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Shakir HJ, Shallwani H, Rangel-Castilla L, Bregy A, Davies JM, Sonig A, Ogilvy CS, Snyder KV, Hopkins LN, Siddiqui AH, Levy EI. Neuroendovascular Fellowship Training: Self-Assessment of a Program Accredited by the Committee on Advanced Subspecialty Training. Neurosurgery 2018; 82:407-413. [PMID: 29351626 DOI: 10.1093/neuros/nyx593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 11/21/2017] [Indexed: 11/15/2022] Open
Abstract
The University at Buffalo's neuroendovascular fellowship is one of the longest running fellowship programs in North America. The burgeoning neurointerventional workforce and the rapid growth in the neurointerventional space on the heels of groundbreaking clinical trials prompted us to assess the fellowship's academic impact and its graduates' perceptions and productivity. An anonymized web-based survey was sent to all former neuroendovascular fellows with specific questions pertaining to current practice, research and funding, and perceptions about the fellowship's impact on their skills, competitiveness, and compensation. Additionally, the h-index was calculated to assess the academic productivity of each graduated fellow. Among 50 former fellows, 42 (84%) completed the survey. The fellows came from various countries, ethnic backgrounds, and specialties including neurosurgery (n = 39, 93%), neurology (n = 2, 5%), and neuroradiology (n = 1, 2%). Twenty (48%) respondents were currently chairs or directors of their practice. Most (n = 30, 71%) spent at least 10% of their time on research activities, with 27 (64%) receiving research funding. The median h-index of all 50 former fellows was 14. The biggest gains from the fellowship were reported to be improvement in endovascular skills (median = 10 on a scale of 0-10 [highest]) and increase in competitiveness for jobs in vascular neurosurgery (median = 10), followed by increase in academic productivity (median = 8), and knowledge of vascular disease (median = 8). In an era with open calls for moratoriums on endovascular fellowships, concerns over market saturation, and pleas to improve training, fellowship programs perhaps merit a more objective assessment. The effectiveness of a fellowship program may best be measured by the academic impact and leadership roles of former fellows.
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Affiliation(s)
- Hakeem J Shakir
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York
| | - Hussain Shallwani
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York
| | - Leonardo Rangel-Castilla
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York.,Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota
| | - Amade Bregy
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York
| | - Jason M Davies
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York.,Department of Biomedical Informatics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | - Ashish Sonig
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York
| | - Christopher S Ogilvy
- Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Kenneth V Snyder
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York.,Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | - L Nelson Hopkins
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York.,Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.,Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, Buffalo, New York.,Jacobs Institute, Buffalo, New York
| | - Adnan H Siddiqui
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York.,Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.,Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, Buffalo, New York.,Jacobs Institute, Buffalo, New York
| | - Elad I Levy
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York.,Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.,Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, Buffalo, New York
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Day AL, Siddiqui AH, Meyers PM, Jovin TG, Derdeyn CP, Hoh BL, Riina H, Linfante I, Zaidat O, Turk A, Howington JU, Mocco J, Ringer AJ, Veznedaroglu E, Khalessi AA, Levy EI, Woo H, Harbaugh R, Giannotta S. Training Standards in Neuroendovascular Surgery: Program Accreditation and Practitioner Certification. Stroke 2017; 48:2318-2325. [PMID: 28706116 DOI: 10.1161/strokeaha.117.016560] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 03/09/2017] [Accepted: 03/15/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE Neuroendovascular surgery is a medical subspecialty that uses minimally invasive catheter-based technology and radiological imaging to diagnose and treat diseases of the central nervous system, head, neck, spine, and their vasculature. To perform these procedures, the practitioner needs an extensive knowledge of the anatomy of the nervous system, vasculature, and pathological conditions that affect their physiology. A working knowledge of radiation biology and safety is essential. Similarly, a sufficient volume of clinical and interventional experience, first as a trainee and then as a practitioner, is required so that these treatments can be delivered safely and effectively. METHODS This document has been prepared under the aegis of the Society of Neurological Surgeons and its Committee for Advanced Subspecialty Training in conjunction with the Joint Section of Cerebrovascular Surgery for the American Association of Neurological Surgeons and Congress of Neurological Surgeons, the Society of NeuroInterventional Surgery, and the Society of Vascular and Interventional Neurology. RESULTS The material herein outlines the requirements for institutional accreditation of training programs in neuroendovascular surgery, as well as those needed to obtain individual subspecialty certification, as agreed on by Committee for Advanced Subspecialty Training, the Society of Neurological Surgeons, and the aforementioned Societies. This document also clarifies the pathway to certification through an advanced practice track mechanism for those current practitioners of this subspecialty who trained before Committee for Advanced Subspecialty Training standards were formulated. CONCLUSIONS Representing neuroendovascular surgery physicians from neurosurgery, neuroradiology, and neurology, the above mentioned societies seek to standardize neuroendovascular surgery training to ensure the highest quality delivery of this subspecialty within the United States.
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Affiliation(s)
- Arthur L Day
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Adnan H Siddiqui
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Philip M Meyers
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Tudor G Jovin
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Colin P Derdeyn
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Brian L Hoh
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Howard Riina
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Italo Linfante
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Osama Zaidat
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Aquilla Turk
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Jay U Howington
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - J Mocco
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Andrew J Ringer
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Erol Veznedaroglu
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Alexander A Khalessi
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Elad I Levy
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Henry Woo
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Robert Harbaugh
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.)
| | - Steven Giannotta
- From the Department of Neurosurgery, Mischer Neuroscience Institute, University of Texas Health Science Center, Houston (A.L.D.); Departments of Neurosurgery and Radiology, School of Medicine and Biomedical Sciences and Toshiba Stroke and Vascular Institute, University at Buffalo, State University of New York (A.H.S., E.I.L.); Jacobs Institute, Buffalo, NY (A.H.S., E.I.L.); Departments of Radiology and Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, NY (P.M.M.); Departments of Neurology and Neurosurgery, University of Pittsburgh Medical Center, PA (T.G.J.); Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, University of Florida, Gainesville (B.L.H.); Department of Neurosurgery, NYU Langone Medical Center (H.R.); Departments of Radiology and Neuroscience, Miami Cardiac and Vascular Institute and Baptist Neuroscience Institute, FL (I.L.); Mercy Endovascular-Neuroscience, Toledo, OH (O.Z.); Department of Neurosurgery, Medical University of South Carolina, Charleston (A.T.); Department of Neurosurgery, Neurological Institute of Savannah, GA (J.U.H.); Department of Neurosurgery, Mount Sinai Health System, New York, NY (J.M.); Department of Neurosurgery, Mayfield Clinic and University of Cincinnati College of Medicine, OH (A.J.R.); Department of Neurosurgery, Capital Health System, Trenton, NJ (E.V.); Department of Neurosurgery, University of California, San Diego (A.A.K.); Departments of Neurosurgery and Radiology, Stony Brook School of Medicine, East Setauket, NY (H.W.); Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, PA (R.H.); and Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles (S.G.).
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