[Neurosurgical and endovascular treatment of intracranial aneurysms: a cost analysis of two different strategies at the University Hospital of Bordeaux (France)].
BACKGROUND
Rupture of intracranial aneurysms causes major mortality and morbidity. Moreover, treatment of this vascular malformation generates high medical costs. We compared the cost of two different strategies employed at the University of Bordeaux to prevent aneurysms from rebleeding: a classical neurosurgical technique consisting in clipping the neck of the aneurysm and a new less invasive neuroradiological technique based on embolization using platinum coils.


METHODS
A micro-cost study was carried out retrospectively from May 1998 to June 2000) comparing data from 44 patients admitted for ruptured intracranial aneurysm: 22 operated patients and 22 patients treated with an endovascular approach. Each operated patient was matched with an embolized patient for clinical status at admission (World Federation of Neurological Surgeons Scale) and complications resulting from cerebral hemorrhage (hydrocephalus, vasospasm, rebleeding).


CONCLUSIONS
Our results showed the same cost for the same efficiency . Expenditures are however made differently. The endovascular technique allows a shorter hospital stay (8 days less), balancing the high cost of single use medical supplies (coils, microcatheters.). The endovascular technique has many advantages for the patients, but cannot be successful in all types of intracranial aneurysms. Both techniques remain indispensable.
Ballet
A-C
AC
Pharmacie des Dispositifs Médicaux Stériles, Service de Neuroradiologie, CHU, Bordeaux, France. ac_ballet@yahoo.fr
Guérin
J
J
Berge
J
J
Taboulet
F
F
Martin
S
S
Philip
V
V
Saux
M-C
MC
Woronoff-Lemsi
M-C
MC
D017542:Aneurysm, Ruptured / Q000191:economics / Q000209:etiology / Q000517:prevention & control; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000191:economics / Q000209:etiology / Q000517:prevention & control; D003365:Costs and Cost Analysis; D004621:Embolization, Therapeutic / Q000191:economics* / Q000295:instrumentation; D005602:France; D017721:Hospital Costs; D006801:Humans; D006849:Hydrocephalus / Q000191:economics / Q000209:etiology / Q000517:prevention & control; D007239:Infections / Q000191:economics; D002532:Intracranial Aneurysm / Q000191:economics / Q000601:surgery / Q000628:therapy*; D007902:Length of Stay / Q000191:economics; D008026:Ligation; D019635:Neurosurgical Procedures / Q000191:economics* / Q000295:instrumentation; D011030:Pneumothorax / Q000191:economics; D011183:Postoperative Complications / Q000191:economics; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D013525:Surgical Instruments / Q000191:economics; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000191:economics / Q000209:etiology / Q000517:prevention & control