Changes in treatment of intracranial aneurysms during the last decade in a large European neurovascular center.
Acta Neurochir (Wien)
; 166(1): 173, 2024 Apr 10.
Article
em En
| MEDLINE
| ID: mdl-38594469
ABSTRACT
OBJECTIVE:
Treatment modality for ruptured and unruptured intracranial aneurysms has shifted during the last two decades from microsurgical treatment towards endovascular treatment. We present how this transition happened in a large European neurovascular center.METHODS:
We conducted a retrospective observational study consecutive patients treated for an unruptured or ruptured intracranial aneurysm at Helsinki University Hospital during 2012-2022. We used Poisson regression analysis to report age-adjusted treatment trends by aneurysm location and rupture status.RESULTS:
A total of 2491 patients with intracranial aneurysms were treated (44% ruptured, 56% unruptured) 1421 (57%) surgically and 1070 (43%) endovascularly. A general trend towards fewer treated aneurysms was noted. The proportion of patients treated surgically decreased from 90% in 2012 to 20% in 2022. The age-adjusted decrease of surgical versus endovascular treatment was 6.9%/year for all aneurysms, 6.8% for ruptured aneurysms, and 6.8% for unruptured aneurysms. The decrease of surgical treatment was most evident in unruptured vertebrobasilar aneurysms (10.8%/year), unruptured communicating artery aneurysms (10.1%/year), ruptured communicating artery aneurysms (10.0%/year), and ruptured internal carotid aneurysms (9.0%/year). There was no change in treatment modality for middle cerebral artery aneurysms, of which 85% were still surgically treated in 2022. A trend towards an increasing size for treated ruptured aneurysms was found (p = 0.033).CONCLUSION:
A significant shift of the treatment modality from surgical to endovascular treatment occurred for all aneurysm locations except for middle cerebral artery aneurysms. Whether this shift has affected long-term safety and patient outcomes should be assessed in the future.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Aneurisma Intracraniano
/
Aneurisma Roto
/
Embolização Terapêutica
/
Procedimentos Endovasculares
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article