Documentation of Improved Outcomes for Intracranial Aneurysm Management Over a 15-Year Interval.

Abstract:

BACKGROUND AND PURPOSE:Despite rapid advancements in intracranial aneurysm management, there is no evidence as of yet that this has translated into improvement in overall prognosis. METHODS:We compared 2 periods of aneurysm management, 1998 to 2003 (n=1023 aneurysms) and 2007 to 2013 (n=1499 aneurysms), at a single, high-volume neurovascular center. Our outcome of interest was low or moderate disability (Glasgow Outcome Scale score of 4 or 5) at 6 months or more post treatment. RESULTS:There were significant improvements in outcome for surgical, endovascular, and overall treatment of unruptured (adjusted odds ratio [OR], 2.33; P=0.0091; adjusted OR, 4.40; P=0.0271; and adjusted OR, 2.58; P=0.0008, respectively) and ruptured (adjusted OR, 3.18; P=0.0004; adjusted OR, 3.54; P=0.0001; and adjusted OR, 3.11; P<0.0001, respectively) aneurysms from the first to the second time period. In 2007 to 2013, the proportion of cases with low or moderate disability at 6 months post subarachnoid hemorrhage was 75.6% for surgical clipping and 76.6% for endovascular therapy. CONCLUSIONS:We report significantly improved outcomes over time for overall aneurysm management and for multiple patient subgroups, associated with increased usage of endovascular therapy.

journal_name

Stroke

journal_title

Stroke

authors

Chua MH,Griessenauer CJ,Stapleton CJ,He L,Thomas AJ,Ogilvy CS

doi

10.1161/STROKEAHA.115.011959

subject

Has Abstract

pub_date

2016-03-01 00:00:00

pages

708-12

issue

3

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.115.011959

journal_volume

47

pub_type

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