Document Detail

Treatment of ruptured cerebral aneurysms - clip and coil, not clip versus coil.
MedLine Citation:
PMID:  19953365     Owner:  NLM     Status:  In-Data-Review    
Background and aims: Recent advances in neurosurgery and interventional neuroradiology have brought us a new aspect in the treatment of cerebral aneurysms. The present single-surgeon series provides a balanced overview of the treatment of ruptured aneurysms in surgical clipping and coil embolization. Clinical materials and methods: One hundred consecutive patients with ruptured cerebral aneurysms underwent surgical clipping or endovascular coil embolization between January 2005 and December 2007. All patients underwent clipping or coil embolization of at least one ruptured cerebral aneurysm by a single neurosurgeon (YK) who performed both the surgical clipping and endovascular coiling. Results: Of the 48 surgically treated patients, 37 (77.1%) achieved a favorable outcome. Of the 52 patients who underwent endovascular embolization, 37 (71.2%) achieved a favorable outcome. No significant difference was observed regarding the proportion of favorable outcomes between the two treatment modalities. Five patients (9.6%) who underwent endovascular embolization needed re-treatments, while no re-treatment was necessary in the surgically treated patients. The rates of symptomatic vasospasm and shunt dependent hydrocephalus were 18.8% and 14.6%, respectively, in the clipped patients, and 19.2% and 21.2%, respectively, in the coiled patients. Endovascular coiling of ruptured aneurysms has a tendency towards a higher risk of developing shunt dependent hydrocephalus. Conclusion: A combined microsurgical-endovascular approach can achieve the best outcomes for patients with ruptured cerebral aneurysms. Our findings support the policy of "Clip and Coil, not Clip versus Coil."
Yasuhiko Kaku; Kentarou Yamashita; Jouji Kokuzawa; Naoki Hatsuda; Takashi Andoh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta neurochirurgica. Supplement     Volume:  107     ISSN:  0065-1419     ISO Abbreviation:  Acta Neurochir. Suppl.     Publication Date:  2010  
Date Detail:
Created Date:  2009-12-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100962752     Medline TA:  Acta Neurochir Suppl     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  9-13     Citation Subset:  IM    
Department of Neurosurgery, Asahi University Murakami Memorial Hospital, Hashimoto-cho 3-23, Gifu, 500-8523, Japan,
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