Treatment of large and giant intracranial aneurysms: cost comparison of flow diversion and traditional embolization strategies.
Publication/Presentation Date
11-1-2014
Abstract
OBJECTIVE: Flow diversion has emerged as a promising strategy for management of intracranial aneurysms. The purpose of this study was to determine whether treatment of large and giant aneurysms with the pipeline embolization device (PED) is more economical than traditional embolization strategies.
METHODS: We identified 30 consecutive aneurysms larger than 10 mm that were treated with PED at our institution. For each aneurysm treated with PED, theoretical coil embolization was performed by filling volume in a consistent, stepwise fashion until a packing density of 25% was reached. Prices of all equipment and implants were taken from price lists provided by each manufacturer.
RESULTS: Median aneurysm volume was 0.90 cm(3). Overall procedure cost was lower with the PED (mean, $23,911) vs. coiling ($30,522, P = .06). Above the median aneurysm volume, PED treatment was significantly less expensive than coiling even if multiple PEDs were used (P = .006). However, below the median aneurysm volume, PED treatment was significantly more expensive than coiling (P = .009). Treatment with multiple PEDs was not cost-beneficial compared with coiling, even above the median aneurysm volume. Potential savings associated with the PED were highly dependent on the type of embolic agent used.
CONCLUSIONS: The cost of initial treatment of large and giant aneurysms with PED is economically favorable compared to traditional embolization techniques. However, any potential cost benefit depends on aneurysm volume, coil type, and number of PEDs used. Accordingly, PED therapy is more expensive than coiling in aneurysms < 0.9 cm(3) or when multiple devices are used.
Volume
82
Issue
5
First Page
696
Last Page
701
ISSN
1878-8769
Published In/Presented At
el-Chalouhi, N., Jabbour, P. M., Tjoumakaris, S. I., Starke, R. M., Dumont, A. S., Liu, H., Rosenwasser, R., El Moursi, S., & Gonzalez, L. F. (2014). Treatment of large and giant intracranial aneurysms: cost comparison of flow diversion and traditional embolization strategies. World neurosurgery, 82(5), 696–701. https://doi.org/10.1016/j.wneu.2013.02.089
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
23474180
Department(s)
Administration and Leadership
Document Type
Article