Endovascular coiling and microsurgical clipping for the treatment of ruptured intracranial aneurysms:a retrospective case series study / 国际脑血管病杂志

ABSTRACT

Objective To investigate the effectiveness and safety of endovascular coiling and microsurgical clipping for ruptured intracranial aneurysms. Methods Patients w ith ruptured intracranial aneurysm treated w ith endovascular coiling or microsurgical clipping w ere enrol ed retrospectively. The demography, baseline clinical data, outcome, and complications in patients received endovascular coiling and microsurgical clipping w ere compared. Results A total of 85 patients w ith ruptured intracranial aneurysm were enroled, including 40 were treated with microsurgical clipping (surgical clipping group) and 45 were treated w ith endovascular coiling (endovascular coiling group). There w ere no significant differences in the proportions of the patients in male (37.5%vs.40.0%; χ2 =0.056, P=0.813), hypertension (30.0%vs. 33.3%; χ2 =0.109, P=0.742 ), smoking ( 50.0%vs.48.9%; χ2 =0.010, P=0.918 ), drinking (45.0%vs.46.7%; χ2 =0.024, P=0.878), aneurysm site (anterior communicating artery 50.0%vs. 48.9%;posterior communicating artery35.0%vs.33.3%; middle cerebral artery10.0 %vs.11.1%;vertebral artery 5.0%vs.6.7%; al P>0.05), aneurysm maximum diameter < 10 mm (80.0%vs. 77.8%;χ2 =0.063, P=0.802), Hunt-Hess grade 1-2 (55.0%vs.57.8%; χ2 =0.066, P=0.797), Fisher grade 1-2 ( 60.0%vs.57.8%; χ2 =0.043, P=0.835 ), and time from onset to treatment < 72 h (62.5%vs.64.4%; χ2 =0.035, P=0.853) in the surgical clipping group and endovascular coiling group. There w ere no significant differences in the complete occlusion rate of aneurysms ( 97.5%vs.91.1%;P=0.364) and the good outcome rate (65.0%vs.68.9%; χ2 =0.145, P=0.703) betw een the surgical clipping group and the endovascular coiling group. No patients died in the surgical clipping group and 1 patient died in the endovascular coiling group, and there w as no significant difference ( P=1.000). One patient (2.5%) had cerebral infarction in the surgical clipping group and no patients had cerebral infarction in the endovascular coiling group, and there w as no significant difference ( P=0.471). Conclusions The efficacy and safety of microsurgical clipping are the same as those of endovascular coiling for ruptured intracranial aneurysms.