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O-009 Short-term outcomes for electively treated unruptured intracranial aneurysms in healthy adults: a feasibility study for ambulatory neurointerventional procedures

results of several randomized trials, but surgery continues to play an important role in management of some subsets of aneurysms. Here, we describe the clinical outcomes of coiling vs clipping for ruptured intracranial aneurysms utilizing a national database. Methods We utilized the TriNetX Analytics Network to query 2,740 cases up to March 27, 2021. We identified patients >18 years old who underwent coiling or clipping for the treatment of ruptured intracranial aneurysm using ICD-10 codes of I60.1, I60.2, I60.3, I60.6, and I60.7. Patient demographics, baseline characteristics, comorbidities, and clinical outcomes were evaluated within 1-year postoperatively. Mortality and adverse outcome analyses were performed after propensity score matching to control for baseline characteristics and comorbidities between the two cohorts. A combined pooled and individual analyses of the above ICDs were conducted to investigate the differences in clinical outcomes due to the aneurysm’s location. Results The coiling cohort consisted of 2011 patients with mean age 56.8±13.9 and 30.9% male and the clipping cohort consisted of 729 patients with mean age 54.1±13.4 and 28.4% male. After propensity matching for baseline characteristics and comorbidities, a total of 666 patients were included in each cohort. The incidence of surgical/ medical complications, ICU, and vasospasm, were significantly lower in the coiling cohort (p-value= 0.008, 0.03, 0.03) compared to the clipping cohort within 1-year postoperatively using the combined ICD codes. There was no significant difference in 1-year-mortality between the two cohorts. Additionally, individual ICD code analysis revealed that coiling of anterior communicating artery (ACoA) aneurysm was associated with significantly less surgical/medical complications and hydrocephalus (p-value= 0.0008, 0.015), and coiling of posterior communicating artery (PCoA) aneurysms was associated with significantly less vasospasm treatment (p-value=0.034) as compared to the respective clipping cohort. There was no significant difference in 1year-mortality between the two cohorts by location of the aneurysm using individual ICDs. Conclusion This national database analysis of 1,332 propensity-matched patients undergoing coiling or clipping after a ruptured intracranial aneurysm provides evidence that 1-year clinical outcomes, including surgical/medical complication, and vasospasm, favored coiling. In particular, ACoA-coiled patients had significantly less hydrocephalus, and PCoA-coiled patients had significantly lower vasospasm treatment within 1-year as compared to clipping. Disclosures A. Nia: None. R. Lall: None. P. Kan: None. V. Srinivasan: None.