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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

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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...
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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: Apr 8, 2026

Arterial Pouch Microsurgical Bifurcation Aneurysm Model in the Rabbit
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The Barrow Ruptured Aneurysm Trial: 6-year results.

Robert F Spetzler1, Cameron G McDougall1, Joseph M Zabramski1

  • 1Divisions of 1 Neurological Surgery, and.

Journal of Neurosurgery
|June 27, 2015
PubMed
Summary
This summary is machine-generated.

The Barrow Ruptured Aneurysm Trial (BRAT) found surgical clipping and endovascular coiling offer similar outcomes for anterior circulation aneurysms. However, coil embolization showed a sustained advantage for posterior circulation aneurysms over six years.

Keywords:
BRATBRAT = Barrow Ruptured Aneurysm TrialISATISAT = International Subarachnoid Aneurysm TrialPICA = posterior inferior cerebellar arterySAH = subarachnoid hemorrhageclip occlusioncoil embolizationintracranial aneurysmmRS = modified Rankin Scalerandomized trialsubarachnoid hemorrhagevascular disorders

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Area of Science:

  • Neurosurgery
  • Interventional Neurology
  • Vascular Surgery

Background:

  • Subarachnoid hemorrhage (SAH) from ruptured aneurysms presents significant morbidity and mortality.
  • Surgical clipping and endovascular coiling are primary treatment modalities.
  • The Barrow Ruptured Aneurysm Trial (BRAT) investigates the long-term safety and efficacy of these treatments.

Purpose of the Study:

  • To compare the 6-year outcomes of surgical clip occlusion versus endovascular coil embolization for ruptured aneurysms.
  • To assess treatment safety, efficacy, and long-term results.

Main Methods:

  • Randomized trial comparing surgical clipping and endovascular coiling in 408 patients with SAH.
  • Primary outcome based on modified Rankin Scale (mRS) score > 2.
  • Follow-up data collected at 6 years post-randomization.

Main Results:

  • No significant difference in outcomes (mRS > 2) between clipping and coiling for anterior circulation aneurysms.
  • Coil embolization demonstrated a sustained advantage for posterior circulation aneurysms.
  • Aneurysm obliteration rates were higher with clipping (96%) versus coiling (48%), with higher retreatment rates for coiling (16.4%) vs. clipping (4.6%).

Conclusions:

  • Surgical clipping and endovascular coiling show comparable outcomes for anterior circulation aneurysms.
  • Endovascular coiling appears to offer a sustained benefit for posterior circulation aneurysms.
  • Further randomized trials are warranted to clarify the relative benefits of these treatment modalities.