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This section provides summaries of published clinical
papers from peer reviewed journals pertaining to the
neurosurgical and endovascular management of intracranial
aneurysms.
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International Subarachnoid Aneurysm Trial
The International Subarachnoid Aneurysm Trial
-- or ISAT -- is the only multi-center, prospective
randomized trial comparing the safety and efficacy
of endovascular coil treatment with neurosurgical
clipping for the treatment of ruptured brain aneurysms.
The study found that, in patients equally suited
for both treatment options, endovascular coil
treatment produces substantially better patient
outcomes than surgery in terms of survival free
of disability at one year.
Molyneux A, Kerr R, Stratton
I, Sandercock P, Clarke M, Shrimpton J, Holman
R. International Subarachnoid Aneurysm Trial (ISAT)
of neurosurgical clipping versus endovascular
coiling in 2143 patients with ruptured intracranial
aneurysms: a randomised trial. Lancet.
2002: 360: 1267-74.
View Study Q&A
View Article Summary
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Association between Subarachnoid Hemorrhage
Outcomes and Number of Cases Treated at California
Hospitals
The discharge abstracts for all patients with
a primary diagnosis of subarachnoid hemorrhage
admitted through the emergency department to nonfederal
hospitals in California from 1990 to 1999 were
analyzed. The study found that hospitals that
treated more cases of subarachnoid hemorrhage
had substantially lower rates of in-hospital mortality.
Bardach NS, et al. Association
between subarachnoid hemorrhage outcomes and number
of cases treated at California hospitals. Stroke.
2002 Jul; 33(7): 1851-6.
View Article
Summary
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Treatment of Unruptured Cerebral Aneurysms
in California
To determine the impact of endovascular coil treatment
as compared with neurosurgical clipping on treatment
outcomes, all primary diagnoses of unruptured
cerebral aneurysms were retrieved from a statewide
database of hospital discharges in California.
The study found that endovascular treatment of
unruptured aneurysms is associated with less risk
of adverse outcomes, lower hospital charges and
shorter hospital stays compared with surgery.
Johnston SC. Treatment of
Unruptured Cerebral Aneurysms in California. Stroke.
2001 Mar; 32(3):597-605.
View Article
Summary
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Endovascular and Surgical Treatment of Unruptured
Cerebral Aneurysms: Comparison of Risks
A blinded retrospective study compared surgical
clipping with endovascular treatment of 130 unruptured
aneurysms at the University of California San
Francisco Hospital. The study found that endovascular
treatment is associated with fewer adverse outcomes,
lower hospital charges, shorter hospital stays
and shorter recovery times than neurosurgical
clipping.
Johnston SC, et.al. Endovascular
and Surgical Treatment of Unruptured Cerebral
Aneurysms: Comparison of Risks. Ann Neurology
2000; 48:11-19
View Article
Summary
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Surgical and Endovascular Treatment of Unruptured
Cerebral Aneurysms at University Hospitals
A three-and-a -half-year study compared adverse
outcomes, hospital stay duration, and cost of
neurosurgical clipping and endovascular coil therapy
in the treatment of unruptured aneurysms at 60
university hospitals. The study found that endovascular
treatment of unruptured aneurysms resulted in
fewer adverse outcomes, lower hospital charges,
shorter hospital stays and shorter recovery times
than neurosurgical clipping.
Johnston SC, et. al. Surgical
and Endovascular Treatment of Unruptured Cerebral
Aneurysms at University Hospitals. Neurology
1999; 52:1799-1805
View Article
Summary
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