Abstract 337: National Trends in Intervention Modality for Hospitalizations with Infectious Intracranial Aneurysms and Associated Outcomes

Introduction Data regarding how to treat infectious intracranial aneurysms most effectively remains sparse. With growing utilization of endovascular therapy for cerebrovascular disease, we examined trends in endovascular versus neurosurgical treatment of infectious aneurysms and investigated the impact of treatment modality on patient outcomes. Methods Using data from the National Inpatient Sample from 2000 to 2019, we conducted a trends analysis on rates of treatment modalities among all hospitalizations with infective endocarditis with ruptured or unruptured cerebral aneurysms. Treatment modalities were categorized as endovascular versus open neurosurgical repair based on ICD‐9 and ICD‐10 codes. Logistic regressions were utilized to assess the association between treatment modality and the outcomes of in‐hospital mortality and discharge disposition. Results We identified 24,461 hospitalizations with an infectious intracranial aneurysm in the setting of infective endocarditis. The mean age was 56.0 years (SD, 17.8) and 61.8% were male. The overall rate of intervention was 5.8% (95% CI, 5.0‐6.5%), and this did not change over time (p=0.669). There was a significant increase in the rate of endovascular repair (APC=3.6%; 95% CI, 1.2%‐8.1%) and a significant decrease in the rate of open neurosurgical repair (APC= ‐5.4%; 95% CI, ‐8.1% to ‐3.5%). Treatment modality was not associated with in‐hospital mortality (p=0.698) or non‐home discharge disposition (p=0.897). Conclusion Although rates of infectious intracranial aneurysm intervention for infective endocarditis did not change, utilization of endovascular treatment increased while the use of open neurosurgical treatment decreased. Further directions include elucidating predictors of favorable outcomes for those undergoing intervention as well as the most beneficial timing for the procedure during hospitalization.