The impact of changing intracranial aneurysm practice on the education of cerebrovascular neurosurgeons

Endovascular repair of intracranial aneurysms has transformed the practice of cerebrovascular surgery. We reviewed the National Hospital Morbidity Database in Australia for the years 2000 to 2008 and investigated the changing trends of aneurysm practice. During this period 7,503 craniotomies for aneurysm repair and 7,863 endovascular coiling procedures were performed. The number of aneurysm procedures performed surgically reduced from 9 cases per neurosurgeon per year to 4.2 cases, a reduction of 53.3%. The number of endovascular treatments increased 2.1 fold, from 3.6 aneurysms per neurosurgeon in 2000 to 7.5 in 2008. The implications of reduced numbers of surgically treated aneurysms were considered for the education of cerebrovascular neurosurgeons in Australia.