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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Pediatric intracranial aneurysms: current national trends in patient management and treatment

Rohit Vasan1, Jaymin Patel, J M Sweeney

  • 1Department of Neurosurgery and Brain Repair, College of Medicine, University of South Florida, Tampa, FL, USA. rohit_vasan@yahoo.com

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|January 5, 2013
PubMed

Insights

Treatment for pediatric intracranial aneurysms remains challenging. While endovascular therapy use increased, hospital charges and length of stay for these procedures rose significantly, with no decline in mortality for subarachnoid hemorrhage.

Area of Science:

  • Pediatric Neurosurgery
  • Vascular Neurology
  • Health Services Research

Background:

  • Pediatric intracranial aneurysms present unique treatment challenges.
  • Existing literature shows conflicting data on endovascular vs. surgical therapy for durable aneurysm obliteration in children.

Purpose of the Study:

  • To analyze trends in the management of pediatric intracranial aneurysms.
  • To compare outcomes, costs, and utilization of endovascular and surgical therapies.

Main Methods:

  • Utilized the Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Dataset (2000-2009).
  • Analyzed length of stay (LOS), charges, and in-hospital deaths for subarachnoid hemorrhage (SAH) and nonruptured aneurysms.
  • Examined procedural trends, LOS, and charges for SAH (2003-2009).

Main Results:

  • Mean LOS for SAH patients was 7-10 days longer than for nonruptured aneurysms.
  • Endovascular procedure costs increased by 50% (2006-2009), while surgical costs slightly increased.
  • Mean LOS for endovascular procedures rose (16.5 to 17.2 days), and decreased for surgical procedures (20.4 to 14.7 days).

Conclusions:

  • In-hospital mortality and LOS for pediatric SAH have not significantly declined since 1997.
  • Hospital charges for aneurysm management increased over 200% (2000-2009), with endovascular procedures rising sharply in cost.
  • Endovascular therapy utilization increased, while surgical therapy frequency remained stable.
Abstract

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