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[Comparative study for ruptured aneurysms treated by surgery and endovascular method].

Marcelo D Conrad1, Isabelle Pelissou-Guyotat, Christophe Morel

  • 1Hôpital Neurologique et Neurochirurgicale Pierre Wertheimer, Lyon, France. mconrad@rocketmail.com

Arquivos De Neuro-Psiquiatria
|April 20, 2002
PubMed
Summary

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Surgical treatment for ruptured intracranial aneurysms offers superior aneurysm exclusion rates compared to endovascular methods. While both approaches yield good clinical outcomes, surgery provides more durable results for aneurysm management.

Area of Science:

  • Neurosurgery
  • Interventional Neurology
  • Vascular Neurology

Background:

  • Intracranial aneurysms require effective management strategies.
  • Endovascular treatment has emerged as an alternative to traditional surgery.
  • Comparing outcomes of surgical versus endovascular approaches is crucial.

Purpose of the Study:

  • To compare the clinical and radiological outcomes of surgical intervention versus endovascular embolization for ruptured intracranial aneurysms.
  • To evaluate the efficacy and safety of different treatment modalities.

Main Methods:

  • Retrospective analysis of 78 patients with ruptured intracranial aneurysms (grades I-III) treated between 1995 and 1999.
  • Patients were categorized into surgical (n=52), endovascular (n=21), and combined treatment (n=5) groups.

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  • Outcomes assessed included clinical results and aneurysm exclusion rates.

    • Main Results:

    • The surgical group showed 80.8% very good clinical outcomes and 96.2% total aneurysm exclusion, with 5% mortality.
    • The endovascular group achieved 95% very good clinical outcomes but only 42.8% total aneurysm exclusion.
    • A significant difference in radiological outcome (aneurysm exclusion) was observed between the two groups.

    Conclusions:

    • Endovascular treatment for intracranial aneurysms can achieve good clinical results but often has suboptimal radiological outcomes.
    • Surgical management provides superior rates of complete aneurysm exclusion.
    • Complementary surgical procedures may be necessary after endovascular treatment to address residual aneurysms.