Interventional Neuroradiology in the United Kingdom

摘要

The success and failures of Interventional Neuroradiology as a specialty in the UK reflect the strengths and weaknesses of its National Health Service (NHS). The lack of economic competition between the clinical specialties has resulted in an unusual degree of cooperation between surgeons and interventionalists in the clinical care of patients. Nearly all patients are treated under the NHS not by the private sector thus any suggestion that UK interventionalists are motivated primarily by financial greed demonstrates a lack of knowledge of the national service. The emphasis on social medicine leads to a cost effective, evidence based approach to patient management. This sometimes results in a conservative approach, with a distrust of new treatments until their value has been rigorously tested. An example of this is the use of intracranial stents in the treatment of intracranial aneurysms. In a typical UK centre stents are used in 5% or fewer cases whereas in the US some centres are using stents in up to 60% of cases. Likewise the use of Onyx (MTI) for the treatment of aneurysms is virtually confined to one centre (Bristol).