Factors predicting the cost of endovascular management of intracranial aneurysms.

Introduction: The management of intracranial aneurysms has evolved in the recent years, and endovascular coiling has become the first treatment option in many countries. In Tunisia, this neuroendovascular treatment meets a progressive but slow development, slowed down, by the economic component.

Aim: This study aimed to evaluate the global cost of endovascular treatment of cerebral aneurysms and determine the factors influencing the variation of direct medical cost.

Methods: A prospective study including patients who underwent interventional neuroradiology procedures for intracranial aneurysms between March 2019 and June 2019. Total cost (direct medical and non medical cost) was assessed using the micro-costing method. Statistical analysis (descriptive followed by a multivariate analysis) was performed by PSPP software with a p-value< 0.05 considered statistically significant.

Results: Twenty-nine patients were included (mean age 54±14 years). The average overall cost of treatment was 15 877 DT (5 081€), ranging from 8 005 DT (2 562 €) to 36 325 DT (11 624 €). The average cost of medical devices used during the procedure was 13 548 DT (4 335 €) which represents 85.3% of the total cost. The direct medical cost was particularly influenced by aneurysm's and neck's size, and by the total cost of coils.

Conclusions: The medical devices used during the procedure greatly influenced the direct medical cost of the management of intracranial aneurysms.