Evidence map›Paper›PMID 41130713›Full record

ArticleJournal of neurointerventional surgery2026

Unseen wounds: a multinational investigation of neurointerventionalists on the psychological toll of complications.

Ansaar T Rai, Emanuele Orru, Kyle M Fargen, Fabian Arnberg Sandor, Ricardo A Hanel, James M Milburn, Thanh N Nguyen, Nathan Farkas, Adam A Dmytriw, Adnan H Siddiqui

Abstract readMulticenter Study
In one paragraph

Article in Journal of neurointerventional surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ansaar T RaiInterventional Neuroradiology, West Virginia University Rockefeller Neuroscience Institute, Morgantown, West Virginia, USA ansaar.rai@hsc.wvu.edu.ORCID http://orcid.org/0000-0001-9864-4805
Emanuele OrruNeurointerventional Radiology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA.ORCID http://orcid.org/0000-0002-6129-8061
Kyle M FargenNeurological Surgery and Radiology, Wake Forest University, Winston-Salem, North Carolina, USA.ORCID http://orcid.org/0000-0001-8979-1993
Fabian Arnberg SandorClinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Ricardo A HanelNeurosurgery, Baptist Medical Center Jacksonville, Jacksonville, Florida, USA.ORCID http://orcid.org/0000-0001-7195-5806
James M MilburnRadiology, Ochsner Medical System, New Orleans, Louisiana, USA.ORCID http://orcid.org/0000-0003-3403-2628
Thanh N NguyenNeurology, Boston University School of Medicine, Boston, Massachusetts, USA.ORCID http://orcid.org/0000-0002-2810-1685
Nathan FarkasNeurointerventional Surgery, Interventional Neuro Associates, University City, Missouri, USA.ORCID http://orcid.org/0000-0003-0982-8341
Adam A DmytriwNeuroendovascular Program, Massachusetts General Hospital, Boston, Massachusetts, USA.ORCID http://orcid.org/0000-0003-0131-5699
Adnan H SiddiquiNeurosurgery and Radiology and Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.ORCID http://orcid.org/0000-0002-9519-0059

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundComplications not only affect patients but also impose a significant psychological burden on physicians. Quantitative data in neurointerventional surgery regarding the 'second victim' phenomenon are lacking. This study aimed to assess the prevalence and severity of post-traumatic stress symptoms among neurointerventionalists after major complications.

methodsA survey was developed by a committee of experienced neurointerventionalists and distributed internationally via multiple platforms. Respondents were anonymous. Demographic information, complication type, and institutional support availability were queried. Psychological distress was measured using the validated Impact of Event Scale-Revised (IES-R), which assesses intrusion, avoidance, and hyperarousal domains. Descriptive statistics and regression analyses were performed to identify factors associated with post-traumatic stress symptoms.

resultsOf 1042 invited physicians, 503 responded (48%), with 413 completing the full survey (40%). The most common pathology was cerebral aneurysm, and the most frequent complication was hemorrhage. Overall, 64% scored above the IES-R threshold for possible post-traumatic stress disorder (PTSD) (≥24), with many reaching levels (≥37) associated with long-term stress and physiological sequelae. Intrusion was the dominant symptom domain, particularly distressing reminders about the complication. Lack of institutional support was significantly associated with possible PTSD (OR 1.63, 95% CI 1.1 to 2.5, P=0.02). No differences were observed by specialty, but geographic variations were present. High stress scores persisted long after the index event.

conclusionComplications exert a profound emotional and physiological toll on neurointerventionalists, with high rates of possible PTSD and a strong association with inadequate institutional support. Systematic support programs are urgently needed to safeguard physician well-being and patient safety.

Indexed as

NeurosurgeonsPostoperative ComplicationsStress Disorders, Post-TraumaticAdultFemaleHumansMaleMiddle AgedSurveys and QuestionnairesAneurysmAngiographyComplicationTechniqueThrombectomy

Identifiers

PMID41130713
PMCPMC13638287

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.