Neurosurgical Clipping Versus Endovascular Coiling For Treatment Of Intracranial Aneurysms: A Clinical Comparative Study

Objective:There are two main therapeutic methods for intracranial aneurysms: neurosurgical clipping and endovascular coiling.Neurosurgical clipping is a traditional therapeutic method and called "golden standard" for treatment of intracranial aneurysms.Endovascular coiling is a newly rising therapeutic method and became more popular in the last decade.Now the amount of endovascular coiling is more than neurosurgical clipping in many hospital,although there are many disputes for the two methods.We compare the postoperative results of neurosurgical clipping or endovascular coiling in patients with intracranial aneurysms by retrospective analysis.Methods:244 patients with intracranial aneurysms treated with neurosurgical clipping or endovascular coiling were reviewed between January 2002 and December 2007.We reserved the data suitable for both two methods while removed follows:①aneurysms in bifurcation of middle cerebral artery;②aneurysms of posterior circulation;③giant aneurysms,wide-necked aneurysms,complicated aneurysms;④age＞70,patients with bad condition;⑤Hunt-Hess SAH classification grade 5;⑥aneurysms of C4 and C5.78 with neurosurgical clipping and 99 with endovascular coiling were used in our analysis.Results:The rates of poor outcomes in the groups of neurosurgical clipping and endovascular coiling were respectively 6.4%and 9.0%(χ2=0.406,P＞0.5);the mortalities were respectively 2.6%and 4.0%(χ2=0.012,P＞0.9);the rates of postoperative complications were respectively 25.6%and 11.0%(χ2=6.531,P＜0.05).Conclusion:The rates of postoperative complications with endovascular coiling was lower than neurosurgical clipping while the rates of poor outcomes in the groups of neurosurgical clipping and endovascular coiling were closed and low.