Abstract Details

Title Trends in Endovascular and Surgical Treatments for Aneurysmal Subarachnoid Hemorrhage in United States

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S40 - Stroke Risk Factors and Epidemiology (4:47 PM-4:58 PM)

Poster/Presentation
Number 008

Background

Recent studies have shown a decreasing trend in in-hospital mortality in aSAH treated with endovascular aneurysm repair. Studies about trends of utilization, in-hospital mortality and none to minimal disability in microsurgical or endovascular aneurysm repair are lacking at the national level.

Objective We wanted to study the trends of in-hospital mortality, non to minimal disability at discharge in endovascular and surgical treatments for aSAH and each utilization at the national level.

Design/Methods We analyzed NIS from 2006 till 2014. aSAH patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) CODE (ICD 430). aSAH who underwent microsurgical or endovascular aneurysm repair were identified using the ICD procedure codes (39.51) and (39.72, 39.75, 39.76, or 39.79) respectively. NIS trend weights were used for annual ratio of endovascular to surgical treatment, in-hospital mortality and none to mild disability.

Results

A total of 34440 (39.4%) and 52863(60.5%) patients with aSAH underwent surgical and endovascular treatment, respectively. The annual ratio of endovascular to surgical treatment increased from 2006 to 2014 (1.05 to 2.41, p value for trend <.0001). There was no change in in-hospital mortality among surgical treated patients over 9 year period (p value for trend =0.88); however, the in-hospital mortality decreased for endovascular treated patients (p value for trend = 0.02). The rate of none to mild disability did not increase for the whole cohort (p value for trend = 0.61) and endovascular (p value for trend = 0.41) but increased for surgically treated patients (p value for trend = 0.02) over 9 years respectively.

Conclusions There has been an increase in utilization of endovascular treatment in aSAH over last 9 years. There is a trend for reduction in in-hospital mortality among endovascular treated patients but no change in trend of none to mild disability at discharge.

Authors/Disclosures
PRESENTER	No disclosure on file
Mohammad Rauf A. Chaudhry, MD	Dr. Chaudhry has nothing to disclose.
Saqib A. Chaudhry, MD	Dr. Chaudhry has nothing to disclose.
	No disclosure on file
Hamza I. Maqsood, MD (Dept of Neurology)	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.

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