Mougnyan Cox MD, Presenter: Nothing to Disclose

David C. Levin MD, Abstract Co-Author: Consultant, HealthHelp, LLC Board of Directors, Outpatient Imaging Affiliates, LLC

Laurence Parker PhD, Abstract Co-Author: Nothing to Disclose

Vijay Madan Rao MD, Abstract Co-Author: Nothing to Disclose

Historically, cerebral catheter angiography and endovascular neurointerventions (ENI) were developed, refined and practiced by early pioneers in the field of neuroradiology. Recently, rapid developments in the safety and efficacy of ENI have resulted in other physician specialties expressing a strong interest in performing these procedures. Our purpose was to compare trends in performance ENI among the various specialties, as well the overall utilization trends from the years 2000 to 2012.

Data from the Center for Medicare and Medicaid Services Physician/Supplier Procedure Summary Master Files for 2000 to 2012 were used. The Current Procedural Terminology, 4th edition (CPT) codes for percutaneous neurointerventions were used to obtain the volume of procedures performed in the Medicare fee-for-service population. Using the provider specialty codes, we classified the physicians performing ENI into 6 groups; radiologists, neurosurgeons, neurologists, vascular surgeons, other surgeons, cardiologists and other physicians. The utilization trends for 2000 to 2012 were studied.  

Overall, the volume of percutaneous neurointerventions increased from 2439 in 2000 to 7181 in 2012. Radiologists’ volume increased from 1956 in 2000 to 3939 in 2012. Neurosurgery ENI volumes increased from 237 in 2000 to 2377 in 2012. Neurology volumes increased from 1 in 2000 to 646 in 2012. Cardiologists’ volumes went from no ENI procedures performed in 2000 to 31 in 2012. ENI volumes for vascular surgeons increased from 1 in 2000 to 44 in 2012, and the ENI volumes for all other physicians went from 244 in 2000 to 144 in 2012.

Radiologists continue to maintain a strong presence in the field of Neurointerventional radiology, performing 55% of the total number of procedures in 2012, down from 80%. However, neurosurgery has made significant inroads into ENI procedures, with their volume increasing from 10% in 2000 to 33% in 2012. The overall volume of ENI continues to rise at a steady pace from 2000 to 2012.

Radiologists continue to maintain a strong presence in the field of neurointerventional radiology, performing the majority (55%) of percutaneous neurointerventions.

Cox, M, Levin, D, Parker, L, Rao, V, Comparison of Recent Volume of Percutaneous Endovascular Neurointerventions among Radiologists, Neurosurgeons, Neurologists, and Other Physicians: Who is Doing Them?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002501.html