open access
Clipping versus coiling for intracranial aneurysms
Affiliations- Neurosurgery Department, 10th Military Research Hospital, Bydgoszcz, Poland
- Radiology Department, 10th Military Research Hospital, Bydgoszcz, Poland
- Department of Public Health, Nicolaus Copernicus University, Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
open access
Abstract
The aim of this study was to compare results of clipping and coiling for aneurysms of the anterior circle of Willis. Previous studies have not identified a clear superiority of one method over the other.
Material and methodsThe study group included 165 consecutive patients. The assessment took into account the risk of death, neurological status according to the scale of the GOS and mRS, the incidence of early complications and quality of life measured by own surveys and questionnaire EORTC QLQ-C30 v. 3.0.
ResultsMean follow-up was more than four years. Early and late results of treatment after embolization and clipping for all patients did not differ. Evaluation of patients with bleeding aneurysms demonstrated better outcomes after embolization, however statistical significance was observed only in terms of symptomatic scale score of QLQ-C30 questionnaire (p=0.02). For patients with non-bleeding aneurysms better outcomes were obtained after clipping, but statistical significance was found only in the early results: more excellent results in GOS score at discharge (p<0.03) and fewer complications during hospitalization (p=0.02).
ConclusionsResults of treatment after clipping and coiling do not differ in total for all patients, but differ depending on the presence of bleeding. Patients with bleeding aneurysms achieve better outcomes after coiling, and patients with non-bleeding aneurysms achieve better outcomes after clipping.
Abstract
The aim of this study was to compare results of clipping and coiling for aneurysms of the anterior circle of Willis. Previous studies have not identified a clear superiority of one method over the other.
Material and methodsThe study group included 165 consecutive patients. The assessment took into account the risk of death, neurological status according to the scale of the GOS and mRS, the incidence of early complications and quality of life measured by own surveys and questionnaire EORTC QLQ-C30 v. 3.0.
ResultsMean follow-up was more than four years. Early and late results of treatment after embolization and clipping for all patients did not differ. Evaluation of patients with bleeding aneurysms demonstrated better outcomes after embolization, however statistical significance was observed only in terms of symptomatic scale score of QLQ-C30 questionnaire (p=0.02). For patients with non-bleeding aneurysms better outcomes were obtained after clipping, but statistical significance was found only in the early results: more excellent results in GOS score at discharge (p<0.03) and fewer complications during hospitalization (p=0.02).
ConclusionsResults of treatment after clipping and coiling do not differ in total for all patients, but differ depending on the presence of bleeding. Patients with bleeding aneurysms achieve better outcomes after coiling, and patients with non-bleeding aneurysms achieve better outcomes after clipping.
Keywords
Intracranial aneurysm, Subarachnoid haemorrhage, Outcome
About this articleTitle
Clipping versus coiling for intracranial aneurysms
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
122-129
Page views
228
Article views/downloads
303
DOI
10.1016/j.pjnns.2014.03.002
Bibliographic record
Neurol Neurochir Pol 2014;48(2):122-129.
Keywords
Intracranial aneurysm
Subarachnoid haemorrhage
Outcome
Authors
Marcin Birski
Cezary Wałęsa
Witold Gaca
Dariusz Paczkowski
Julita Birska
Aleksandra Harat
