对手术前栓塞在患有动脉静脉变异的患者中的有效性进行了审查
Joshua S Catapano1, Stefan W Koester, Kavelin Rumalla
1Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix , Arizona , USA.
Neurosurgery
|July 31, 2023
概括
动脉静脉形 (AVMs) 的手术前栓塞对于斯佩茨勒-马丁III级AVMs来说是具有成本效益的. 然而,对于较低级别的AVM来说,它不具有成本效益,这表明这种干预方法具有细微差别.
科学领域:
- 神经外科 神经外科
- 干预性放射学 干预性放射学
- 卫生经济学 卫生经济学
背景情况:
- 对于动脉静脉形形 (AVM) 的术前栓塞的实用性仍然是争论的主题.
- 这项研究研究了在AVM治疗中术前栓塞的经济影响.
研究的目的:
- 为AVM进行手术前栓塞的成本效益分析.
- 为了在不同级别的AVM中比较栓塞与非栓塞策略的成本效益.
主要方法:
- 在2015年1月1日至2020年12月31日期间接受AVM切除的188名患者的回顾性分析.
- 对接受手术前栓塞治疗的患者与没有接受手术前栓塞治疗的患者进行比较.
- 成本效益评分 (CE) 计算为1年总成本除以修改后的兰金级公用事业评分的变化.
主要成果:
- 栓塞队伍的总成本和CE平均得分高于非栓塞队伍.
- 对于Spetzler-Martin (SM) 级别I和II AVM,栓塞组的CE显著更高 (成本效益较低).
- 对于SM等级III AVM,栓塞组表现出较低的CE (更具成本效益),特别是在未破裂的子组中.
结论:
- 术前栓塞是SMIII级AVM患者的成本有效策略.
- 这种干预对患有较低级别 (I 和 II) AVM 的患者来说不具有成本效益.
- 关于手术前栓塞的治疗决策应考虑AVM分级和破裂状态.
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