Patient Follow-up After Endovascular Treatment of Cerebral Aneurysms: Identifiable Barriers and Implications for Treatment Decisions
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND OBJECTIVES: Cerebral aneurysms are the major cause of spontaneous subarachnoid hemorrhage, and a common treatment is endovascular embolization. Aneurysmal recurrence after embolization is frequent, and clinical follow-up to monitor for this is critical to prevent subarachnoid hemorrhage. Herein, we assess demographic and socioeconomic factors associated with poor clinical follow-up to determine which patients are at high risk of loss to follow-up. METHODS: A retrospective analysis was performed of 937 patients who underwent endovascular treatment of cerebral aneurysms at a single center from 2006 to 2017. Attendance at follow-up visits for 5 years after treatment was correlated with various demographic and socioeconomic factors. Follow-up for patients who initially presented with unruptured vs ruptured aneurysms was also compared. RESULTS: The most significant factors associated with poor follow-up were lack of insurance and non–English-speaking status. Noninsured patients had significantly less follow-up in both mean number of follow-up visits (2.5 ± 1.7 visits for insured patients and 1.0 ± 1.2 visits for noninsured, P < .0001), and in time until lost to follow-up (2.9 ± 1.9 years for insured and 1.1 ± 1.4 years for non-insured, P < .0001). Non–English-speaking patients had less follow-up visits (2.3 ± 1.7 visits for English-speaking and 0.74 ± 1.0 visits for non–English-speaking, P < .0001) and were more quickly lost to follow-up (2.6 ± 1.9 years for English-speaking and 0.82 ± 1.2 years for non–English-speaking, P < .0001). CONCLUSION: Demographics and socioeconomic factors, particularly lack of insurance and non–English-speaking status, are correlated with poor clinical follow-up after endovascular treatment of cerebral aneurysms. Patients at high risk of loss to follow-up should be counseled before treatment about risk of aneurysm recurrence.
Source: Neurosurgery Open
Institutions: University of Florida Health, University of Florida
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4415113223