Abstract W P68: Treatment of Unruptured Intracranial Aneurysms Within the Pediatric Population

Abstract

Background: The rates and outcomes of treatments for intracranial aneurysms have not been exclusively determined within the pediatric population. We determined the rates of endovascular and microsurgical treatments for unruptured intracranial aneurysms (UIA) and associated rates of favorable outcome. Methods: We analyzed the data obtained as part of the Kids’ Inpatient Database between 2003 and 2009 with primary diagnosis of UIA (identified by the International Classification of Disease codes, Ninth Revision). Patients undergoing endovascular treatment (ET) were compared to those undergoing microsurgical treatment (MT). Outcomes were defined as rates of intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), in-hospital mortality, or favorable outcome (discharge disposition of home/self-care). Results: There were 818 cases of UIAs during the timeline examined. A total of 111 patients (mean age 14±6 years, 37.6% female) underwent MT and another 200 patients (mean age 13±7 years, 42.5% female) underwent ET. There were no significant differences in rates of ICH (MT 4.4% versus ET 2%, p=0.4) and SAH (MT 15.5% versus ET 9.3%, p=0.2). There was no in-hospital mortality among those who received MT, and 3 patients died among those who received ET. A high rate of favorable outcome was observed in patients who received either treatment (MT 87.7% versus ET 91.6%, p=0.4). There was a trend towards a significantly shorter mean hospitalization stay among those who received ET as opposed to MT (6±12 days versus 9±11 days, p=0.06). There was also a significant trend towards higher utilization of ET as opposed to MT from 2003 to 2009 (p=0.02). Conclusion: Although outcomes except for length of stay are comparable between ET and MT patients, there is a trend towards higher utilization of ET among children with UIAs from 2003 to 2009.