Relative Roles of Radiologists and Other Physicians in Percutaneous Endovascular Neurointerventions

Cerebral catheter angiography and endovascular neurointerventions (ENIs) were developed and refined by early pioneers in neuroradiology. Recently, with developments in the safety and efficacy of ENIs, other physician specialists have expressed strong interest in performing these procedures. Our purpose was to compare volume and utilization of ENIs, among the various specialties, from 2000 to 2013.

Data from the Medicare Part B Physician/Supplier Procedure Summary Master Files for 2000 to 2013 were used to study ENI volume and utilization rates, by radiologists, neurosurgeons, neurologists, vascular surgeons, cardiologists, and other physicians.

From 2000 to 2013, the volume of intracranial ENIs increased: overall, from 2,439 to 7,424; for radiologists, from 1,956 to 3,993; and for neurosurgeons, from 237 to 2,900. Although cardiologists did not perform many intracranial ENIs in these years, they performed most of the carotid artery stenting procedures (4,097, which is 51% of the total 8,201 performed in 2013).

Radiologists continue to maintain a strong presence in the field of neurointerventional radiology, particularly in percutaneous intracranial interventions, performing 51% of all intracranial procedures in 2013, down from 80% in 2000. However, neurosurgeons have made substantial inroads into ENI procedures, with their volume increasing from 10% to 33%, from 2000 to 2013. The overall volume of ENIs rose steadily from 2000 to 2013.