ED CTA Head/Neck Volumes Surge 8.5-fold Over Decade, Outpacing CT Perfusion Growth

Combined CTA head/neck volumes surged 8.5-fold (745 to 6,317/yr) over a decade; share rose from 3.7% to 14.9% of neuro-ED imaging. CT perfusion (CTP) use was unchanged, and CTA-to-CTP ratio grew from 4.2 to 9.9. Demand increased similarly during regular and on-call hours.

• Encounter-normalized utilization increased significantly for CTA head (IRR 1.22) and CTA neck (IRR 1.20) but not for CTP (IRR 1.00).
• Secondary analyses suggested increasing CTA use in patients with NIHSS 0 and declining large-vessel occlusion yield.

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