Evidence map›Paper›PMID 42366249›Full record

ReviewNeurosurgical review2026

Association of cerebrovascular center volume with patient outcomes.

Stacey Quintero Wolfe, Justin R Mascitelli, Kyle Fargen, Peter Kan, Ketan Bulsara, Christopher P Kellner, Brian M Howard, Michael R Levitt, Rocco Armonda, Joshua Osbun and 5 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Neurosurgical review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

15 authors.

Stacey Quintero WolfeDepartment of Neurosurgery, Wake Forest School of Medicine, Winston- Salem, NC, USA.
Justin R MascitelliDepartment of Neurosurgery, University of Texas Health Science Center, San Antonio, TX, USA. jmascite@gmail.com.
Kyle FargenDepartment of Neurosurgery, Wake Forest School of Medicine, Winston- Salem, NC, USA.
Peter KanDepartment of Neurosurgery, University of Texas Medical Branch, Galveston, TX, USA.
Ketan BulsaraDepartment of Neurosurgery, University of Connecticut, Farmington, CT, USA.
Christopher P KellnerDepartment of Neurosurgery, Mount Sinai, New York, NY, USA.
Brian M HowardDepartment of Neurosurgery, Emory University, Atlanta, GA, USA.
Michael R LevittDepartment of Neurological Surgery, University of Washington, Seattle, WA, USA.
Rocco ArmondaDepartment of Neuroendovascular Surgery, Washington Hospital Center, Bethesda, MD, USA.
Joshua OsbunDepartment of Neurosurgery, Washington University in St. Louis, St. Louis, MO, USA.
Clemens SchirmerDepartment of Neurosurgery, Geisinger Health, Wilkes-Barre, PA, USA.
Mark BainDepartment of Neurosurgery, Cleveland Clinic, Cleveland, OH, USA.
William J MackDepartment of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Stavropoula TjoumakarisDepartment of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
Adam ArthurDepartment of Neurosurgery, Semmes-Murphey Neurologic and Spine Clinic, University of Tennessee Health Sciences, Memphis, TN, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Current guidelines acknowledge the importance of both microsurgical and neuroendovascular expertise in the treatment of cerebrovascular disease. To achieve optimal care for these patients, it is becoming increasingly evident that procedural volumes impact patient outcomes. This is demonstrated across various cerebrovascular diseases.In this literature review, we demonstrate the association of volume with patient outcomes across multiple cerebrovascular disease states and interventions. Microsurgical aneurysm clipping remains essential even with the rise of endovascular therapy and mortality and patient-safety indicator events are clearly lower at high-volume centers for both ruptured and unruptured aneurysms. Likewise, patients undergoing surgery for cerebrovascular malformations and carotid endarterectomy have significantly better outcomes in high-volume centers by high-volume surgeons. Studies of mechanical thrombectomy and carotid stenting reinforce the association between higher procedural volumes, decreased mortality, and improved outcomes across various intervention modalities. The integration of neurocritical care has further improved outcomes, with specialized units demonstrating reduced mortality rates and lengths of stay.Modern cerebrovascular and stroke care necessitates comprehensive care by experienced providers in high-volume centers to optimize patient outcomes for both hemorrhagic and ischemic cerebrovascular disease. The relationship between higher institutional and provider case volumes and better patient outcomes is clearly delineated in the literature. Maintaining high-volume standards for endovascular and microsurgical cerebrovascular care can help ensure high-quality care across centers.

Indexed as

Cerebrovascular DisordersHospitals, High-VolumeNeurosurgical ProceduresEndovascular ProceduresHumansIntracranial AneurysmMicrosurgeryTreatment OutcomeArteriovenous malformationsCarotid stenosisCerebral aneurysmsClinical outcomesIntracerebral hemorrhageMechanical thrombectomyVolume-outcome relationship

Identifiers

PMID42366249
PMCPMC13310822

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.