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. 2011:2:110.
doi: 10.4103/2152-7806.83728. Epub 2011 Aug 13.

Trends over time in the management of 2253 patients with cerebral aneurysms: A single practice experience

Troy D Payner  1 , Itay Melamed, Shaheryar Ansari, Thomas J Leipzig, John A Scott, Andrew J Denardo, Terry G Horner, Kathleen Redelman, Aaron A Cohen-Gadol
Affiliations

Trends over time in the management of 2253 patients with cerebral aneurysms: A single practice experience

Troy D Payner et al. Surg Neurol Int. 2011.

Abstract

Background: To better understand the longitudinal trend in the proportion of techniques employed for cerebral aneurysm treatment, we reviewed our experience with 2253 patients over the last 11 years.

Methods: We reviewed data in our prospective aneurysm database for all consecutive patients treated from January 1998 through December 2009. Data regarding age, sex, aneurysm location, presence or absence of hemorrhage, Fisher grade, clinical grade, treatment methods, length of hospitalization, and mortality rates by the time of discharge were retrieved and retrospectively analyzed. The most common aneurysm types were subsequently classified and analyzed separately.

Results: The patient population included 663 males (29%) and 1590 females (71%). A total of 2253 patients presented with 3413 aneurysms; 1523 (63%) of the aneurysms were diagnosed as aneurysmal subarachnoid hemorrhage. A total of 2411 (71%) aneurysms were treated. Overall, 645 (27%) of the 2411 aneurysms underwent endosaccular coiling and 1766 (73%) underwent clip ligation; 69 (3%) of these aneurysms required both treatment modalities. The percentage of all aneurysms treated by endosaccular coiling increased from 8% (21) in 1998 to 28% (87) in 2009. There was no statistical difference between the average length of hospitalization for patients who underwent endosaccular coiling and clip ligation for their ruptured (P = 0.19) and unruptured (P = 0.80) aneurysms during this time period.

Conclusions: In our practice, endovascular treatment has continued to be more frequently employed to treat cerebral aneurysms. This technique has had the greatest proportional increase in the treatment of posterior circulation aneurysms.

Keywords: Cerebral aneurysm; clip ligation; endovascular coiling; trend.

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Figures

Figure 1
Figure 1
Total number of aneurysms showing the number untreated and treated by endosaccular coiling and clip ligation from 1998 to 2009
Figure 2
Figure 2
Percentage of basilar artery bifurcation aneurysms treated by endosaccular coiling versus clip ligation
Figure 3
Figure 3
The percentage of anterior communicating artery aneurysms managed with endosaccular coiling increased, and the percentage of these aneurysms treated by clip ligation declined during the study period
Figure 4
Figure 4
The percentage of posterior communicating artery aneurysms managed with endosaccular coiling increased and the percentage of these aneurysms treated by clip ligation declined during the study period
Figure 5
Figure 5
Older patients have increasingly been treated with endosaccular coiling
See this image and copyright information in PMC

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