Current status and prospects of ambulatory surgery model for neurovascular interventions_West China Medical Journal

Authors：

ZHANG Zhiyong ¹ , LIU Xinyu ¹ ,  NI Ruyang ²

1. Department of Neurology, Beijing Geriatric Hospital, Beijing 100095, P. R. China;
2. Hospital Office, Beijing Geriatric Hospital, Beijing 100095, P. R. China;

Corresponding?author：

NI Ruyang, Email: niruyang@126.com

Keywords：

Ambulatory surgery; neurovascular intervention; cerebral angiography; aneurysm; chronic subdural hematoma

DOI：

10.7507/1002-0179.202601058

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Neurovascular interventional technology serves as a crucial means for the diagnosis and treatment of cerebrovascular diseases. The ambulatory surgery model, characterized by its efficiency and minimally invasive nature, has been widely adopted across multiple clinical specialties. However, its development in the field of neurovascular interventions remains at an early exploratory stage. This article systematically reviews the current status of the ambulatory surgery model for neurovascular interventions and provides insights into future research directions and development pathways, aiming to provide references for promoting the safe, standardized, and large-scale implementation in ambulatory surgery model for neurovascular interventions.

Citation： ZHANG Zhiyong, LIU Xinyu, NI Ruyang. Current status and prospects of ambulatory surgery model for neurovascular interventions. West China Medical Journal, 2026, 41(2): 308-314. doi: 10.7507/1002-0179.202601058 Copy

