gms | German Medical Science

Objective: Evolving endovascular techniques as well as re-established indications for endovascular interventions like thrombectomies in ischemic strokesled to a shortage of trained physicians with a high expertise in the field of endovascular interventions. In Europe, movements to establish a standardized curriculum to train interventionalists are underway, emerging from different specializations: neurosurgeons, neuroradiologists, neurologists and cardiologists. This survey was done to assess the need for an interventional curriculum in the training of neurosurgeons in Germany.

Methods: A survey containing 25 items was conceived with a commercial software (SurveyMonkey®), and participants were invited through the Vascular Section of the German Society of Neurosurgery. Two reminders were sent within a three months period.

Results: A total of 322 participants assessed the survey. Participants were mainly heads of departments or consultants (72%) working in hospitals of level 3 (-65%) or level 2 (-24%). The vast majority had certified trans-regional stroke units. 68% of the facilities included an institute for neuroradiology with a 24/7 on-call for endovascular interventions. Nevertheless, 45% responded that endovascular procedures had to be postponed due to staff shortage within the past 12 months. 75% of the participants would be keen to offer endovascular interventions on their own or in an interdisciplinary setting, willing to invest 6 up to 12 months of training in this field (84%).

Conclusion: The data suggest an undersupply of endovascular interventionalists from a neurosurgical perspective, and clearly advocate standardized training schedules for "hybrid" neurosurgeons of the coming generations. Societies of the neurovascular science field should join together in a national solution that is closely coordinated with the European efforts in this regard.