Sustainability in Neurointervention—Results from an Exploratory International Cross-sectional Online Survey Among Peers

PURPOSE: Neurointerventional procedures, which are resource-intensive and generate significant waste, remain a major environmental challenge. This international survey aimed to explore the awareness, practices, and barriers surrounding sustainability in neurointervention. METHODS: A cross-sectional online survey was conducted among neurointerventional specialists using a convenience sampling approach. The questionnaire focused on sustainability awareness, surgical gown preferences, workplace sustainability initiatives, perceived barriers, and support for sustainability measures. RESULTS: One-hundred-thirty-eight respondents completed the survey between October 15th, 2025 and December 15th, 2025 (107 [77.5%] male, with a background in neuroradiology [88/138, 63.8%], neurology [32/138, 23.2%], and neurosurgery [16/138, 11.6%]). Results revealed a gap between personal and professional sustainability actions, with respondents engaging more in sustainable practices in private life than at work. While 78.7% prioritized sustainability privately, only 71.7% did so professionally. Key barriers to implementing sustainability included "limited alternatives", "lack of awareness", and "inadequate financial incentives". However, there was strong support for sustainability initiatives, especially in areas such as sustainable procurement and events organized by professional societies. Notably, despite a preference for reusable surgical gowns (75.9%), disposable gowns dominated current practice (76.7%). CONCLUSION: This study suggests a gap between neurointerventional specialists' personal sustainability preferences and professional practices, which may be influenced by systemic barriers. While respondents generally expressed support for sustainable initiatives, broader adoption likely requires structural changes at institutional and policy levels.