22. European Stroke Conference 945 Interventional neurology Bifurcation Geometry of Intracranial Arteries and Reopening of Coiled Aneurysms J.D. Schaafsma1, A. Rutten2, B.K. Velthuis3, T.H. Lo4, T.D. Witkamp5, G.J.E. Rinkel6 University Medical Centre, Utrecht, THE NETHERLANDS1, University Medical Centre, Utrecht, THE NETHERLANDS2, University Medical Centre, Utrecht, THE NETHERLANDS3, University Medical Centre, Utrecht, THE NETHERLANDS4, University Medical Centre, Utrecht, THE NETHERLANDS5, University Medical Centre, Utrecht, THE NETHERLANDS6 Background: To assess whether bifurcation angles of blood vessels at the base of coiled intra-cranial aneurysms are related to reopening. Methods: Two observers, blinded for presence of re-opening, measured angles on CT angiography between parent and branch arteries of aneurysms at bifurcations. Two other observers scored the presence of reopening on follow-up intra-arterial digital subtraction angiography (IA-DSA) after coiling. Logistic regression analysis was used to assess the association between bifurcation-angle tertiles and reopening. Results: In 82 patients with 86 aneurysms, 25 aneurysms had reopened on follow-up IA-DSA. Sharper bifurcation an-gles, indicating more flow deviation, tended to be related to reopening (regression-coefficient: 2.9; 95%CI:0.8↔11.4). Conclusion: Bifurcation angles of blood vessels at coiled aneurysms are likely to have impact on reopening after coiling. 846 © 2013 S. Karger AG, Basel Scientific Programme 946 Interventional neurology Economic Burden between Carotid Endarterectomy and Carotid Stenting: Retrospective Study H.K. Park1, J.H. Ahn2 Inha University Hospital, Incheon, SOUTH KOREA1, inha university hospital, Incheon, SOUTH KOREA2 Purpose : Carotid artery artherosclerosis is one of stroke risk factors. Carotid endarterectomy(CEA) and carotid angioplasty assisted with stenting(CAS) have been known as effective treatments for this lesion. However, the difference in economic burden between two options remained still unclear in Korea. This study investigated the difference in economic burden between two groups Methods : A total of 40 patients were included in this study. All patients underwent either carotid angioplasty and stenting(CAS) or carotid endarterectomy(CEA) between 2010 and 2012 in Inha University hos-pital. We analyzed in-hospital cost(including pre-procedure, procedure and postprocedure), length of stay for economic loading. Results : Forty patients were finally enrolled. There was no significant difference in age, sex ratio and the frequency of hypertension between two groups. The CEA group(N=20) had more symptom-atic (95% vs 65%; P<0.01) and hyperlipidemia (55% vs 25%;P=0.02) patients, compared to CAS group(N=20). The CAS group had the history of alcohol intake(25% versus 10%;P<0.01) and of pe-ripheral artery occlusive disease (15% versus 5%;P<0.01), more frequently than CEA group. There was no difference in total in-hospital cost between CEA group than CAS group(9,238 vs 10,507. *1000 KW). After national insurance coverage, patients burden of CAS group was smaller than CEA group(CAS 4,878 vs CEA 5,619. *1000KW). Although there was no difference in total costs before procedure, CAS group had the larger economic burden during procedure day and smaller bur-den during post-procedure care, compared to CEA group. The length of stay was less in CAS group than CEA group(15±9 vs 35±37 day). There was no difference in procedure-related complication between two groups. Conclusions : Total economic burden was similar and the length of stay and the patient’s burden were substantially less in CAS group than CEA group. These data might give some helps for the se-lection of treatment option for the patients with carotid artery stenosis.
Karger_ESC London_2013
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