Pituitary

, Volume 17, Issue 5, pp 430–435 | Cite as

Cerebrovascular complications and utilization of endovascular techniques following transsphenoidal resection of pituitary adenomas: a study of the Nationwide Inpatient Sample 2001–2010

  • Waleed Brinjikji
  • Giuseppe Lanzino
  • Harry J. Cloft
Article

Abstract

Purpose

Cerebrovascular complications following transsphenoidal resection of pituitary tumors are rare and often evaluated and treated with endovascular techniques. We determined the utilization rate and outcomes of endovascular procedures in transsphenoidal pituitary resection patients using an administrative database.

Methods

Using the Nationwide Inpatient Sample 2001–2010, patients receiving transsphenoidal resection of benign pituitary tumors were identified. The rate of cerebrovascular complications and utilization of endovascular repair procedures and cerebral angiography were compared between high (≥75 procedures/year) and low volume (<75 procedures/year) centers. Chi squared tests were used to compare categorical variables.

Results

70,878 were patients included in this study. ICH/SAH occurred in 0.9 % of patients (652/70,878) and stroke occurred in 0.5 % of patients (327/70,878). Patients treated at high volume centers had significantly lower rates of stroke (0.5 % vs. 1.0 %, P = 0.04), and ICH/SAH (0.5 vs. 1.0 %, P = 0.05) when compared to patients treated at low-volume centers. Overall, 531 patients (0.7 %) received post-operative angiography and 83 patients (0.1 %) received endovascular repair procedures. High volume center patients underwent angiography in 0.4 % of cases compared to 0.9 % for low volume center patients (P = 0.02). There was no significant difference in endovascular repair procedure rates at high and low volume centers (0.1 vs. 0.2 %, P = 0.37).

Conclusions

Cerebrovascular surgical complications requiring cerebral angiography and endovascular repair are rare among transsphenoidal pituitary resection patients. These occur with higher frequency at low volume centers and are associated with high mortality rates.

Keywords

Pituitary adenoma Transsphenoidal resection Endovascular Hospital outcomes Hemorrhage 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Waleed Brinjikji
    • 1
  • Giuseppe Lanzino
    • 1
    • 2
  • Harry J. Cloft
    • 1
    • 2
  1. 1.Department of RadiologyMayo ClinicRochesterUSA
  2. 2.Department of NeurosurgeryMayo ClinicRochesterUSA

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