1.	Dawkins AA, Evans AL, Wattam J, et al. Complications of cerebral angiography: a prospective analysis of 2, 924 consecutive procedures. Neuroradiology, 2007, 49(9): 753-759.
2.	Scullen TA, Lian MX, Jaikumar V, et al. First reported series of cerebral angiography performed at an outpatient center: safety and satisfaction results. Neurosurgery, 2025, 96(3): 539-544.
3.	于麗華. 中國日間手術發展的歷程與展望. 中國醫院管理, 2016, 36(6): 16-18.
4.	Preece R, Stenson K, Shaw S, et al. Recent developments and current controversies in short-stay endovascular aneurysm repair. J Cardiovasc Surg (Torino), 2019, 60(4): 460-467.
5.	國家老年疾病臨床醫學研究中心(湘雅醫院), 國家科技部內鏡微創技術裝備與標準國際聯合研究中心. 綜合醫院日間手術室運行和管理中國專家共識(2022 版). 中華消化外科雜志, 2022, 21(9): 1173-1179.
6.	Taxiarchi P, Kontopantelis E, Martin GP, et al. Same-day discharge after elective percutaneous coronary intervention: insights from the British Cardiovascular Intervention Society. JACC Cardiovasc Interv, 2019, 12(15): 1479-1494.
7.	Lai PMR, DeGaetano AC, Levy EI. Cerebral angiography in outpatient endovascular centers: roadmap and lessons learned from interventional radiology, cardiology, and vascular surgery. J Neurointerv Surg, 2025, 17(8): 907-908.
8.	Agarwal S, Thakkar B, Skelding KA, et al. Trends and outcomes after same-day discharge after percutaneous coronary interventions. Circ Cardiovasc Qual Outcomes, 2017, 10(8): e003936.
9.	Doby T. Cerebral angiography and Egas Moniz. AJR Am J Roentgenol, 1992, 159(2): 364.
10.	段傳志, 李鐵林. 神經介入放射學的發展現狀及未來展望. 中華神經醫學雜志, 2025, 24(1): 2-7.
11.	郭德華, 孔令華, 白衛星, 等. 腦血管介入手術機器人的研究進展. 中華放射學雜志, 2021, 55(6): 682-686.
12.	Fifi JT, Meyers PM, Lavine SD, et al. Complications of modern diagnostic cerebral angiography in an academic medical center. J Vasc Interv Radiol, 2009, 20(4): 442-447.
13.	Qureshi AI, Naseem N, Saleem MA, et al. Migraine and non-migraine headaches following diagnostic catheter-based cerebral angiography. Headache, 2018, 58(8): 1219-1224.
14.	Cho SM, Deshpande A, Pasupuleti V, et al. Radiographic and clinical brain infarcts in cardiac and diagnostic procedures: a systematic review and meta-analysis. Stroke, 2017, 48(10): 2753-2759.
15.	Lapow JM, Pammal RS, Brozynski M, et al. Complication rates following cerebral and coronary angiography: nationwide analysis 2008-2014. Cardiol Rev, 2024, 32(6): 507-512.
16.	Rai AT, Domico J. Routine pre-procedure laboratory testing for patients undergoing outpatient cerebral angiography is not indicated. J Neurointerv Surg, 2013, 5(2): 172-176.
17.	Jeong YG, Kim EH, Hwang SM, et al. Outpatient (same-day care) neuroangiography and neurointervention. Neurointervention, 2012, 7(1): 17-22.
18.	Liu H, Park D, Hwang SM, et al. Outpatient day-care neuroangiography and neurointervention of unruptured intracranial aneurysms. Neurointervention, 2016, 11(1): 37-41.
19.	Behrens L, Adam A, Rubeck A, et al. Safety aspects and procedural characteristics of ambulatory diagnostic cerebral catheter angiography. Clin Neuroradiol, 2024, 34(1): 155-162.
20.	Razavi SM, Masangkay E, Chelikam N, et al. Safety of cerebral angiography in private outpatient clinical setting. Ann Neurol, 2020, 88: S169-S169.
21.	Heyde GS, Koch KT, de Winter RJ, et al. Randomized trial comparing same-day discharge with overnight hospital stay after percutaneous coronary intervention: results of the Elective PCI in Outpatient Study (EPOS). Circulation, 2007, 115(17): 2299-2306.
22.	Brayton KM, Patel VG, Stave C, et al. Same-day discharge after percutaneous coronary intervention: a meta-analysis. J Am Coll Cardiol, 2013, 62(4): 275-285.
23.	Rao SV, Kaltenbach LA, Weintraub WS, et al. Prevalence and outcomes of same-day discharge after elective percutaneous coronary intervention among older patients. JAMA, 2011, 306(13): 1461-1467.
24.	Hyasat K, Femia G, Alzuhairi K, et al. Safety, feasibility and economic analysis of same day discharge following elective percutaneous coronary intervention. Clin Med Insights Cardiol, 2022, 16: 11795468221116852.
