Document Detail

Completion angiography for surgically treated cerebral aneurysms: an economic analysis.
MedLine Citation:
PMID:  18162894     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare cost-effectiveness of different strategies for completion angiography after cerebral aneurysm clipping. METHODS: A literature search was used to determine the outcome probabilities and costs of various strategies. The pooled results were used in a Markov cost-effectiveness model to compare quality-adjusted life-years and costs of each strategy. Sensitivity (threshold) analyses and Monte Carlo simulation were used to test variation in the model. RESULTS: Routine (for all cases) intraoperative angiography proved to be slightly more cost-effective than selective (only for cases deemed "high risk") intraoperative angiography, being both less costly and more effective. Routine postoperative angiography was the least cost-effective. However, in centers whose rates of clip-induced arterial compromise are much lower than the averages reported in the literature, selective angiography might be warranted. CONCLUSION: Routine intraoperative angiography remains the most cost-effective form of completion angiography after aneurysm clipping, at least at our present state of technology.
Sherman C Stein; Mark G Burnett; Eric L Zager; Howard A Riina; Seema S Sonnad
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  61     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-28     Completed Date:  2008-02-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1162-7; discussion 1167-9     Citation Subset:  IM    
Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania 19106, USA.
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MeSH Terms
Cerebral Angiography / economics*,  methods*
Cost-Benefit Analysis*
Intracranial Aneurysm / economics*,  surgery
MEDLINE / statistics & numerical data
Markov Chains
Quality-Adjusted Life Years
Retrospective Studies
Sensitivity and Specificity
Surgical Instruments / supply & distribution
Surgical Procedures, Operative / economics*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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