Sick Leave and Drug Use After Endovascular Versus Surgical Treatment of Unruptured Intracranial Aneurysms: A Nationwide Registry‐Based Study

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Background Both endovascular and surgical treatments are often reasonable alternatives in the treatment of unruptured intracranial aneurysms (UIAs). Studies on how these alternatives affect the well‐being of patients beyond rebleeding and mortality are surprisingly scarce. We therefore aimed to study the rate of sick leave and use of antidepressant, sedative, and pain‐relieving medication following surgical or endovascular treatment of UIA. Methods After identifying all 1659 patients treated endovascularly ( n = 1021) or surgically ( n = 638) for UIAs in the period from 2010 to 2020, we linked several population‐based registries using SQL software to determine the use of medications and sick leave. The index date was defined as the day of treatment. Findings At 1 month after treatment, sick leave compensation was less frequent ( p < 0.001) in the endovascularly treated group (55.2%) compared with the surgically treated group (82.5%), but 2 years after the intervention, there was no meaningful difference between groups. Use of opioids was higher during the first month in the surgically treated group. Use of antidepressants and sedatives did not differ significantly. Interpretation Sick leave was more common in patients treated for UIAs than age‐matched controls, both 2 years before and 2 years after treatment. Endovascularly treated patients with UIAs have a lower rate of sick leave during the first months after treatment and a lower rate of opioid use during the first month after treatment, compared with surgically treated patients.

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