Endovascular or Microsurgical Treatment of Intracranial Aneurysms: Single Center Analysis / 고신대학교의과대학학술지

ABSTRACT

OBJECTIVES: The objective of this study was to assess effectiveness and outcomes of endovascular versus microsurgical treatment for intracranial aneurysms in single hospital. METHODS: This was a retrospective study, using data collected during 4 year (between 2008 and 2011) from single hospital(Kosin University Gospel Hospital). A total of 274 treated, intracranial aneurysm cases were evaluated. The measurements used were effectiveness as measured by hospital discharge outcomes: 1) mortality (in-hospital death), 2) clinical outcomes(modified Ranking Scale mRS). RESULTS: Among total of 274 cases, unruptured intracranial aneurysm cases were 132 cases and ruptured cases were 142 cases. Among unruptured 132 cases, 65 cases were treated by microsurgical treatment and 67 cases were treated by endovascular treatment. Among ruptured 142 cases, 61 cases were treated by microsurgical treatment and 81 cases were treated by endovascular treatment. In unruptured cases, there was not any fatal complication and same adverse outcomes (3% versus 3%). In ruptured case, in regards of treatment modality (i.e., endovascular versus microsurgical treatment), each clinical outcomes were as followings; good clinical outcome was 53.1% (43/81) versus 41.0% (25/61), moderate clinical outcome was 13.6% (1/81) versus 9.8% (6/61), severe clinical outcome was 18.5% (15/81) versus 22.9% (29/142) and fatal outcome was 14.8 (12/81) versus 26.2% (16/61). CONCLUSIONS: This analysis of single hospital data indicates that endovascular therapy is associated with significantly less morbidity, less mortality, compared with conventional microsurgical treatment for all intracranial aneurysms. Endovascular therapy, as a treatment alternative to microsurgical clipping, should be offered as a viable therapeutic option for all patients considering treatment of an intracranial aneurysm.