Technological advancements in medicine have resulted in complex systems for diagnosis and treatment. In the past, a few tertiary medical centers offered advanced medical treatments through highly trained practitioners. In recent years, more rural hospitals have gained experience using these technically demanding systems. An example of this is cardiac catheterization which evolved from primarily being utilized in large medical centers in the 1980s to later diffusion of treatment capabilities into smaller, remote hospitals. As technology and expertise spread from selected few large medical centers to numerous smaller centers, procedural guidelines and quality assurance protocols were required in order to standardize treatment and evaluate results. The same is now true for vascular neurosurgery to make sure quality care is provided to all patients.
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