Clipping versus coiling in posterior circulation intracranial aneurysms: a meta-analysis

Chinese Neurosurgical Journal

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[1] 0000 0000 6686 1816, grid.418542.e, Department of Neurotraumatology, “N.N. Burdenko” Neurosurgery Institute, 16 4th Tverskaya – Yamskaya Str., Moscow, Russia;0000 0000 6686 1816, grid.418542.e, Department of Spine Neurosurgery, “N.N. Burdenko” Neurosurgery Institute, 16 4th Tverskaya – Yamskaya Str., Moscow, Russia;0000 0004 0637 234X, grid.414506.2, Department of Neurosurgery, Ibn Sina Hospital, Sabah Medical Area, Shuwaikh, Kuwait;Department of Neurosurgery, Ygeia Private Hospital, Golgon 33, 3025, Limassol, Cyprus;grid.411299.6, Department of Neurosurgery, University Hospital of Larissa, Viopolis, 41111, Larissa, Greece;grid.411299.6, Department of Neurosurgery, University Hospital of Larissa, Viopolis, 41111, Larissa, Greece;0000 0000 6686 1816, grid.418542.e, Department of Spine Neurosurgery, “N.N. Burdenko” Neurosurgery Institute, 16 4th Tverskaya – Yamskaya Str., Moscow, Russia;

关键词: Clipping;    Coiling;    Intracranial aneurysms;    Meta-analysis;    Posterior circulation;   

DOI  :  10.1186/s41016-019-0163-x

来源: publisher

【 摘 要 】

BackgroundPosterior circulation intracranial aneurysm (IA) treatment remains challenging, due to the anatomy of the area and the high rupture possibility. Endovascular treatment seems to be more suitable for these aneurysms, but studies focused on endovascular treatment demonstrate a high rate of re-intervention needing. A meta-analysis might offer a clearer view, being useful in a more effective treatment planning.MethodsA systematic search was performed, using the PubMed database platform. The final article pool contained 20 articles. Studied parameters were operative mortality, late mortality, permanent neurologic deficit (PND), and the need for re-intervention (Re-int). We divided patients into two subgroups, those with ruptured and those with unruptured aneurysm. Statistical analysis was performed using appropriate software.ResultsIn the total population (645 patients), there was a superiority of coiling over clipping in terms of PND and of coiling in terms of Re-int. As regards mortality, there was no clear superiority of one method over the other.ConclusionsThe current study came to the conclusion that there is a superiority of coiling over clipping in terms of PND. On the other hand, clipping seems to be superior to coiling in terms of the need for re-intervention. As regards mortality (both operative and late), there is no clear superiority of one method over the other. Studying subgroups of patients (ruptured and unruptured posterior circulation IAs), in terms of PND, there is no superiority of one method over the other. The same goes for Op-Mo on ruptured aneurysms.

【 授权许可】

CC BY