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Krylov VV, Shatokhin TA, Shetova IM, Eliava SS, Belousova OB, Airapetyan AA, Alekseev AG, Asratyan SA, Bakharev EY, Vorobyov IA, Dedkov DS, Dubovoy AV, Eliseev VV, Elfimov AV, Kozhaev ZU, Kolotvinov VS, Kosmachev MV, Kravets LY, Kushniruk PI, Myachin NL, Parfenov VE, Rodionov SV, Semin PA, Khasanshin EM, Shnyakin PG, Yakhontov IS. [Russian study on brain aneurysm surgery: a continuation (RIHA II)]. Zh Vopr Neirokhir Im N N Burdenko 2024; 88:7-20. [PMID: 38334726 DOI: 10.17116/neiro2024880117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To assess the main performance indicators of neurosurgical departments in surgical treatment of cerebral aneurysms in the Russian Federation. MATERIAL AND METHODS We analyzed 22 neurosurgical departments (19 regional and 3 federal hospitals) in 2017 and 2021. The study enrolled 6.135 patients including 3.160 ones in 2017 and 2.975 ones in 2021. We studied the features of surgical treatment of cerebral aneurysms in different volume hospitals and factors influencing postoperative outcomes. RESULTS The number of surgeries for cerebral aneurysms decreased from 2.950 in 2017 to 2.711 in 2021. Postoperative mortality rate was 6.3% and 5.6%, respectively. The number of microsurgical interventions decreased from 60% in 2017 to 48% in 2021. The share of endovascular interventions increased from 40% to 52%, respectively. Endovascular embolization was accompanied by stenting in 55% of cases. Simultaneous revascularization was carried out in 2% of cases. In 2021, the number of patients undergoing surgery in acute period of hemorrhage increased to 70% (in 2017 - 61%). The number of hospitals performing more than 50 surgical interventions for cerebral aneurysms annually increased from 14 in 2017 to 17 in 2021. CONCLUSION Certain changes in neurosurgical service occurred in 2021 compared to 2017. Lower number of surgical interventions for cerebral aneurysms, most likely caused by the COVID-19 pandemic, is accompanied by lower postoperative mortality. Endovascular interventions and revascularization techniques became more common. The number of surgeries in acute period after aneurysm rupture and hospitals performing more than 50 surgical interventions for cerebral aneurysms annually increased.
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Affiliation(s)
- V V Krylov
- Pirogov Russian National Research Medical University, Moscow, Russia
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
- Neurology Research Center, Moscow, Russia
| | - T A Shatokhin
- Pirogov Russian National Research Medical University, Moscow, Russia
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
- Neurology Research Center, Moscow, Russia
| | | | | | | | - A A Airapetyan
- Inozemtsev Moscow City Clinical Hospital, Moscow, Russia
| | - A G Alekseev
- Interregional Clinical Diagnostic Center, Kazan, Russia
| | - S A Asratyan
- Buyanov Moscow City Clinical Hospital, Moscow, Russia
| | - E Yu Bakharev
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
| | - I A Vorobyov
- First Republican Clinical Hospital, Izhevsk, Russia
| | - D S Dedkov
- Semashko Republican Clinical Hospital, Simferopol, Russia
| | - A V Dubovoy
- Federal Center for Neurosurgery, Novosibirsk, Russia
| | - V V Eliseev
- Stavropol Regional Clinical Hospital, Stavropol, Russia
| | - A V Elfimov
- Yaroslavl Regional Clinical Hospital, Yaroslavl, Russia
| | - Z U Kozhaev
- Republican Clinical Hospital, Nalchik, Russia
| | - V S Kolotvinov
- Ekaterinburg City Clinical Hospital No. 40, Ekaterinburg, Russia
| | - M V Kosmachev
- Vladimirtsev Regional Clinical Hospital, Khabarovsk, Russia
| | - L Ya Kravets
- Nizhny Novgorod City Clinical Hospital No. 13, Nizhny Novgorod, Russia
| | - P I Kushniruk
- Volgograd Regional Clinical Hospital No. 1, Volgograd, Russia
| | - N L Myachin
- Baranov Republican Hospital, Petrozavodsk, Russia
| | - V E Parfenov
- Dzhanelidze Research Institute for Emergency Care, St. Petersburg, Russia
| | - S V Rodionov
