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Review Article



Cost economics of endovascular coiling versus surgical clipping of intracranial aneurysm: Literature review and critical analysis

Taiwo Akhigbe, Adalan Zolnourian, Fahad Saadi.




Abstract
Cited by 2 Articles

Background
Cost-effectiveness of medical intervention is becoming increasingly important in healthcare delivery, treatment in Neurosurgery is very expensive and there have been very few publications on neurosurgical health economics and comparative effectiveness analysis of neurosurgical procedures. Previous studies comparing cost of clipping to coiling were from European centres with data specifically from the ISAT study conducted in Europe. They found no significant difference in the total cost of coiling when compared to clipping at one year.
Method
A literature search was conducted using electronic data bases including MEDLINE and EMBASE. Inclusion Criteria are literature search limited to the last 10 years (2006-2016), Studies on adult human patients only, only papers published in English, editorials, comments and correspondences excluded.
Result
Systematic literature search yielded 5784 but after removal of duplicates and non-relevant studies, finally had four studies that specifically analysed cost economics of coiling and clipping of intracranial aneurysm. Overall coiling more expensive than clipping in three studies. Wolsteholme et al study showed no significant difference between the two procedures in terms of cost economics
Conclusion
Cost economics of intracranial aneurysm showed that surgical clipping results to reduced re-operation rate when compared to endovascular coiling and also associated with increased complication, longer hospital stay and ultimately greater hospital cost.

Key words: intracranial aneurysm; surgical clipping; endovascular coiling; cost economics






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