Alice S Wang 1 , Jessica K Campos 2 , Geoffrey P Colby 3 , Alexander L Coon 4 , Li-Mei Lin 5 Show Affiliations »
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. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
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. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Entities: Chemical
Disease
Species
Keywords:
aneurysm; coil; flow diverter; stent
Mesh： See more »
Year: 2020
PMID： 32188760 DOI： 10.1136/neurintsurg-2019-015702
Source DB: PubMed Journal: J Neurointerv Surg ISSN： 1759-8478 Impact factor: 5.836