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- Title
Unruptured intracranial aneurysms: Comparison of perioperative complications, discharge disposition, outcome, and effect of calciication, between clipping and coiling: A single institution experience.
- Authors
Sharma, Mayur; Brown, Benjamin; Madhugiri, Venkatesh; Cuellar-Saenz, Hugo; Sonig, Ashish; Ambekar, Sudheer; Nanda, Anil
- Abstract
Objective: The aim of the study was to compare the perioperative complications, obliteration rates, discharge dispositions, clinico-radiological outcomes, and the role of calcification between the microsurgical and endovascular treatment of unruptured intracranial aneurysms. Materials and Methods: Retrospective data of the patients treated with microsurgical clipping and those treated by endovascular coiling from January 2007 to August 2012 was collected from the database. Results: Intraoperative rupture was not different in both the treatment groups (4.05% vs. 1.5% clip vs. coil). A total of 9.4% of the patients in the clipping group and 4.5% of the patients in the coiling group suffered postoperative stroke. At last follow up, 89% of the patients in the clipping group and 93% of the patients in the coiling group had favorable outcomes. The mean length of stay was more in clipping group (6.1 vs. 2.7, clip vs. coil, P < 0.05). Patients discharged to home without assistance/rehabilitation services were more in coiling (P = 0.001). A total of 28.4% (23/81) of the coiled aneurysms were found to have residue neck on postoperative angiograms as compared with 12.6% (10/79) of the clipped aneurysms (P = 0.01). Calcification within the aneurysm was strongly correlated to the size, perioperative complications, and the outcome (P < 0.05). However, on excluding the calcified cases the size and outcome do not show a significant correlation. Conclusion: With appropriate patient selection, the majority of the UIAs can be managed by either of the treatment modalities with very low mortality and morbidity . Both the treatment modalities should be employed synergistically .
- Subjects
INTRACRANIAL aneurysms; CALCIFICATION; ANEURYSMS; POSTOPERATIVE care; MICROSURGERY
- Publication
Neurology India, 2013, Vol 61, Issue 3, p270
- ISSN
0028-3886
- Publication type
Article
- DOI
10.4103/0028-3886.115067