Endovascular Treatment and Microsurgical Clipping for Intracranial Aneurysms: A Comprehensive Comparative Study

Area of Science:

• Neurosurgery
• Interventional Neurology

Background:

• Intracranial aneurysms can rupture, causing subarachnoid hemorrhage (SAH) with severe neurological deficits.
• Endovascular treatment presents a minimally invasive alternative to surgical clipping, potentially reducing morbidity and improving recovery.
• Comparing clinical profiles, outcomes, and prognostic factors of both treatment modalities is crucial for optimal patient management.

Purpose of the Study:

• To compare the clinical characteristics, treatment outcomes, and prognostic factors between microsurgical clipping and endovascular treatment for intracranial aneurysms.
• To evaluate the efficacy and safety of both surgical and endovascular approaches in managing intracranial aneurysms.
• To identify predictors of poor outcomes in patients undergoing treatment for intracranial aneurysms.

Main Methods:

• A retrospective analysis of 103 patients treated for intracranial aneurysms between January 2018 and December 2023.
• Data collection included demographics, clinical presentation, aneurysm characteristics, and treatment details for both microsurgical clipping (n=53) and endovascular treatment (n=50) groups.
• Statistical analyses, including Chi-square and t-tests, were employed to compare outcomes and identify significant predictors of poor prognosis.

Main Results:

• No significant age difference between clipping (52.43 years) and endovascular (54.42 years) groups (P=0.951).
• Microsurgical clipping had a significantly longer operative time (120.5 min) compared to endovascular treatment (68.53 min, P<0.001).
• Higher postoperative complications were observed in the clipping group, though endovascular patients experienced shorter hospital stays (18.30 days vs. 27.55 days, P=0.162).

Conclusions:

• Both endovascular treatment and microsurgical clipping are effective for intracranial aneurysms, with distinct advantages.
• Endovascular treatment offers a less invasive option with shorter hospital stays and potentially better long-term outcomes.
• Microsurgical clipping ensures durable occlusion and is vital for complex aneurysms; treatment choice requires individualization based on aneurysm and patient factors.