Fellowship training in neurointerventional surgery requires building a verifiable case log. Attending privileges at most academic medical centres require demonstrating case volume and outcome data in specific procedure categories — AVM embolization, intracranial stenting, coil embolization of aneurysms, carotid stenting. A procedure log that can't be sorted by ProcCat, filtered by ProcType, and summarized by outcome isn't a career document — it's a date list that answers no credentialing committee's questions.
Hardware as the Audit Record
Stent, Balloon, Coils, and EmboAgent are the implant and consumable fields that make each procedure record medically accurate and commercially traceable. When a neurovascular stent is deployed — a Pipeline embolization device, an Enterprise stent-assisted coil platform, a Neuroform EZ — the specific device is logged in Stent. This isn't documentation for documentation's sake: device registry reporting requirements for intracranial stents, post-market surveillance programs, and adverse event tracking all require specific device identification by procedure date and patient identifier.
Sheath, Guiding, and Micro/Wire document the access and delivery hardware. The combination of guiding catheter selection and microwire used for a specific procedure — a 6F Envoy into a tortuous M1 versus an 8F Neuron MAX with a 3MAX intermediate — reflects the operator's assessment of anatomy and approach. Over a case series, these field entries build a technical profile of how specific anatomy is being managed and whether technique modifications are driving outcome improvements.
Pre- and Post-Procedure Imaging
Pre01 through Pre04 and Post01 through Post04 are the eight imaging documentation fields. For cerebrovascular interventions, the pre-procedure angiogram sequence documents the target lesion — an aneurysm morphology before coiling, a stenosis severity before angioplasty, an AVM feeding artery pattern before embolization. The post-procedure sequence documents the treatment result: aneurysm occlusion grade, residual stenosis percentage, degree of AVM devascularization.
These paired fields create the outcome documentation that audit committees and quality review processes require. Raymond-Roy occlusion classification for aneurysms, WASID criteria for intracranial stenosis, Spetzler-Martin grading for AVMs — the classification exists; the imaging that supports it needs to be attached to the procedure record.
Outcome and Comorbidity Context
Result and Comments are the procedural outcome and narrative fields. Result captures the technical outcome classification — complete occlusion, near-complete, partial, procedural complication. Comments is the narrative layer: the intraoperative decision that changed the approach, the immediate post-procedure clinical status, the complication that occurred and how it was managed.
Comorbid is the risk stratification field. A patient with a known coagulopathy undergoing AVM embolization carries a different procedural risk profile than the same intervention in a healthy patient. The comorbidity record, combined with Diagnosis and Result, gives the outcome analysis its clinical context — which patient populations have worse outcomes with which procedure types.
CathNo is the case volume counter. Sorted by ProcType, it tells you how many intracranial aneurysms you've coiled, how many carotid stents you've placed, how many AVM embolizations you've performed — the credentialing numbers that define your scope of practice. Over a career, it's the document that answers the question about procedure-specific competence with specific numbers rather than estimates.