According to the new findings presented at the Society of Neurointerventional Surgery (SNIS) 17th Annual Meeting, mortality rates after treatment of unruptured intracranial aneurysms have substantially decreased over the past decade.
In this observational retrospective study, individuals who underwent endovascular embolization had a significantly higher rate of favorable clinical outcome compared with those who had microsurgical clipping (91% vs 74%). With endovascular embolization, there was also an average of 3 days shorter hospital stay. The utilization of endovascular embolization has increased in the past decade. The study analyzed data from 21,609 participants in the nationwide inpatient sample (NIS) database across a 10-year period.
This research also found that the overall rate of in-hospital mortality decreased from 0.9% in 2006 to 0.2% in 2016. Overall, 83% of the participants had favorable clinical outcomes. Other independent predictors of in-hospital mortality included being age 80 or more and the presence of multiple comorbidities. Women and African Americans had a lower chance of favorable clinical outcome that was independent of treatment modality.
“Our research indicates that treatment of unruptured brain aneurysm has become exceedingly safer over the last 10 years due to advancement in both microsurgical techniques and endovascular technology,” said Dr. Shahram Majidi, lead author of the study and assistant professor of Neurosurgery, Neurology and Radiology at Icahn School of Medicine at Mount Sinai Hospital and director of Cerebrovascular Services at Mount Sinai Brooklyn. “While overall clinical outcomes have been significantly improved, we found a higher rate of favorable hospital outcome and lower mortality rate among endovascularly treated patients compared to microsurgical clipping.”
F. Stephen Benesh, MD, and Shruti P. Agnihotri, MD
Fabio Fieni Toso, MD; Rene de Araújo Gleizer, MD; and Lívia Almeida Dutra, MD, PhD
Jill M. Giordano Farmer, DO