Article Summary

Endovascular and Surgical Treatment of Unruptured Cerebral Aneurysms: Comparison of Risks

Johnston SC, et.al.
Ann Neurology. 2000; 48:11-19

OBJECTIVE:
To compare risks of neurosurgical clipping and endovascular coil treatment in the treatment of unruptured cerebral aneurysms in patients whose aneurysms were judged to be treatable by both options.

METHODS:
A blinded retrospective study compared surgical clipping and endovascular treatment of 130 unruptured cerebral aneurysms at the University of California San Francisco Hospital. Neurosurgeons and neurointerventional radiologists were given patient age, past medical history, symptoms, and signs on presentation based on medical records abstraction and preprocedural radiographic images.

RESULTS:
Surgical
(n=68)
Coiled
(n=62)
Change in Rankin Score of greater than or equal to 2
25%
8%
Length of Hospital Stay (days)
7.7
5.0
Hospital Charges
$38,000
$33,400
New Symptoms/Disability at follow-up (mean 3.9 yrs)
 
34%
8%
Recovery Time
1 year
27 days

CONCLUSION:
Endovascular coil treatment of unruptured cerebral aneurysms seems to be associated with significantly fewer complications and shorter recovery time than surgical clipping.