Perioperative management of scheduled interventional neuroradiology procedures: Results of a nationwide French survey

BACKGROUND AND PURPOSE: Interventional neuroradiology (INR) spans a broad range of elective indications, yet perioperative management for scheduled care remains poorly characterized. We conducted a nationwide survey to describe current practices and examine differences by center procedural volume. MATERIALS AND METHODS: A cross-sectional questionnaire (June-August 2025) was distributed to all accredited French INR centers. Descriptive analyses were performed. Prespecified univariate comparisons were conducted according to the 2024 aneurysm embolization volume (high-volume ≥150 vs. low-volume <150 procedures). The primary comparative outcome was hospital length of stay (LOS) across scheduled procedures. RESULTS: Out of the 39 existing centers, 26 responded (66.7%). Only 5/26 (19.2%) reported a dedicated inpatient INR unit, all high-volume centers. LOS differed significantly between high- and low-volume centers (p = 0.03), with a shift toward shorter stays in high-volume centers: 24-hour stays were more frequent in high-volume centers (30.5%vs. 17.6%), whereas 72-hour stays were more common in low-volume centers (37.8%vs. 19.0%). One center reported ambulatory treatment of chronic intracranial venous hypertension syndrome (CIVHS) and another center reported ambulatory embolization of unpremedicated aneurysms. Management of CIVHS appeared relatively homogeneous, whereas intracranial hypotension pathways were heterogeneous. For vascular anomalies, INR involvement was largely therapeutic with limited participation in diagnostic imaging. CONCLUSIONS: Perioperative management of scheduled INR care in France is heterogeneous, with dedicated inpatient units and shorter hospitalizations concentrated in high-volume centers. Ambulatory pathways for selected procedures, including aneurysm embolization, remain very limited at present, with only isolated reports in selected centers. These data provide a baseline to inform pathway development and quality improvement.