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Treatment of Unruptured Cerebral Aneurysms in California

OBJECTIVE:
To determine the impact of endovascular therapy on treatment outcomes of unruptured intracranial aneurysms in a defined geographical area.

METHODS:
All primary diagnoses of unruptured intracranial aneurysms were retrieved from a statewide database of hospital discharges in California from January 1990 through December 1998. A total of 2069 patients were treated for unruptured intracranial aneurysms. 1,699 were treated surgically, 370 endovascularly.

*An adverse outcome was defined as an in-hospital death or discharge to nursing home or rehabilitation hospital at any point during the treatment course.

Multivariable analyses were performed with generalized estimating equations with adjustment for age, sex, ethnicity, source of admission, year of treatment, hospital volume, and clustering of observations at institutions.

CONCLUSIONS:
In California, endovascular therapy of unruptured cerebral aneurysms is associated with less risk of adverse outcomes, lower hospital charges and shorter hospital stays as compared with surgery.