding that neurosurgically trained physicians may demonstrate improved outcomes with respect to endovascular treatment of unruptured aneurysms in this cohort. This finding warrants further investigation.

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Nagoya University Training System for Neuroendovascular Therapists

Cited by 4 publications

References 7 publications

The Current Status of Treatment Strategies for Cerebral Aneurysms in Nagoya University and Affiliated Hospitals Based on a Questionnaire Survey

The Current Status of Treatment Strategies for Cerebral Aneurysms in Nagoya University and Affiliated Hospitals Based on a Questionnaire Survey

Standards for Endovascular Neurosurgical Training and Certification of the Society of Korean Endovascular Neurosurgeons 2013

Morbidity and mortality of patients with endovascularly treated intracerebral aneurysms: does physician specialty matter?

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