Cost analysis and outcomes of Woven EndoBridge Device embolization vs microsurgical clipping for intracranial bifurcation aneurysms.
Publication/Presentation Date
7-8-2025
Abstract
OBJECTIVE: Woven EndoBridge Device (WEB) embolization is an endovascular technique used to intracranial bifurcation aneurysms. Although WEB embolization is a less invasive alternative to microsurgical clipping, it may be associated with higher rates of recurrence and retreatment. Our study compares hospitalization costs and outcomes with WEB embolization versus microsurgical clipping.
METHODS: This was a single-center retrospective study of patients who underwent WEB embolization or microsurgical clipping of intracranial bifurcation aneurysms. The primary outcome of interest was total hospitalization cost. Secondary outcomes were post-operative complications, length of stay (LOS), functional outcome, non-home discharge (NHD), mortality, aneurysm recurrence and retreatment.
RESULTS: Of 188 patients, 61 were treated using WEB embolization and 127 underwent microsurgical clipping. Median (IQR) total hospitalization costs were higher for WEB embolization ($41918, 35309-72641) compared to microsurgical clipping ($34050, 27068-48998) (P < 0.001)). On linear regression, ruptured aneurysms ($14437.84, 95 % CI: 7406.93 - 21468.76, P < 0.001) and per-day increase in LOS ($5826.66, 5381.43 - 6271.90, P < 0.001) were independently associated with increased total hospitalization costs, while microsurgical clipping was associated with a $22756 decrease in total hospitalization costs (95 % CI: -26885.36 - -18628.10, P < 0.001). Median LOS was significantly higher in the microsurgical clipping cohort (3 (3-6) compared to the WEB cohort (1 (1-5.5)) (P < 0.001). The WEB cohort had a higher proportion of patients with incomplete occlusion (34.6 % vs 12.5 % (P < 0.001)). Complications, functional outcome, NHD, mortality and retreatment rates were comparable.
CONCLUSIONS: Our results show that WEB embolization for bifurcation aneurysms resulted in higher hospital costs, shorter LOS and increased recurrence rates compared to microsurgical clipping. Long-term studies are needed to clarify the economic impact of these treatment modalities.
Volume
139
First Page
111468
Last Page
111468
ISSN
1532-2653
Published In/Presented At
Roy, J. M., Musmar, B., Pedapati, V., Pontarelli, M. K., Chen, A. Y., Saadat, N., Lan, M., Momin, A., Koduri, S., Atallah, E., Tjoumakaris, S. I., Gooch, M. R., Rosenwasser, R. H., & Jabbour, P. M. (2025). Cost analysis and outcomes of Woven EndoBridge Device embolization vs microsurgical clipping for intracranial bifurcation aneurysms. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 139, 111468. Advance online publication. https://doi.org/10.1016/j.jocn.2025.111468
Disciplines
Medicine and Health Sciences
PubMedID
40633230
Department(s)
Department of Surgery
Document Type
Article