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August 4, 2020

Study Reveals 10-Year Trends in Treatment of Unruptured Intracranial Aneurysms

August 4, 2020—The Society of NeuroInterventional Surgery (SNIS) announced new findings that show mortality rates after treatment of unruptured intracranial aneurysms have substantially decreased in the past decade. The data were presented at the SNIS 17th annual meeting held virtually August 4-7, 2020.

The study, “Trends in Mortality and Morbidity after Treatment of Unruptured Intracranial Aneurysm in the United States, 2006–2016,” analyzed data from 21,609 patients in the Nationwide Inpatient Sample (NIS) database across a 10-year period.

Investigators compared two treatments for unruptured intracranial aneurysms: microsurgical clipping and endovascular embolization.

According to SNIS, patients who underwent endovascular embolization had a significantly higher rate of favorable clinical outcome—defined as discharge to home or acute rehabilitation facility—compared with microsurgical clipping group (91% vs 74%) and an average of 3 days shorter hospital stays. Additionally, SNIS noted that the use of endovascular embolization has increased in the past decade.

SNIS reported that the study also found the following:

  • The overall rate of in-hospital mortality decreased from 0.9% in 2006 to 0.2% in 2016.
  • Overall, 83% of the patients had favorable clinical outcomes.
  • Other independent predictors of in-hospital mortality included advanced age (≥ 80 years) and the presence of multiple comorbidities.
  • Women and African Americans had a lower chance of favorable clinical outcomes independent to the treatment modality.

Shahram Majidi, MD, lead author of the study, commented in the SNIS announcement, “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. 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.” 

Dr. Majidi is Assistant Professor of Neurosurgery, Neurology, and Radiology at Icahn School of Medicine at Mount Sinai Hospital in New York, New York, and Director of Cerebrovascular Services at Mount Sinai Brooklyn in Brooklyn, New York.

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