Ruptured intracranial aneurysms: Acute endovascular treatment with electrolytically detachable coils - A prospective randomized study

Citation
R. Vanninen et al., Ruptured intracranial aneurysms: Acute endovascular treatment with electrolytically detachable coils - A prospective randomized study, RADIOLOGY, 211(2), 1999, pp. 325-336
Citations number
44
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
Journal title
RADIOLOGY
ISSN journal
00338419 → ACNP
Volume
211
Issue
2
Year of publication
1999
Pages
325 - 336
Database
ISI
SICI code
0033-8419(199905)211:2<325:RIAAET>2.0.ZU;2-6
Abstract
PURPOSE: To compare the use of electrolytically detachable coils versus sur gical ligation for the management of acutely ruptured intracranial aneurysm . MATERIALS AND METHODS: A prospective randomized study included 109 patients with acute (<72 hours) subarachnoid hemorrhage caused by a ruptured aneury sm (Hunt and Hess grade I-II [n = 67], grade III [n = 26], or grade IV-V [n = 16]). Ail patients were suitable candidates for both endovascular and su rgical treatment and were randomly assigned to undergo coil embolization (n = 52) or surgical ligation (n = 57). RESULTS: Significantly better primary angiographic results were achieved af ter surgery in patients with anterior cerebral artery aneurysm (n = 55, P = .005) and after endovascular treatment in those with posterior circulation aneurysm (n = 11, P = .045). No significant differences were seen in middl e cerebral artery (n = 19) or internal carotid artery (n = 24) aneurysms. E arly rebleeding occurred in one patient after incomplete coil embolization. The technique-related mortality rate was 4% in the surgical group and 2% i n the endovascular group. Clinical outcome (Glasgow Outcome Scale score) at 3 months was not significantly different between treatment groups in terms of intended treatment modality. No late rebleedings had occurred at the ti me of this writing. CONCLUSION: In selected patients with a recently ruptured intracranial aneu rysm, favorable results were achieved by using endovascular treatment. Subs equent acute or late open surgery was sometimes required. The clinical outc ome at 3 months was comparable in the endovascular and surgical treatment g roups.