- Voronezh Regional Clinical Hospital No. 1, Voronezh, Russia
| | - P A Semin
- Meshalkin National Medical Research Center, Novosibirsk, Russia
| | - E M Khasanshin
- Kaliningrad Regional Clinical Hospital, Kaliningrad, Russia
| | | | - I S Yakhontov
- Republican Hospital No. 2-Center for Emergency Care, Yakutsk, Russia
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Krylov VV, Dash'yan VG, Shatokhin TA, Shetova IM, Eliava SS, Belousova OB, Orlov KY, Dubovoy AV, Asratyan SA, Kambiev RL, Chechulov PV, Maksimov VV, Kolotvinov VS, Kravets LY, Myachin NL, Rodionov SV, Kosmachev MV, Yakhontov IS, Mozheyko RA, Kozhaev ZU, Elfimov AV, Shnyakin PG, Alekseev AG, Khasanshin EM, Kushniruk PI, Dedkov DS. [Surgical treatment of cerebral aneurysms in the Russian Federation]. Zh Vopr Neirokhir Im N N Burdenko 2018; 82:5-14. [PMID: 30721212 DOI: 10.17116/neiro2018820615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate the results of surgical treatment of cerebral aneurysms in the Russian Federation. MATERIAL AND METHODS We analyzed performance indicators in neurosurgical departments of regional and federal health institutions of the Russian Federation for 2017. The results of surgical treatment of cerebral aneurysms (CAs) were analyzed in 19 regional vascular centers (RVCs) in several federal districts and in 3 federal centers (FCs) with the most dynamically developing vascular neurosurgery and smoothly running system of statistical data processing. RESULTS The study included 3160 patients hospitalized to 22 medical institutions in 2017. Of these, 1808 patients were treated in RVCs, and 1352 patients were treated in FCs. We analyzed factors affecting the treatment outcome in CA patients. We identified features of CA treatment in clinics with a different amount of surgical intervention. CONCLUSION An increase in the surgical activity in centers and simultaneous development of microsurgical and endovascular treatments for cerebral aneurysms reduce postoperative mortality. Due to the presence of a RVC network in the Russian Federation, many patients could receive necessary specialized treatment. The number of operations for cerebral aneurysms has increased 6-fold for the past 10 years.
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Affiliation(s)
- V V Krylov
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia; Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia
| | - V G Dash'yan
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia; Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia
| | - T A Shatokhin
- Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia
| | - I M Shetova
- Ministry of Health of the Russian Federation, Moscow, Russia
| | - Sh Sh Eliava
- Burdenko Neurosurgical Institute, Moscow, Russia
| | | | - K Yu Orlov
- Meshalkin National Medical Research Center, Novosibirsk, Russia
| | - A V Dubovoy
- Federal Center of Neurosurgery, Novosibirsk, Russia
| | - S A Asratyan
- Buyanov Moscow City Clinical Hospital, Moscow, Russia
| | - R L Kambiev
- Inozemtsev Municipal Clinical Hospital, Moscow, Russia
| | - P V Chechulov
- Saint-Petersburg Dzhanelidze Research Institute of Emergency Medicine, St. Petersburg, Russia
| | - V V Maksimov
- Republican Clinical Hospital #1, Izhevsk, Russia
| | | | - L Ya Kravets
- Municipal Clinical Hospital #13, Nizhniy Novgorod, Russia
| | - N L Myachin
- Baranov Republican Hospital, Petrozavodsk, Russia
| | - S V Rodionov
- Voronezh Regional Clinical Hospital #1, Voronezh, Russia
| | | | | | - R A Mozheyko
- Stavropol' Regional Clinical Hospital, Stavropol', Russia
| | - Z U Kozhaev
- Republican Clinical Hospital, Nal'chik, Russia
| | - A V Elfimov
- Regional Clinical Hospital, Yaroslavl', Russia
| | | | - A G Alekseev
- Interregional Clinical Diagnostic Center, Kazan', Russia
| | - E M Khasanshin
- Kaliningrad Regional Clinical Hospital, Kaliningrad, Russia
| | - P I Kushniruk
- Volgograd Clinical Regional Hospital #1, Volgograd, Russia
| | - D S Dedkov
- Semashko Republican Clinical Hospital, Simferopol', Russia
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