Endovascular Intervention

Values outside of the suggested thresholds should trigger a review of policies and/or practices within the department to determine the causes and to implement changes to manage the incidence of related indicators.

1.     For quality Improvement Issues related to cervicocerebral/spinal angiography; the following indicators and related thresholds may be used:

a.     Reported Success Rates of Diagnostic cervicocerebral/spinal catheter angiography is 98% (suggested threshold <98%).

b.     Reported Overall Procedure complication, either neurologic or systemic occurring within 24 hours of the angiography, is 2% (suggested threshold <2%)

2.     For quality improvement issues related to spinal dural AVF endovascular embolization; the following indicators and related thresholds may be used:

a.     The reported threshold indicators of the efficacy are technical success (81%) with occlusion of the targeted vessels and clinical success (60%) with improvement or stabilization of symptoms.

b.     The reported overall complication of dural AVF embolization is 10-15% (suggested threshold <5%).

3-    For quality improvement issues related to spinal AVM endovascular embolization; the following indicators and related thresholds may be used:

a.     The reported threshold indicators of the efficacy are technical success (90%) with occlusion of the targeted vessels and clinical success (50%) with improvement or stabilization of symptoms.

b.     The reported overall complication of dural AVF embolization is 10-15% (suggested threshold <10%).

4-    For quality improvement issues related to extracranial tumor endovascular embolization, major complications are rare. However, stroke and intracerebral hemorrhage have been reported in up to 3-6% during intracranial embolization (suggested threshold <5%).