title: Outcomes of endovascular coiling versus surgical clipping in the treatment of ruptured intracranial aneurysms.
abstract: OBJECTIVE
  The effects of treatment modality (endovascular coiling or surgical clipping) on incidence of cerebral vasospasm and infarction following aneurysmal subarachnoid haemorrhage (aSAH) remain controversial. This study compared outcomes between endovascular coiling versus surgical  clipping to treat patients with acute (< 72 h) aSAH.
  
  
  METHODS
  Patients with aSAH were randomized to receive endovascular or surgical treatment. All patients underwent clinical assessments, angiography and brain computed tomography.
  
  
  RESULTS
  Data from 186 patients were analysed: 94 in the  endovascular group and 92 in the surgical group. Demographics and severity of aSAH were comparable between the groups. Incidence of symptomatic vasospasm, cerebral infarction and complete occlusion were significantly lower in the endovascular coiling group than in the surgical clipping group.  Good clinical recovery 12 months after aSAH was seen in 75.0% and 69.7% of surviving patients in the endovascular versus coiling group, respectively.
  
  
  CONCLUSIONS
  In this study, coiling yielded less symptomatic vasospasm, cerebral infarction and complete occlusion than surgical clipping, with  no between-group differences in clinical outcome.
authors: Department of Neurosurgery, Fengxian District Central Hospital (Branch Hospital of Shanghai Sixth People's Hospital), Shanghai Jiaotong University, Shanghai, China.
authors: Z-Q
authors: ZQ
authors: Li
authors: Q-H
authors: QH
authors: Wang
authors: G
authors: G
authors: Chen
authors: Z
authors: Z
authors: Quan
mesh_terms: D017542:Aneurysm, Ruptured / Q000601:surgery*; D002544:Cerebral Infarction; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D013345:Subarachnoid Hemorrhage / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000209:etiology*