Establishing an Interventional Radiology Service for Intracranial Aneurysms: Early Outcomes from Nigeria's First...

Area of Science:

• Neurosurgery
• Interventional Radiology
• Vascular Neurology

Background:

• Intracranial aneurysms pose significant risks, necessitating advanced treatment options.
• Access to specialized endovascular neurointerventional services is limited in many regions, including Nigeria.
• Establishing such services requires robust training and mentorship for local healthcare professionals.

Purpose of the Study:

• To assess the early clinical outcomes of a newly established endovascular neurointerventional service for intracranial aneurysms in Nigeria.
• To evaluate the procedural safety and effectiveness of endovascular techniques in this setting.
• To determine the success of a structured skill transfer program for local interventional radiologists.

Main Methods:

• Retrospective review of the first 22 adult patients treated for intracranial aneurysms.
• Data collection included patient demographics, aneurysm characteristics, procedural details, and operator experience.
• Skill transfer involved remote and/or physical proctoring by experienced neurointerventional radiologists for a local interventional radiologist.

Main Results:

• The study included 22 patients (81.8% female, mean age 49.8 years).
• Common aneurysm sites included the anterior communicating artery (41.7%); 75.0% were treated post-rupture.
• Complications occurred in 18.2% of cases; 68.2% achieved favorable outcomes (mRS 0 at 30 days).
• 45.5% of procedures were performed independently by the local radiologist, with comparable outcomes to proctored cases.
• Tele-neurocritical care facilitated safe postoperative management.

Conclusions:

• The establishment of a neuroendovascular service in Nigeria resulted in favorable early outcomes and a low complication rate.
• A structured skill transfer framework facilitated operator independence and safe progression.
• Tele-neurocritical care proved effective for patient management in the absence of on-site specialists.