Cost analysis of endovascular treatment for unruptured intracranial aneurysms at a private hospital in Brazil.

Abstract

Intracranial aneurysms have a prevalence of 1-6% and significant rupture risks, leading to high morbidity and mortality. Endovascular therapy demands an understanding of its economic impacts. This study evaluates the costs and complications of unruptured intracranial aneurysm treatment in a private Latin American hospital. A retrospective longitudinal observational study was carried out in a private hospital in Brazil from February 2015 to January 2021. Patients undergoing elective endovascular treatment for unruptured intracranial aneurysms (UIAs) were included in the study. Data collected included patient demographics, aneurysm characteristics, treatment modalities, costs, and clinical outcomes. Costs were adjusted to their present value in 2023 US dollars (USD). Descriptive statistics summarized the data. A total of 77 patients (68 females and nine males) with 111 aneurysms were included. The average total cost per patient was $31,831.08, with materials (65.9%) and hospital daily rates (11.3%) being the primary cost drivers. Device associations included flow diverter (51.9%), stent-assisted coiling (19.2%), and coiling (11.5%). Clinical outcomes were favorable, with an average inpatient stay of 6.5 ± 10.2 days, 6.5% of patients requiring readmission for complications, and no deaths within 90 days. The highest costs were associated with coiling and stent-assisted coiling. The cost of endovascular treatment for UIAs at a private hospital in Brazil is substantial, primarily driven by materials and hospital daily rates. Despite high costs, clinical outcomes were favorable, with low complication rates. These findings underscore the need for continuous cost-effectiveness evaluation and treatment optimization to balance clinical benefits with financial considerations.