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Comparative Study Controlled Clinical Trial
The role of endovascular treatment for ruptured distal anterior cerebral artery aneurysms: comparison with microsurgical clipping.
- Keun Young Park, Byung Moon Kim, Yong Cheol Lim, Joonho Chung, Dong Joon Kim, Jin Yang Joo, Seung Kon Huh, Dong Ik Kim, Kyu Chang Lee, and Jae Whan Lee.
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
- J Neuroimaging. 2015 Jan 1;25(1):81-6.
Background And PurposeThe purpose of this study was to compare clinical outcomes and treatment-related complications between coiling and clipping for ruptured distal anterior cerebral artery (DACA) aneurysms.MethodsEighty-four consecutive patients (M:F = 36:48; mean 53.8 years) with ruptured DACA aneurysms were treated by either clipping (n = 46, 54.8%) or coiling (n = 38, 45.2%). The clinical outcomes and procedure-related complications were evaluated and compared between the two groups.ResultsProcedure-related complications tend to occur more frequently in the clipping (n = 6, 13.0%) than coiling group (n = 1, 2.6%) (P = .121). At discharge, 51 patients (60.7%) had favorable outcomes (Glasgow outcome scale [GOS], 4 or 5). There was no significant difference between the two groups in favorable outcome (63.2% vs. 58.7%; P = .677). Hunt and Hess (HH) grade (P < .001; 95% CI, 3.354-29.609) and treatment modality (P = .044; 95% CI, 1.039-16.325) were independent risk factors for poor outcome (GOS, 1-3).ConclusionsCoiling was more favorable to clipping in clinical outcomes and incidence of treatment-related complications for ruptured DACA aneurysms.Copyright © 2013 by the American Society of Neuroimaging.
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