title: Single-center experience of surgical and endovascular treatment of ruptured intracranial aneurysms.
abstract: OBJECTIVE
  ISAT provided valuable data on patient outcome after endovascular coiling and surgical clipping of ruptured aneurysms. The purpose of this study was to retrospectively review the ≥1-year outcome (in terms of survival, independence, and rebleeding) of patients who were treated in a routine clinical setting.
  
  
  METHODS
  Records of patients presenting with an SAH from a ruptured aneurysm between 2000 and 2008 were reviewed. The 403 patients who met the inclusion criteria harbored 443 treated aneurysms; 173 were managed surgically and 230 by endovascular means. Mean clinical follow-up was 33.9 months (range, 12-106 months).
  
  
  RESULTS
  The pretreatment clinical condition according to the HH was significantly better in the surgically treated patients (P = .018). Death occurred in 11.6% after surgery and in 17.4% after endovascular treatment (P = .104). Of the surviving patients in the surgical and endovascular groups, 80.3% and 87.2%, respectively, were able to live independently with grades 0-2 on the mRS (P = .084). Complete aneurysm occlusion was achieved significantly more often after surgical treatment (P < .001). Rebleeding occurred in 3.1% and 2.3% of the patients after surgical treatment and endovascular coiling, respectively. The occurrence of a residual aneurysm at the end of a coiling procedure was significantly related to the frequency of rebleeding (P = .007).
  
  
  CONCLUSIONS
  The management of patients with intracranial aneurysms in a routine clinical setting shows good and comparable rates of mortality and independence. Coiling results in lower rates of complete aneurysm occlusion. Postcoiling angiography showing a residual aneurysm is a good predictor of the risk of rebleeding.
authors.affiliation: Department of Radiology, Maastricht University Medical Center, the Netherlands.
authors.forename: E G
authors.initials: EG
authors.lastname: Klompenhouwer
authors.forename: J T A
authors.initials: JT
authors.lastname: Dings
authors.forename: R J
authors.initials: RJ
authors.lastname: van Oostenbrugge
authors.forename: S
authors.initials: S
authors.lastname: Oei
authors.forename: J T
authors.initials: JT
authors.lastname: Wilmink
authors.forename: W H
authors.initials: WH
authors.lastname: van Zwam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000453:epidemiology*; D004621:Embolization, Therapeutic / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data*; D055815:Young Adult