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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...

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Related Experiment Video

Updated: May 11, 2026

Arterial Pouch Microsurgical Bifurcation Aneurysm Model in the Rabbit
06:11

Arterial Pouch Microsurgical Bifurcation Aneurysm Model in the Rabbit

Published on: May 14, 2020

The Barrow Ruptured Aneurysm Trial: 3-year results.

Robert F Spetzler1, Cameron G McDougall, Felipe C Albuquerque

  • 1Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013, USA. Neuropub@dignityhealth.org

Journal of Neurosurgery
|April 30, 2013
PubMed
Summary
This summary is machine-generated.

The Barrow Ruptured Aneurysm Trial (BRAT) found no significant difference in outcomes between clipping and coiling for ruptured cerebral aneurysms at 3 years. Clipping showed better obliteration and lower recurrence rates, particularly for anterior circulation aneurysms.

Related Experiment Videos

Last Updated: May 11, 2026

Arterial Pouch Microsurgical Bifurcation Aneurysm Model in the Rabbit
06:11

Arterial Pouch Microsurgical Bifurcation Aneurysm Model in the Rabbit

Published on: May 14, 2020

Area of Science:

  • Neurosurgery
  • Interventional Neurology
  • Vascular Neurology

Background:

  • Aneurysmal subarachnoid hemorrhage (aSAH) remains a critical cause of neurological morbidity and mortality.
  • Microsurgical clip occlusion and endovascular coil embolization are primary treatment modalities for ruptured cerebral aneurysms.
  • Comparative long-term outcome data are essential for guiding treatment decisions.

Purpose of the Study:

  • To compare the safety, efficacy, and functional outcomes of microsurgical clipping versus endovascular coiling for acutely ruptured cerebral aneurysms.
  • To report the 3-year results of the randomized Barrow Ruptured Aneurysm Trial (BRAT).

Main Methods:

  • A randomized trial comparing clip occlusion (n=238) and coil embolization (n=233) for ruptured cerebral aneurysms.
  • Primary outcome analysis based on initial treatment assignment; modified Rankin Scale (mRS) used for outcome assessment (poor outcome defined as mRS > 2).
  • 3-year follow-up data available for 349 treated patients, with analysis considering aneurysm location.

Main Results:

  • No significant difference in poor outcome rates between clipping and coiling at 3 years (35.8% vs 30%, p=0.25).
  • Clipping demonstrated significantly higher aneurysm obliteration rates and lower recurrence and retreatment rates (p=0.0001 and p=0.01, respectively).
  • Anterior circulation aneurysms showed no significant outcome difference between groups; posterior circulation aneurysms had better outcomes with coiling after 1 year, persisting at 3 years.

Conclusions:

  • While not statistically significant, coil embolization showed a favorable trend in outcomes at 3 years.
  • Clip occlusion achieved superior aneurysm obliteration and reduced recurrence and retreatment rates.
  • Anterior circulation aneurysms had comparable outcomes regardless of treatment modality; posterior circulation aneurysms favored coiling at long-term follow-up.