25.	Brown CS, Smith ME, Kim GY, et al. Exploring the rapid expansion of office-based laboratories and peripheral vascular interventions across the United States. J Vasc Surg, 2021, 74(3): 997-1005.e1.
26.	Goland J, Doroszuk G, Ypa P, et al. Outpatient treatment of cerebral aneurysms: a case series. Surg Neurol Int, 2020, 11: 400.
27.	Suh DC, Choi YH, Park SI, et al. Outpatient day-care management of unruptured intracranial aneurysm: a retrospective cohort study. Korean J Radiol, 2022, 23(8): 828-834.
28.	Lai PMR, Snyder KV, Levy EI. First reported series of intracranial and carotid aneurysm embolization performed at an ambulatory neurosurgery center: preliminary experience. J Neurointerv Surg, 2025, 18: jnis-2025-023228.
29.	Entezami P, Rock AK, Topp GP, et al. Developing a fast-track discharge protocol for patients with cerebral aneurysms treated via neuroendovascular techniques. Interv Neuroradiol, 2024, 30(2): 163-169.
30.	Barkyoumb D, Balasubramanian K, Ibrahim S, et al. Feasibility of outpatient middle meningeal artery embolization for chronic subdural hematoma. Surg Neurol Int, 2025, 16: 277.
31.	Entezami P, Field NC, Dalfino JC. Outpatient management of chronic expanding subdural hematomas with endovascular embolization to minimize inpatient admissions during the COVID-19 viral pandemic. Interv Neuroradiol, 2021, 27(5): 716-721.
32.	中國研究型醫院學會介入神經病學專委會經橈動脈介入協作組. 經橈動脈或遠端橈動脈入路行腦血管介入操作中國專家共識. 中國腦血管病雜志, 2023, 20(1): 63-72, 封 3.
33.	Kim H, Lee HJ, Choi SW, et al. Comprehensive analysis of neurologic complications following transradial cerebral angiography. AJNR Am J Neuroradiol, 2025, 46(6): 1166-1172.
34.	Fischman AM, Swinburne NC, Patel RS. A technical guide describing the use of transradial access technique for endovascular interventions. Tech Vasc Interv Radiol, 2015, 18(2): 58-65.
35.	Kaufmann TJ, Huston J 3rd, Mandrekar JN, et al. Complications of diagnostic cerebral angiography: evaluation of 19, 826 consecutive patients. Radiology, 2007, 243(3): 812-819.
36.	Tafelmeier S, Kesseler E, Iancu AM, et al. Spectrum of complications and complication rates after diagnostic catheter angiography in neuroradiology. Clin Neuroradiol, 2023, 33(3): 763-768.
37.	Thiex R, Norbash AM, Frerichs KU. The safety of dedicated-team catheter-based diagnostic cerebral angiography in the era of advanced noninvasive imaging. AJNR Am J Neuroradiol, 2010, 31(2): 230-234.
38.	Shen J, Karki M, Jiang T, et al. Complications associated with diagnostic cerebral angiography: a retrospective analysis of 644 consecutive cerebral angiographic cases. Neurol India, 2018, 66(4): 1154-1158.
39.	中華醫學會神經病學分會, 中華醫學會神經病學分會神經血管介入協作組. 腦血管造影術操作規范中國專家共識. 中華神經科雜志, 2018, 51(1): 7-13.
40.	《冠狀動脈造影日間手術專家共識》撰寫委員會, 曾春雨, 張瑞巖, 等. 冠狀動脈造影日間手術專家共識. 中華高血壓雜志, 2023, 31(10): 902-907.
41.	Solomon R. Preventing contrast-induced nephropathy: problems, challenges and future directions. BMC Med, 2009, 7: 24.
42.	Lachat ML, Pecoraro F, Mayer D, et al. Outpatient endovascular aortic aneurysm repair: experience in 100 consecutive patients. Ann Surg, 2013, 258(5): 754-759.
43.	Jaroenngarmsamer T, Bhatia KD, Kortman H, et al. Procedural success with radial access for carotid artery stenting: systematic review and meta-analysis. J Neurointerv Surg, 2020, 12(1): 87-93.
44.	中華醫學會神經外科學分會, 中華醫學會麻醉學分會, 中國醫療保健國際交流促進會加速康復外科學分會. 未破裂顱內動脈瘤患者加速康復外科臨床實踐指南. 中華醫學雜志, 2022, 102(41): 3257-3266.
45.	Amin AP, Pinto D, House JA, et al. Association of same-day discharge after elective percutaneous coronary intervention in the United States with costs and outcomes. JAMA Cardiol, 2018, 3(11): 1041-1049.
46.	Findlay MC, Baker CM, Childs S, et al. Analysis of treatment cost differences in patients undergoing femoral versus radial access in outpatient diagnostic cerebral arteriograms. Interv Neuroradiol, 2023, 10: 15910199231207408.
47.	Catapano JS, Ducruet AF, Koester SW, et al. Propensity-adjusted cost analysis of radial versus femoral access for neuroendovascular procedures. J Neurointerv Surg, 2021, 13(8): 752-754.

