Cost-effectiveness of CTA, MRA and DSA in patients with non-traumatic subarachnoid hemorrhage 141 Conclusion Comparing DSA, CTA and MRA to each other on the basis of case cost-effectiveness analysis shows that DSA is superior to both MRA and CTA due to higher quality of life and less overall one-year costs. Comparing the two non-invasive diagnostic tests, CTA is superior to MRA. A scenario strategy where CTA was followed by DSA if endovascular coiling was not deemed feasible, was found to be the most cost- effective diagnostic option in patients with suspected ruptured intracranial aneurysm. References 1 de Rooij, N. K., Linn, F. H., van der Plas, J. A., Algra, A. & Rinkel, G. J. Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends. J Neurol Neurosurg Psychiatry 78, 1365-1372, (2007). 2 Connolly, E. S., Jr. et al. Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke, (2012). 3 Starke, R. M. & Connolly, E. S., Jr. Rebleeding after aneurysmal subarachnoid hemorrhage. Neurocrit Care 15, 241-246, (2011). 4 de Gans, K., Nieuwkamp, D. J., Rinkel, G. J. & Algra, A. Timing of aneurysm surgery in subarachnoid hemorrhage: a systematic review of the literature. Neurosurgery 50, 336-340; discussion 340-332, (2002). 5 Weil, A. G. & Zhao, J. Z. Treatment of Ruptured Aneurysms: Earlier is Better. World Neurosurg 77, 263-265, (2012). 6 Klompenhouwer, E. G. et al. Single-center experience of surgical and endovascular treatment of ruptured intracranial aneurysms. AJNR Am J Neuroradiol 32, 570-575, (2011). 7 Molyneux, A. et al. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet 360, 1267-1274, (2002). 8 Molyneux, A. J. et al. International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 366, 809- 817, (2005). 9 van der Schaaf, I. et al. Endovascular coiling versus neurosurgical clipping for patients with aneurysmal subarachnoid haemorrhage. Cochrane Database Syst Rev, CD003085, (2005). 10 Bairstow, P., Dodgson, A., Linto, J. & Khangure, M. Comparison of cost and outcome of endovascular and neurosurgical procedures in the treatment of ruptured intracranial aneurysms. Australas Radiol 46, 249-251, (2002). 11 Hoh, B. L., Chi, Y. Y., Lawson, M. F., Mocco, J. & Barker, F. G., 2nd. Length of stay and total hospital charges of clipping versus coiling for ruptured and unruptured adult cerebral aneurysms in the Nationwide Inpatient Sample database 2002 to 2006. Stroke 41, 337-342, (2010). 12 Lawson, M. F. & Hoh, B. L. Clipping versus coiling: the total hospital cost of aneurysm treatment. World Neurosurg 73, 430-431, (2010). 13 Wolstenholme, J. et al. Treatment pathways, resource use, and costs of endovascular coiling versus surgical clipping after aSAH. Stroke 39, 111-119, (2008). 14 van Gijn, J., Kerr, R. S. & Rinkel, G. J. Subarachnoid haemorrhage. Lancet 369, 306-318, (2007). 15 Willinsky, R. A. et al. Neurologic complications of cerebral angiography: prospective analysis of 2,899 procedures and review of the literature. Radiology 227, 522-528, (2003). 16 Cloft, H. J., Joseph, G. J. & Dion, J. E. Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation: a meta-analysis. Stroke 30, 317-320, (1999). 17 Kaufmann, T. J. et al. Complications of diagnostic cerebral angiography: evaluation of 19,826 consecutive patients. Radiology 243, 812-819, (2007). 18 Fifi, J. T. et al. Complications of modern diagnostic cerebral angiography in an academic medical center. J Vasc Interv Radiol 20, 442-447, (2009).
proefschrit Van Zwam inhoud met kaft en stellingen.indd
To see the actual publication please follow the link above