Vol 48, No 2 (2014)

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Clipping versus coiling for intracranial aneurysms

Marcin Birski1, Cezary Wałęsa2, Witold Gaca2, Dariusz Paczkowski1, Julita Birska1, Aleksandra Harat3
DOI: 10.1016/j.pjnns.2014.03.002
Neurol Neurochir Pol 2014;48(2):122-129.

Abstract

Background and purpose

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 methods

The 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.

Results

Mean 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).

Conclusions

Results 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.

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Neurologia i Neurochirurgia Polska