Abstract
BACKGROUND AND PURPOSE: Both CT angiography and digital subtraction angiography are used to detect aneurysms in patients with subarachnoid hemorrhage. We examined a large multihospital data base to determine how practice is evolving with regard to the use of CT angiography and DSA in patients with ruptured cerebral aneurysm. MATERIALS AND METHODS: The Premier Perspective data base was used to identify hospitalizations of patients treated with clipping or coiling of ruptured cerebral aneurysms from 2006-2011. Billing information was used to determine pretreatment and posttreatment use of DSA and CT angiography during hospitalization. RESULTS: A total of 4972 patients (1022 clipping, 3950 coiling) at 116 hospitals were identified. The percentage of patients with SAH who underwent pretreatment CT angiography significantly increased from 20% in 2006 to 44% in 2011 (P <.0001), whereas the percentage of patients who underwent DSA remained unchanged from 96-94% (P =.28). This CT angiography trend was observed in coiling patients (17-42%, P <.0001) and clipping patients (32-54%, P <.0001). There was a significant increase in the percentage of patients who underwent posttreatment imaging from 41% in 2006 to 48% in 2011 (P =.0037). This trend was observed in clipping patients (33-65%, P<.0001) but not coiling patients (43-45%, P =.62). CONCLUSIONS: For the pretreatment evaluation of ruptured aneurysms, the use of CT angiography increased from 2006-2011 without a corresponding decrease in the use of DSA. These results raise the question of potential redundancy without added clinical value of the second test.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1774-1777 |
| Number of pages | 4 |
| Journal | American Journal of Neuroradiology |
| Volume | 34 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 2013 |
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ASJC Scopus subject areas
- Clinical Neurology
- Radiology Nuclear Medicine and imaging
Cite this
Use of CT angiography and digital subtraction angiography in patients with ruptured cerebral aneurysm : Evaluation of a large multihospital data base. / McDonald, Jennifer S; Kallmes, David F; Lanzino, G.; Cloft, H. J.
In: American Journal of Neuroradiology, Vol. 34, No. 9, 09.2013, p. 1774-1777.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Use of CT angiography and digital subtraction angiography in patients with ruptured cerebral aneurysm
T2 - Evaluation of a large multihospital data base
AU - McDonald, Jennifer S
AU - Kallmes, David F
AU - Lanzino, G.
AU - Cloft, H. J.
PY - 2013/9
Y1 - 2013/9
N2 - BACKGROUND AND PURPOSE: Both CT angiography and digital subtraction angiography are used to detect aneurysms in patients with subarachnoid hemorrhage. We examined a large multihospital data base to determine how practice is evolving with regard to the use of CT angiography and DSA in patients with ruptured cerebral aneurysm. MATERIALS AND METHODS: The Premier Perspective data base was used to identify hospitalizations of patients treated with clipping or coiling of ruptured cerebral aneurysms from 2006-2011. Billing information was used to determine pretreatment and posttreatment use of DSA and CT angiography during hospitalization. RESULTS: A total of 4972 patients (1022 clipping, 3950 coiling) at 116 hospitals were identified. The percentage of patients with SAH who underwent pretreatment CT angiography significantly increased from 20% in 2006 to 44% in 2011 (P <.0001), whereas the percentage of patients who underwent DSA remained unchanged from 96-94% (P =.28). This CT angiography trend was observed in coiling patients (17-42%, P <.0001) and clipping patients (32-54%, P <.0001). There was a significant increase in the percentage of patients who underwent posttreatment imaging from 41% in 2006 to 48% in 2011 (P =.0037). This trend was observed in clipping patients (33-65%, P<.0001) but not coiling patients (43-45%, P =.62). CONCLUSIONS: For the pretreatment evaluation of ruptured aneurysms, the use of CT angiography increased from 2006-2011 without a corresponding decrease in the use of DSA. These results raise the question of potential redundancy without added clinical value of the second test.
AB - BACKGROUND AND PURPOSE: Both CT angiography and digital subtraction angiography are used to detect aneurysms in patients with subarachnoid hemorrhage. We examined a large multihospital data base to determine how practice is evolving with regard to the use of CT angiography and DSA in patients with ruptured cerebral aneurysm. MATERIALS AND METHODS: The Premier Perspective data base was used to identify hospitalizations of patients treated with clipping or coiling of ruptured cerebral aneurysms from 2006-2011. Billing information was used to determine pretreatment and posttreatment use of DSA and CT angiography during hospitalization. RESULTS: A total of 4972 patients (1022 clipping, 3950 coiling) at 116 hospitals were identified. The percentage of patients with SAH who underwent pretreatment CT angiography significantly increased from 20% in 2006 to 44% in 2011 (P <.0001), whereas the percentage of patients who underwent DSA remained unchanged from 96-94% (P =.28). This CT angiography trend was observed in coiling patients (17-42%, P <.0001) and clipping patients (32-54%, P <.0001). There was a significant increase in the percentage of patients who underwent posttreatment imaging from 41% in 2006 to 48% in 2011 (P =.0037). This trend was observed in clipping patients (33-65%, P<.0001) but not coiling patients (43-45%, P =.62). CONCLUSIONS: For the pretreatment evaluation of ruptured aneurysms, the use of CT angiography increased from 2006-2011 without a corresponding decrease in the use of DSA. These results raise the question of potential redundancy without added clinical value of the second test.
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U2 - 10.3174/ajnr.A3464
DO - 10.3174/ajnr.A3464
M3 - Article
C2 - 23578673
VL - 34
SP - 1774
EP - 1777
JO - American Journal of Neuroradiology
JF - American Journal of Neuroradiology
SN - 0195-6108
IS - 9
ER -