Is coiling cost-effective compared to clipping in patients with ruptured cerebral aneurysms?
Might the procedural costs associated with coiling—particularly the cost of the coils and of surveillance angiograms—offset the financial benefits of shorter intensive care unit/hospital stays during the initial treatment phase? Recent cost analyses at several ISAT centers suggest that, while this offset is in fact seen, the overall costs of initial and subsequent treatments in the 12–24-month follow-up period are not significantly different between coiling and clipping(5). It is also important to note that these studies evaluated health care costs at ISAT centers, but did not take into account important societal factors such as the impact on employment or the cost of long-term care for survivors. In the UK, ISAT patients in the coiling arm were significantly more likely to return to work in the first year of recovery; the trend continued to favor coiling at 24 months, though this was no longer significant. While no comparative data are available concerning the costs of long-term healt
