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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Clipping versus coiling for intracranial aneurysms

Marcin Birski1, Cezary Wałęsa2, Witold Gaca2

  • 1Neurosurgery Department, 10th Military Research Hospital, Bydgoszcz, Poland.

Neurologia I Neurochirurgia Polska
|May 14, 2014
PubMed

Insights

Clipping and coiling for anterior circle of Willis aneurysms show similar overall results. However, coiling is better for bleeding aneurysms, while clipping offers advantages for non-bleeding cases.

Area of Science:

  • Neurosurgery
  • Interventional Neurology
  • Vascular Neurology

Background:

  • Anterior circle of Willis aneurysms pose significant risks.
  • Surgical clipping and endovascular coiling are primary treatment modalities.
  • Comparative effectiveness of these treatments remains debated.

Purpose of the Study:

  • To compare the outcomes of clipping versus coiling for anterior circle of Willis aneurysms.
  • To evaluate treatment efficacy based on aneurysm status (bleeding vs. non-bleeding).
  • To assess long-term results, including neurological status and quality of life.

Main Methods:

  • A cohort of 165 consecutive patients undergoing treatment for aneurysms.
  • Assessment included risk of death, Glasgow Outcome Scale (GOS), modified Rankin Scale (mRS), and quality of life (EORTC QLQ-C30).
  • Follow-up averaged over four years.

Main Results:

  • No significant overall difference in early or late outcomes between clipping and coiling.
  • Coiling showed better outcomes for bleeding aneurysms, notably in quality of life scores (p=0.02).
  • Clipping demonstrated superior early results for non-bleeding aneurysms, with more excellent GOS scores (p<0.03) and fewer complications (p=0.02).

Conclusions:

  • Treatment outcomes for anterior circle of Willis aneurysms do not differ significantly overall between clipping and coiling.
  • Coiling is associated with better outcomes in patients with bleeding aneurysms.
  • Clipping appears more advantageous for patients with non-bleeding aneurysms.
Abstract

Keywords:
Intracranial aneurysmOutcomeSubarachnoid haemorrhage

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