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Despite prospective findings from the International Study of Unruptured Intracranial Aneurysms (ISUIA), much controversy remains regarding the criteria for treatment of unruptured aneurysms with either surgical clipping or endovascular coiling. Now, researchers have used data from the ISUIA and from more-recent studies to model the cost-effectiveness of these two treatments compared with no treatment. The authors used a Markov model to estimate quality-adjusted life-years (QALYs) and lifetime costs of each option for men and for women who are either 50 or 70 years of age, with expected rupture rates ranging from 0.3% to 3.5% per year.
Estimated cost-effectiveness depended largely on age and rupture risk. Both treatment modalities were consid…