Clipping versus coiling, in anterior circulation ruptured intracranial aneurysms: A meta-analysis

• Published in: World neurosurgery 2017-08, Vol.104, p.482-488
• Main Authors: Fotakopoulos, George, Ph.D, Tsianaka, Eleni, Fountas, Kostas, Makris, Demosthenes, Spyrou, Michael, Hernesniemi, Juha, Prof
• Format: Article
• Language: English
• Subjects: Aneurysm, Ruptured - diagnosis; Aneurysm, Ruptured - mortality; Aneurysm, Ruptured - surgery; Anterior circulation aneurysm; Brain Damage, Chronic - etiology; Brain Damage, Chronic - mortality; Clinical Trials as Topic; Clipping; Coiling; Confidence Intervals; Embolization, Therapeutic; Endovascular treatment; Hospital Mortality; Humans; Intracranial Aneurysm - diagnosis; Intracranial Aneurysm - mortality; Intracranial Aneurysm - surgery; Neurologic Examination; Neurosurgery; Odds Ratio; Postoperative Complications - etiology; Postoperative Complications - mortality; Prognosis; Surgical Instruments
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2017.05.040

Absctract Background The treatment plan with open surgical or endovascular repair in anterior circulation ruptured intracranial aneurysms must be taken on the basis of its special characteristics Objective To evaluate the possible superiority on outcomes, studying operative mortality (Op-Mo), permanent neurologic deficit (PND), late mortality (La-Mo) and need for re-intervention (re-iter), after open surgical and endovascular repair in anterior circulation ruptured intracranial aneurysms. Methods This Meta-Analysis included articles that compared outcomes of the two methods, published in full text form (last search performed on 06 December 2016). Extracted data was organized on a standard table form, including first author, country, covered study period, publication year, general number of patients and patients at follow-up, operative mortality rate (with 30 days from the selecting treatment), permanent neurological deficit (appearing after surgery), late mortality (after 1 month) and re-intervention (surgery or coiling), for both group patients. Follow-up included a period of at least 1 year. Results There were 8 articles, ithat matched our study criteria. The total study population was 628 patients, 374 of which were treated by surgical clipping and 254 with endovascular repair using coiling. The pooled results saw no statistical significance difference between the two groups, in terms of operative mortality, permanent neurologic deficit, late mortality and need for re-intervention. Conclusion The selection of the appropriate procedure for every case must be taken on the basis of its special characteristics.