P-050 Recent outcomes following endovascular vs open surgical treatment of ruptured and unruptured cerebral aneurysm: insights from the national inpatient sample 2017

Introduction/Background Advancements in endovascular therapies have significantly impacted cerebral aneurysm management in recent years. Recent release of the National Inpatient Sample (NIS) data for 2017 provides the opportunity to explore novel population-based insights into outcomes following surgical clipping vs endovascular embolization of ruptured and unruptured cerebral aneurysms. Materials and Methods This is an analysis of US National Inpatient Sample of hospitalizations with non-traumatic subarachnoid hemorrhage (SAH) or unruptured cerebral aneurysms from January 1, 2017 to December 31, 2017. Baseline patient demographics, open vs endovascular treatment modalities and the associated hospitalization outcomes were analyzed. Primary outcomes included in-hospital mortality and favorable discharge disposition defined as discharge to home. Results Among 56,165 hospitalizations with unruptured aneurysms, 13,090 (23.3%) underwent endovascular embolization (median age 59, IQR 51-68; Female 74.9% ) and 4105 (7.3%) had surgical clipping (median age 58, IQR 51-65; Female 74.1%). In-hospital mortality occurred in 1.45% in endovascular vs 1.83% in clipping group (p=0.17), whereas favorable discharge outcome was achieved in 87.5% in endovascular vs 74.8% in clipping group (p Conclusion In 2017 in US, about 75% of patients were discharged home after clipping and 90% were discharged home after endovascular treatment of an unruptured cerebral aneurysm. About 1 in 7 patients died following clipping and 1 in 8 following endovascular treatment for aneurysmal SAH. Endovascular therapy remains associated with better in-hospital outcomes, including the younger age population with ruptured or unruptured aneurysms. Disclosures H. Saber: None. M. Jafari: None. A. Desai: None. N. Kaneko: None. G. Colby: 2; C; Medtronic, Stryker, MicroVention. V. Szeder: None. R. Jahan: 2; C; Medtronic. G. Duckwiler: 2; C; Medtronic. S. Tateshima: 2; C; Medtronic, Stryker, Cerenovus.