Establishing an Interventional Radiology Service for Intracranial Aneurysms: Early Outcomes from Nigeria's First Cohort.

PURPOSE: To evaluate early clinical outcomes following the establishment of an endovascular neurointerventional service for intracranial aneurysm treatment in Nigeria, emphasizing procedural safety and skill transfer.

MATERIALS AND

METHODS

The authors retrospectively reviewed the first 22 adult patients who underwent endovascular treatment for intracranial aneurysms. Data collected included demographics, aneurysm characteristics, procedural details, operator type, complications, and short-term neurological outcomes. Skill transfer was defined as a structured mentorship process in which experienced neurointerventional radiologists remotely and/or physically proctored a locally based interventional radiologist, proficient in body endovascular techniques but requiring dedicated neuroendovascular mentorship.

RESULTS

Mean patient age was 49.8 years (SD ± 12.5), with 81.8% female. The most common aneurysm site was the anterior communicating artery (41.7%), and 75.0% of aneurysms were treated after rupture. Procedural complications occurred in 18.2% of cases, primarily intraoperative rupture/coil perforation (9.1%), vasospasm (4.5%), and thrombus formation (4.5%). One patient developed a new postoperative neurological deficit. Favorable outcomes, defined as modified Rankin Scale score of 0 at 30 days, were achieved in 68.2% of patients. Skill transfer was successful, with 45.5% of cases performed independently by the local interventional radiologist and outcomes and postoperative length of stay comparable to proctored cases. Teleneurocritical care enabled safe postoperative management in the absence of on-site neurocritical-care specialists.

CONCLUSIONS

Establishing a neuroendovascular service in Nigeria yielded favorable early outcomes with a low complications rate. A structured skill transfer framework enabled safe progression toward operator independence. Teleneurocritical care further supported patient management in the absence of an on-site neurocritical care service.