{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:02:17Z","timestamp":1790694137910,"version":"4.1.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Interv Neuroradiol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Endovascular management options for pulsatile tinnitus (PT) patients have increased in recent years with promising results. However, standardized endovascular team referral criteria remain limited. We conducted a systematic review and suggested an evidence-based referral protocol for PT patients to the neuroendovascular team.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature review was conducted in February 2025 using the PubMed\/MEDLINE database. We included English-written studies published in the last 5 years, focusing on PT diagnosis and management. Exclusion criteria included: (1) in vitro or animal studies, (2) studies focused on open surgery approaches, (3) studies addressing only non-PT, and (4) case reports, case series (3\u201310 cases), commentaries, letters to the editor, editorials, and book chapters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our initial search retrieved 257 papers. Of these, 219 were excluded after reading the title and abstract, and an additional 12 were excluded after full-text review. A total of 26 papers were eligible for inclusion in this review and in developing our protocol. After PT diagnosis and imaging, our protocol consists of the following three questions: (1) Is non-invasive imaging suspicious for a dural arteriovenous fistula, high-risk vascular lesions, or idiopathic intracranial hypertension? (2) Despite normal neuroimaging, is there clinical suspicion of a high-risk vascular lesion? (3) Although a low-risk lesion is diagnosed, is PT debilitating? If there is a \u201cyes\u201d to any of these questions, referral to the endovascular team is recommended.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We suggested an evidence-based referral protocol for PT patients to the neuroendovascular team.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15910199251380393","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T13:49:37Z","timestamp":1758721777000},"page":"2930-2937","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["An evidence-based pulsatile tinnitus clinical workflow: A systematic review of literature"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6750-8170","authenticated-orcid":false,"given":"Jo\u00e3o Victor","family":"Sanders","sequence":"first","affiliation":[{"name":"Brain and Spine Institute, Advocate Lutheran General Hospital, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6896-1244","authenticated-orcid":false,"given":"Kiffon","family":"Keigher","sequence":"additional","affiliation":[{"name":"Brain and Spine Institute, Advocate Lutheran General Hospital, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1801-9055","authenticated-orcid":false,"given":"Marion","family":"Oliver","sequence":"additional","affiliation":[{"name":"Brain and Spine Institute, Advocate Lutheran General Hospital, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6280-0113","authenticated-orcid":false,"given":"Demetrius","family":"Lopes","sequence":"additional","affiliation":[{"name":"Brain and Spine Institute, Advocate Lutheran General Hospital, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3564-6958","authenticated-orcid":false,"given":"Krishna","family":"Joshi","sequence":"additional","affiliation":[{"name":"Brain and Spine Institute, Advocate Lutheran General Hospital, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.25259\/SNI_1_2021"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11596-022-2691-4"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021202584"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-024-01263-1"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyab299"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-024-08806-7"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000006166"},{"key":"e_1_3_2_10_2","first-page":"663","article-title":"Tinnitus: diagnosis and management","volume":"103","author":"Dalrymple SN","year":"2021","unstructured":"Dalrymple SN, Lewis SH, Philman S. Tinnitus: diagnosis and management. Am Fam Physician 2021; 103: 663\u2013671.","journal-title":"Am Fam Physician"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2024.03.002"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000001778"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.31326"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2023-020949"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003370"},{"key":"e_1_3_2_16_2","article-title":"Diagnostic yield and utility of radiographic imaging in the evaluation of pulsatile tinnitus: a systematic review","volume":"3","author":"Cao AC","year":"2023","unstructured":"Cao AC, Hwa TP, Cavarocchi C, et al. Diagnostic yield and utility of radiographic imaging in the evaluation of pulsatile tinnitus: a systematic review. Otol Neurotol Open 2023; 3: e030.","journal-title":"Otol Neurotol Open"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon.12955"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/19714009211041530"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurad.2023.06.002"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/15910199241236323"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00062-023-01268-0"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2021-018015"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2023.12.128"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diii.2021.05.008"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2023.12.164"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/15910199231168751"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000004365"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2024.08.048"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2022.106617"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2024-022638"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/15910199251342397"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/1591019920974185"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000004324"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/15910199251355298"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.891"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14134721"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2024-022540"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2024-021458"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1177\/15910199251358917"}],"updated-by":[{"DOI":"10.1177\/15910199261444853","type":"expression_of_concern","label":"Expression of concern","source":"publisher","updated":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T00:00:00Z","timestamp":1777075200000}}],"container-title":["Interventional Neuroradiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15910199251380393","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15910199251380393","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15910199251380393","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:46:37Z","timestamp":1790693197000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15910199251380393"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,24]]},"references-count":38,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1177\/15910199251380393"],"URL":"https:\/\/doi.org\/10.1177\/15910199251380393","relation":{},"ISSN":["1591-0199","2385-2011"],"issn-type":[{"value":"1591-0199","type":"print"},{"value":"2385-2011","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,24]]}}}