Treatment of ruptured intracranial aneurysms: a decision analysis

The British Journal of Radiology
H TakaoK Ohtomo

Abstract

The purpose of our study was to evaluate the outcomes of neurosurgical and endovascular treatment of ruptured intracranial aneurysms over a lifetime, based on the results of the International Subarachnoid Aneurysm Trial. We performed a decision analysis, using a Markov model, to evaluate outcomes of neurosurgical and endovascular treatment of ruptured intracranial aneurysms that were suitable for both treatments over a lifetime. We chose 50 years as cohort age. Effectiveness was measured in quality-adjusted life-years (QALYs). In addition, we calculated life expectancy and subarachnoid haemorrhage (SAH)-related mortality and disability rates. Compared with neurosurgery, endovascular treatment increased effectiveness by 1.0 QALY (neurosurgery, 13.1 QALYs; endovascular treatment, 14.1 QALYs) and life expectancy by 0.7 years (neurosurgery, 23.2 years; endovascular treatment, 23.9 years), and decreased SAH-related mortality by 0.4% (neurosurgery, 11.5%; endovascular treatment, 11.1%) and SAH-related disability by 5.0% (neurosurgery, 21.3%; endovascular treatment, 16.3%). One-way sensitivity analysis showed that no parameters influenced the effectiveness of endovascular treatment compared with neurosurgery. For ruptured intracranial...Continue Reading

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Citations

Feb 18, 2009·The British Journal of Radiology
Mar 2, 2011·Japanese Journal of Radiology·Snežana LukićRadivoje Nikolić
May 18, 2012·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·K MalmivaaraJ Siironen
Mar 24, 2016·The Cochrane Database of Systematic Reviews·Luying Ryan LiBhuwan Chaudhary
Dec 18, 2010·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Y-J LaiC-J Lin

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