1. Dawkins AA, Evans AL, Wattam J, et al. Complications of cerebral angiography: a prospective analysis of 2, 924 consecutive procedures. Neuroradiology, 2007, 49(9): 753-759.
2. Scullen TA, Lian MX, Jaikumar V, et al. First reported series of cerebral angiography performed at an outpatient center: safety and satisfaction results. Neurosurgery, 2025, 96(3): 539-544.
3. 于麗華. 中國日間手術發展的歷程與展望. 中國醫院管理, 2016, 36(6): 16-18.
4. Preece R, Stenson K, Shaw S, et al. Recent developments and current controversies in short-stay endovascular aneurysm repair. J Cardiovasc Surg (Torino), 2019, 60(4): 460-467.
5. 國家老年疾病臨床醫學研究中心(湘雅醫院), 國家科技部內鏡微創技術裝備與標準國際聯合研究中心. 綜合醫院日間手術室運行和管理中國專家共識(2022 版). 中華消化外科雜志, 2022, 21(9): 1173-1179.
6. Taxiarchi P, Kontopantelis E, Martin GP, et al. Same-day discharge after elective percutaneous coronary intervention: insights from the British Cardiovascular Intervention Society. JACC Cardiovasc Interv, 2019, 12(15): 1479-1494.
7. Lai PMR, DeGaetano AC, Levy EI. Cerebral angiography in outpatient endovascular centers: roadmap and lessons learned from interventional radiology, cardiology, and vascular surgery. J Neurointerv Surg, 2025, 17(8): 907-908.
8. Agarwal S, Thakkar B, Skelding KA, et al. Trends and outcomes after same-day discharge after percutaneous coronary interventions. Circ Cardiovasc Qual Outcomes, 2017, 10(8): e003936.
9. Doby T. Cerebral angiography and Egas Moniz. AJR Am J Roentgenol, 1992, 159(2): 364.
10. 段傳志, 李鐵林. 神經介入放射學的發展現狀及未來展望. 中華神經醫學雜志, 2025, 24(1): 2-7.
11. 郭德華, 孔令華, 白衛星, 等. 腦血管介入手術機器人的研究進展. 中華放射學雜志, 2021, 55(6): 682-686.
12. Fifi JT, Meyers PM, Lavine SD, et al. Complications of modern diagnostic cerebral angiography in an academic medical center. J Vasc Interv Radiol, 2009, 20(4): 442-447.
13. Qureshi AI, Naseem N, Saleem MA, et al. Migraine and non-migraine headaches following diagnostic catheter-based cerebral angiography. Headache, 2018, 58(8): 1219-1224.
14. Cho SM, Deshpande A, Pasupuleti V, et al. Radiographic and clinical brain infarcts in cardiac and diagnostic procedures: a systematic review and meta-analysis. Stroke, 2017, 48(10): 2753-2759.
15. Lapow JM, Pammal RS, Brozynski M, et al. Complication rates following cerebral and coronary angiography: nationwide analysis 2008-2014. Cardiol Rev, 2024, 32(6): 507-512.
16. Rai AT, Domico J. Routine pre-procedure laboratory testing for patients undergoing outpatient cerebral angiography is not indicated. J Neurointerv Surg, 2013, 5(2): 172-176.
17. Jeong YG, Kim EH, Hwang SM, et al. Outpatient (same-day care) neuroangiography and neurointervention. Neurointervention, 2012, 7(1): 17-22.
18. Liu H, Park D, Hwang SM, et al. Outpatient day-care neuroangiography and neurointervention of unruptured intracranial aneurysms. Neurointervention, 2016, 11(1): 37-41.
19. Behrens L, Adam A, Rubeck A, et al. Safety aspects and procedural characteristics of ambulatory diagnostic cerebral catheter angiography. Clin Neuroradiol, 2024, 34(1): 155-162.
20. Razavi SM, Masangkay E, Chelikam N, et al. Safety of cerebral angiography in private outpatient clinical setting. Ann Neurol, 2020, 88: S169-S169.
21. Heyde GS, Koch KT, de Winter RJ, et al. Randomized trial comparing same-day discharge with overnight hospital stay after percutaneous coronary intervention: results of the Elective PCI in Outpatient Study (EPOS). Circulation, 2007, 115(17): 2299-2306.
22. Brayton KM, Patel VG, Stave C, et al. Same-day discharge after percutaneous coronary intervention: a meta-analysis. J Am Coll Cardiol, 2013, 62(4): 275-285.
23. Rao SV, Kaltenbach LA, Weintraub WS, et al. Prevalence and outcomes of same-day discharge after elective percutaneous coronary intervention among older patients. JAMA, 2011, 306(13): 1461-1467.
24. Hyasat K, Femia G, Alzuhairi K, et al. Safety, feasibility and economic analysis of same day discharge following elective percutaneous coronary intervention. Clin Med Insights Cardiol, 2022, 16: 11795468221116852.
25. Brown CS, Smith ME, Kim GY, et al. Exploring the rapid expansion of office-based laboratories and peripheral vascular interventions across the United States. J Vasc Surg, 2021, 74(3): 997-1005.e1.
