J Korean Neurosurg Soc.  2019 Sep;62(5):502-518. 10.3340/jkns.2018.0216.

Endovascular Treatments Performed Collaboratively by the Society of Korean Endovascular Neurosurgeons Members: A Nationwide Multicenter Survey

• Kim TG
• Kwon O
• Shin YS
• Sung JH
• Koh JS
• Kim BT

• KMID: 2457940
• DOI: http://doi.org/10.3340/jkns.2018.0216

Abstract

OBJECTIVE
Since less invasive endovascular treatment was introduced to South Korea in 1994, a considerable proportion of endovascular treatments have been performed by neuroradiology doctors, and endovascular treatments by vascular neurosurgeons have recently increased. However, few specific statistics are known regarding how many endovascular treatments are performed by neurosurgeons. Thus, authors compared endovascular treatments collaboratively performed by vascular neurosurgeons with all cases throughout South Korea from 2013 to 2017 to elucidate the role of neurosurgeons in the field of endovascular treatment in South Korea.
METHODS
The Society of Korean Endovascular Neurosurgeons (SKEN) has issued annual reports every year since 2014. These reports cover statistics on endovascular treatments collaboratively or individually performed by SKEN members from 2013 to 2017. The data was requested and collected from vascular neurosurgeons in various hospitals. The study involved 77 hospitals in its first year, and 100 in its last. National statistics on endovascular treatment from all over South Korea were obtained from the Healthcare Bigdata Hub website of the Health Insurance Review & Assessment Service based on the Electronic Data Interchange (EDI) codes (in the case of intra-arterial (IA) thrombolysis, however, statistics were based on a combination of the EDI and I63 codes, a cerebral infarction disease code) from 2013 to 2017. These two data sets were directly compared and the ratios were obtained.
RESULTS
Regionally, during the entire study period, endovascular treatments by SKEN members were most common in Gyeonggi-do, followed by Seoul and Busan. Among the endovascular treatments, conventional cerebral angiography was the most common, followed by cerebral aneurysmal coiling, endovascular treatments for ischemic stroke, and finally endovascular treatments for vascular malformation and tumor embolization. The number of endovascular treatments performed by SKEN members increased every year.
CONCLUSION
The SKEN members have been responsible for the major role of endovascular treatments in South Korea for the recent 5 years. This was achieved through the perseverance of senior members who started out in the midst of hardship, the establishment of standards for the training/certification of endovascular neurosurgery, and the enthusiasm of current SKEN members who followed. To provide better treatment to patients, we will have to make further progress in SKEN.

Keyword

Endovascular procedures; Big data; Data interpretation, Statistical

MeSH Terms

Busan
Cerebral Angiography
Cerebral Infarction
Data Interpretation, Statistical
Dataset
Delivery of Health Care
Endovascular Procedures
Gyeonggi-do
Humans
Insurance, Health
Intracranial Aneurysm
Korea
Neurosurgeons*
Neurosurgery
Seoul
Stroke
Vascular Malformations

Figure

• 

  Fig. 1. Required statistical data sheet delivered to SKEN members. The number of aneurysmal treatments reported in this annual report was counted as the number of aneurysms, which is different from the number in the HIRA, which was counted by patient. SKEN : The Society of Korean Endovascular Neurosurgeons, HIRA : the Health Insurance Review & Assessment Service, DSA : digital subtraction angiography, PAO : parent artery occlusion, UIA : unruptured intracranial aneurysms, PTA : percutaneous transluminal angioplasty, CAS : carotid artery stenting, AVM : arteriovenous malformation, AVF : arteriovenous fistula, CCF : carotid-cavernous stula.

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  Fig. 2. Graphical data from the SKEN members according to region and category in 2017. Endovascular treatments were the most common in Gyeonggi-do, followed by Seoul and Busan. This trend was also observed in all periods from 2013 to 2017. SKEN : The Society of Korean Endovascular Neurosurgeons.

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  Fig. 3. Serial data from SKEN members according to each category. With the exception of digital subtraction angiography (DSA), cerebral aneurysmal coiling was the most common, endovascular treatments for ischemic stroke were second, followed by endovascular treatments for vascular malformation and tumor embolization. SKEN : The Society of Korean Endovascular Neurosurgeons.

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  Fig. 4. Comparison between data collected from SKEN members and nationwide data from the Healthcare Bigdata Hub of the HIRA from 2013 to 2017. SKEN : The Society of Korean Endovascular Neurosurgeons, HIRA : the Health Insurance Review & Assessment Service.

Reference

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