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Long-term economic impact of coiling vs clipping for unruptured intracranial aneurysms.

Publication ,  Journal Article
Lad, SP; Babu, R; Rhee, MS; Franklin, RL; Ugiliweneza, B; Hodes, J; Nimjee, SM; Zomorodi, AR; Smith, TP; Friedman, AH; Patil, CG; Boakye, M
Published in: Neurosurgery
June 2013

BACKGROUND: : Treatment of unruptured intracranial aneurysms (UIAs) involves endovascular coiling or aneurysm clipping. While many studies have compared these treatment modalities with respect to various clinical outcomes, few studies have investigated the economic costs associated with each procedure. OBJECTIVE: : To determine the reoperation rate, postoperative complications, and inpatient and outpatient costs associated with surgical or endovascular treatment of patients with UIAs in the United States. METHODS: : We utilized the MarketScan database to examine patients who underwent surgical clipping or endovascular coiling procedures for UIAs from 2000 to 2009, comparing reoperation rates, complications, and angiogram and healthcare resource use. Propensity score matching techniques were used to match patients. RESULTS: : We identified 4,504 patients with surgically treated UIAs, with propensity score matching of 3,436 patients. Reoperation rates were significantly lower in the clipping group compared to the coiling group at 1- (P < .001), 2- (P < .001), and 5 years (P < .001) following the procedure. However, postoperative complications (immediate, 30 and 90 days) were significantly higher in those undergoing surgical clipping. Although hospital length of stay and costs were higher in the clipping group for the index procedure, the number of postoperative angiograms and outpatient services used at 1, 2, and 5 years were significantly higher in the coiling group. CONCLUSION: : Though surgical clipping resulted in lower reoperation rates, it was associated with higher complication rates and initial costs. However, overall costs at 2 and 5 years were similar to endovascular coiling due to the significantly higher number of follow-up angiograms and outpatient costs in these patients. ABBREVIATIONS: : SAH, subarachnoid hemorrhageUIAs, unruptured intracranial aneurysms.

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Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

June 2013

Volume

72

Issue

6

Start / End Page

1000 / 1011

Location

United States

Related Subject Headings

  • United States
  • Time
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Lad, S. P., Babu, R., Rhee, M. S., Franklin, R. L., Ugiliweneza, B., Hodes, J., … Boakye, M. (2013). Long-term economic impact of coiling vs clipping for unruptured intracranial aneurysms. Neurosurgery, 72(6), 1000–1011. https://doi.org/10.1227/01.neu.0000429284.91142.56
Lad, Shivanand P., Ranjith Babu, Michael S. Rhee, Robbi L. Franklin, Beatrice Ugiliweneza, Jonathan Hodes, Shahid M. Nimjee, et al. “Long-term economic impact of coiling vs clipping for unruptured intracranial aneurysms.Neurosurgery 72, no. 6 (June 2013): 1000–1011. https://doi.org/10.1227/01.neu.0000429284.91142.56.
Lad SP, Babu R, Rhee MS, Franklin RL, Ugiliweneza B, Hodes J, et al. Long-term economic impact of coiling vs clipping for unruptured intracranial aneurysms. Neurosurgery. 2013 Jun;72(6):1000–11.
Lad, Shivanand P., et al. “Long-term economic impact of coiling vs clipping for unruptured intracranial aneurysms.Neurosurgery, vol. 72, no. 6, June 2013, pp. 1000–11. Pubmed, doi:10.1227/01.neu.0000429284.91142.56.
Lad SP, Babu R, Rhee MS, Franklin RL, Ugiliweneza B, Hodes J, Nimjee SM, Zomorodi AR, Smith TP, Friedman AH, Patil CG, Boakye M. Long-term economic impact of coiling vs clipping for unruptured intracranial aneurysms. Neurosurgery. 2013 Jun;72(6):1000–1011.
Journal cover image

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

June 2013

Volume

72

Issue

6

Start / End Page

1000 / 1011

Location

United States

Related Subject Headings

  • United States
  • Time
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Humans