26. Goland J, Doroszuk G, Ypa P, et al. Outpatient treatment of cerebral aneurysms: a case series. Surg Neurol Int, 2020, 11: 400.
27. Suh DC, Choi YH, Park SI, et al. Outpatient day-care management of unruptured intracranial aneurysm: a retrospective cohort study. Korean J Radiol, 2022, 23(8): 828-834.
28. Lai PMR, Snyder KV, Levy EI. First reported series of intracranial and carotid aneurysm embolization performed at an ambulatory neurosurgery center: preliminary experience. J Neurointerv Surg, 2025, 18: jnis-2025-023228.
29. Entezami P, Rock AK, Topp GP, et al. Developing a fast-track discharge protocol for patients with cerebral aneurysms treated via neuroendovascular techniques. Interv Neuroradiol, 2024, 30(2): 163-169.
30. Barkyoumb D, Balasubramanian K, Ibrahim S, et al. Feasibility of outpatient middle meningeal artery embolization for chronic subdural hematoma. Surg Neurol Int, 2025, 16: 277.
31. Entezami P, Field NC, Dalfino JC. Outpatient management of chronic expanding subdural hematomas with endovascular embolization to minimize inpatient admissions during the COVID-19 viral pandemic. Interv Neuroradiol, 2021, 27(5): 716-721.
32. 中國研究型醫院學會介入神經病學專委會經橈動脈介入協作組. 經橈動脈或遠端橈動脈入路行腦血管介入操作中國專家共識. 中國腦血管病雜志, 2023, 20(1): 63-72, 封 3.
33. Kim H, Lee HJ, Choi SW, et al. Comprehensive analysis of neurologic complications following transradial cerebral angiography. AJNR Am J Neuroradiol, 2025, 46(6): 1166-1172.
34. Fischman AM, Swinburne NC, Patel RS. A technical guide describing the use of transradial access technique for endovascular interventions. Tech Vasc Interv Radiol, 2015, 18(2): 58-65.
35. Kaufmann TJ, Huston J 3rd, Mandrekar JN, et al. Complications of diagnostic cerebral angiography: evaluation of 19, 826 consecutive patients. Radiology, 2007, 243(3): 812-819.
36. Tafelmeier S, Kesseler E, Iancu AM, et al. Spectrum of complications and complication rates after diagnostic catheter angiography in neuroradiology. Clin Neuroradiol, 2023, 33(3): 763-768.
37. Thiex R, Norbash AM, Frerichs KU. The safety of dedicated-team catheter-based diagnostic cerebral angiography in the era of advanced noninvasive imaging. AJNR Am J Neuroradiol, 2010, 31(2): 230-234.
38. Shen J, Karki M, Jiang T, et al. Complications associated with diagnostic cerebral angiography: a retrospective analysis of 644 consecutive cerebral angiographic cases. Neurol India, 2018, 66(4): 1154-1158.
39. 中華醫學會神經病學分會, 中華醫學會神經病學分會神經血管介入協作組. 腦血管造影術操作規范中國專家共識. 中華神經科雜志, 2018, 51(1): 7-13.
40. 《冠狀動脈造影日間手術專家共識》撰寫委員會, 曾春雨, 張瑞巖, 等. 冠狀動脈造影日間手術專家共識. 中華高血壓雜志, 2023, 31(10): 902-907.
41. Solomon R. Preventing contrast-induced nephropathy: problems, challenges and future directions. BMC Med, 2009, 7: 24.
42. Lachat ML, Pecoraro F, Mayer D, et al. Outpatient endovascular aortic aneurysm repair: experience in 100 consecutive patients. Ann Surg, 2013, 258(5): 754-759.
43. Jaroenngarmsamer T, Bhatia KD, Kortman H, et al. Procedural success with radial access for carotid artery stenting: systematic review and meta-analysis. J Neurointerv Surg, 2020, 12(1): 87-93.
44. 中華醫學會神經外科學分會, 中華醫學會麻醉學分會, 中國醫療保健國際交流促進會加速康復外科學分會. 未破裂顱內動脈瘤患者加速康復外科臨床實踐指南. 中華醫學雜志, 2022, 102(41): 3257-3266.
45. Amin AP, Pinto D, House JA, et al. Association of same-day discharge after elective percutaneous coronary intervention in the United States with costs and outcomes. JAMA Cardiol, 2018, 3(11): 1041-1049.
46. Findlay MC, Baker CM, Childs S, et al. Analysis of treatment cost differences in patients undergoing femoral versus radial access in outpatient diagnostic cerebral arteriograms. Interv Neuroradiol, 2023, 10: 15910199231207408.
47. Catapano JS, Ducruet AF, Koester SW, et al. Propensity-adjusted cost analysis of radial versus femoral access for neuroendovascular procedures. J Neurointerv Surg, 2021, 13(8): 752-754.

Previous Article
Application progress of artificial intelligence in the standardized management of anesthesia for day surgery
Next Article
Management progress in same-day cancellations of day surgery

West China Medical Journal

Current status and prospects of ambulatory surgery model for neurovascular interventions

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content