Cerebral aneurysm treatment trends in National Inpatient Sample 2007-2016: endovascular therapies favored over surgery.

Abstract:

BACKGROUND:Flow modulation is the newest endovascular technique for treatment of cerebral aneurysms. OBJECTIVE:To investigate changes in aneurysm treatment practice patterns in the USA. METHODS:From the 2007 to 2016, the National Inpatient Sample databases, hospital discharges associated with unruptured aneurysms (UA), and/or ruptured aneurysms (RA) having undergone surgical clipping (SC) and/or endovascular treatments (EVT) were identified using the International Classification of Diseases codes. Patient demographics, hospital characteristics, and clinical outcomes were reviewed. Five year subgroup analyses were performed for treatment differences. RESULTS:A total of 39 282 hospital discharges were identified with a significant increase in EVT (UA: SC n=7847 vs EVT n=12 797, p<0.001; RA: SC n=8108 vs EVT n=10 530, p<0.001). Hospitals in the South demonstrated the most significant EVT use regardless of aneurysm status (UA: SC n=258.5±53.6 vs EVT n=480.7±155.8, p<0.001; RA: SC n=285.6±54.3 vs EVT n=393.3±102.9, p=0.003). From 2007 to 2011, there was no significant difference in the mean number of cases for the treatment modalities (UA: SC n=847.4±107.7 vs EVT n=1120.4±254.1, p=0.21; RA: SC n=949.4±52.8 vs EVT n=1054.4±219.6, p=0.85). Comparatively, from 2012 to 2016, significantly more UA and RA were treated endovascularly (UA: SC n=722.0±43.4 vs EVT n=1439.0±419.2, p<0.001; RA: SC n=672.2±61.4 vs EVT n=1051.6±330.2, p=0.02). CONCLUSIONS:As technological innovations continue to advance the neuroendovascular space, the standard of care for treatment of cerebral aneurysms is shifting further towards endovascular therapies over open surgical approaches in the USA.

journal_name

J Neurointerv Surg

authors

Wang AS,Campos JK,Colby GP,Coon AL,Lin LM

doi

10.1136/neurintsurg-2019-015702

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

957-963

issue

10

eissn

1759-8478

issn

1759-8486

pii

neurintsurg-2019-015702

journal_volume

12

pub_type

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