NYMC Faculty Publications

Treatment Trends and Clinical Outcomes of Endovascular Embolization for Unruptured Intracranial Aneurysms in the Pediatric Population

Author Type(s)

Student, Faculty

DOI

10.1136/jnis-2024-021648

Journal Title

Journal of Neurointerventional Surgery

First Page

475

Last Page

477

Document Type

Article

Publication Date

5-1-2025

Department

Neurology

Second Department

Neurosurgery

Third Department

Pediatrics

Keywords

Aneurysm, Intervention, Pediatrics

Disciplines

Medicine and Health Sciences

Abstract

Background Owing to the relative rarity of unruptured intracranial aneurysms (UIAs) in the pediatric population, evidence regarding treatment modalities and clinical outcomes remains limited. Objective To characterize the use and clinical outcomes of endovascular therapy (EVT) and microsurgical clipping (MSC) for pediatric UIAs over a two-decade interval using a large national registry. Methods Pediatric (<18 years of age) UIA hospitalizations were identified in the National Inpatient Sample from 2002 to 2019. Temporal use and clinical outcomes were compared for treatment with EVT and MSC. Results Among 734 UIAs identified, 64.9% (n=476) were treated with EVT. Use of EVT significantly increased during the study period from 54.3% (2002-2004) to 78.6% (2017-2019) (P=0.002 by Cochrane-Armitage test). In comparison with those treated with MSC, pediatric patients treated with EVT demonstrated higher rates of favorable outcomes (discharge to home without services) (96.0% vs 91.1%, P=0.006), shorter durations of hospital stay (4.6 vs 10.0 days, P<0.001), and lower rates of ischemic or hemorrhagic procedural-related complications (1% vs 4%, P=0.010). Conservative management also increased significantly over the study period (P<0.001 by Cochrane-Armitage test). Conclusion A retrospective evaluation of nearly 20 years of population-level data from the United States demonstrates increasing use of EVT for the treatment of pediatric UIAs, with high rates of favorable outcomes and shorter hospital stays in comparison with those treated with microsurgery.

Link to Full Text

Share

COinS