title: Endovascular coiling versus neurosurgical clipping in patients with a ruptured basilar tip aneurysm.
abstract: OBJECTIVE
  To compare endovascular coiling with neurosurgical clipping of ruptured basilar bifurcation aneurysms.
  
  
  METHODS
  Patient and aneurysm characteristics, procedural complications, and clinical and anatomical results were compared retrospectively in 44 coiled patients and 44 patients treated by clipping. The odds ratios for poor outcome (Glasgow outcome scale 1, 2, 3) adjusted for age, clinical condition, and aneurysm size were assessed by logistic regression analysis.
  
  
  RESULTS
  In the endovascular group, five patients (11%) had a poor outcome v 13 (30%) in the surgical group; the adjusted odds ratio for poor outcome after coiling v clipping was 0.28 (95% confidence interval, 0.08 to 0.99). Procedural complications were more common in the surgical group. Optimal or suboptimal occlusion of the aneurysm immediately after coiling was achieved in 41 patients (93%). Clipping was successful in 40 patients (91%).
  
  
  CONCLUSIONS
  The results suggest that embolisation with coils is the preferred treatment for patients with ruptured basilar bifurcation aneurysms.
authors.affiliation: Department of Neurology, St Elisabeth Hospital, Tilburg, Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Lusseveld
authors.forename: E H
authors.initials: EH
authors.lastname: Brilstra
authors.forename: P C G
authors.initials: PC
authors.lastname: Nijssen
authors.forename: W J J
authors.initials: WJ
authors.lastname: van Rooij
authors.forename: M
authors.initials: M
authors.lastname: Sluzewski
authors.forename: C A F
authors.initials: CA
authors.lastname: Tulleken
authors.forename: D
authors.initials: D
authors.lastname: Wijnalda
authors.forename: R L L A
authors.initials: RL
authors.lastname: Schellens
authors.forename: Y
authors.initials: Y
authors.lastname: van der Graaf
authors.forename: G J E
authors.initials: GJ
authors.lastname: Rinkel
mesh_terms: D017542:Aneurysm, Ruptured / Q000150:complications / Q000473:pathology / Q000601:surgery*; D001488:Basilar Artery / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000473:pathology / Q000601:surgery*; D007431:Intraoperative Complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation*; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D012189:Retrospective Studies