Documentation of Improved Outcomes for Intracranial Aneurysm Management Over a 15-Year Interval. Issue 3 (March 2016)

• Record Type: Journal Article
• Authors: Chua, Michelle H.; Griessenauer, Christoph J.; Stapleton, Christopher J.; He, Lucy; Thomas, Ajith J.; Ogilvy, Christopher S.
• Is Part Of: Stroke. Volume 47:Issue 3(2016)
• Publication Date: 2016-03
• Subjects: endovascular techniques -- Glasgow Outcome Scale -- intracranial aneurysms -- outcomes research -- surgical instruments; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.115.011959
• Languages: English
• ISSNs: 0039-2499

Abstract

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.