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Related Experiment Video

Updated: Aug 2, 2025

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

Published on: August 11, 2015

[Ruptured Cerebral Aneurysm:Indications and Outcomes].

Toshio Higashi¹

¹Department of Neurosurgery, Fukuoka University Chikushi Hospital.

No Shinkei Geka. Neurological Surgery

|April 13, 2023

Summary

Endovascular coiling is superior to neurosurgical clipping for treating ruptured cerebral aneurysms, improving both short-term and long-term patient outcomes. This finding guides optimal treatment selection for ruptured brain aneurysms.

Area of Science:

Neurosurgery
Interventional Neurology
Vascular Neurology

Background:

Ruptured cerebral aneurysms pose a significant risk of rebleeding, necessitating effective treatment strategies.
Treatment options have evolved from surgical clipping to endovascular coil embolization.
Comparing treatment efficacy is crucial for improving patient outcomes.

Purpose of the Study:

To compare the effectiveness of endovascular coiling versus neurosurgical clipping for ruptured cerebral aneurysms.
To evaluate the impact of treatment choice on patient survival and functional independence.
To inform clinical decision-making for ruptured intracranial aneurysms.

Main Methods:

Analysis of data from the International Subarachnoid Aneurysm Trial (a multicenter randomized controlled trial).

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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

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Published on: August 11, 2015

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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment

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Review of findings from the Barrow Ruptured Aneurysm Trial and multiple meta-analyses.

Evaluation of short- and long-term clinical outcomes, including survival and activities of daily living.

Main Results:

Endovascular coiling showed superiority over neurosurgical clipping in reducing poor outcomes at 1 year (23.7% vs. 30.6%, p = 0.0019).
Long-term follow-up (10 years) indicated higher rates of survival and independence in the coiling group (OR: 1.34; 95% CI: 1.07-1.67).
Multiple studies and meta-analyses corroborate the advantages of endovascular coiling.

Conclusions:

Endovascular coiling is the preferred treatment for ruptured cerebral aneurysms, offering better clinical outcomes than neurosurgical clipping.
Advances in medical devices and techniques continue to enhance endovascular treatment efficacy.
Personalized treatment selection based on aneurysm characteristics and clinical findings is essential.