First Reported Series of Cerebral Angiography Performed at an Outpatient Center: Safety and Satisfaction Results

Tyler A Scullen; Ming X Lian; Vinay Jaikumar; Jennifer L Gay; Pui Man Rosalind Lai; Matthew J McPheeters; Steven B Housley; Kunal P Raygor; Mehdi Bouslama; Hamid S Khan; Adnan H Siddiqui; Jason M Davies; Douglas B Moreland; Elad I Levy

doi:10.1227/neu.0000000000003119

First Reported Series of Cerebral Angiography Performed at an Outpatient Center: Safety and Satisfaction Results

Neurosurgery. 2024 Jul 23. doi: 10.1227/neu.0000000000003119. Online ahead of print.

Authors

Tyler A Scullen^{1

2}, Ming X Lian³, Vinay Jaikumar^{1

2}, Jennifer L Gay^{1

2}, Pui Man Rosalind Lai^{1

2

4

5}, Matthew J McPheeters^{1

2}, Steven B Housley^{1

2}, Kunal P Raygor^{1

2}, Mehdi Bouslama^{1

2}, Hamid S Khan^{1

2}, Adnan H Siddiqui^{1

2

4

5

6}, Jason M Davies^{1

2

4

5

7}, Douglas B Moreland^{1

2}, Elad I Levy^{1

2

4

5

6}

Affiliations

¹ Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
² Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York, USA.
³ Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
⁴ Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, New York, USA.
⁵ Jacobs Institute, Buffalo, New York, USA.
⁶ Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
⁷ Department of Bioinformatics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.

PMID: 39041790
DOI: 10.1227/neu.0000000000003119

Abstract

Background and objective: Ambulatory surgery centers (ASCs) are increasingly common venues for same-day neurosurgical procedures, allowing for cost-effective, high-quality patient care. We present the first and largest series of patients undergoing diagnostic cerebral angiography at an ASC to demonstrate the effectiveness, safety, and efficiency of outpatient endovascular care.

Methods: We retrospectively reviewed data for consecutive patients who underwent diagnostic cerebral angiography at our ASC between January 1, 2024, and May 29, 2024. Data collected included vascular access approach, procedural duration, turnover time, and periprocedural complications. Using a standardized 2-week postprocedural survey, patients were asked to provide comments and rate their subjective satisfaction from a 1 to 5 scale, with "5" being completely satisfied. All cases were performed with a physician team comprising 1 attending neuroendovascular neurosurgery and 1 neuroendovascular fellow present. Fentanyl and midazolam were administered for conscious sedation in all cases.

Results: Among the 67 patients included in this series, the mean procedural duration was 29.4 ± 8.6 minutes. The mean turnover time was 13.7 ± 3.6 minutes. Between transradial (46 of 67 [68.7%]) and transfemoral (21 of 67 [31.3%]) access site approaches, there were no statistically significant differences in mean procedural duration (29.4 ± 8.0 vs 29.2 ± 9.9 minutes, respectively; P = .72) or turnover time (14.0 ± 3.9 vs 12.9 ± 2.8 minutes, respectively; P = .4). No complications occurred periprocedurally or within the 2-week follow-up period. A total of 48 (71.6%) of 67 patients responded to the postprocedural survey, all of whom unanimously reported a score of "5."

Conclusion: We found that diagnostic cerebral angiography performed at our ASC was safe and effective for patient care. In addition, all survey respondents (71.6% of those provided the survey) reported highest levels of satisfaction. The integration of neuroendovascular procedures into ASCs potentially offers a cost-effective and highly efficient option in an evolving economic landscape.