title: Unruptured intracranial aneurysms: comparison of perioperative complications, discharge disposition, outcome, and effect of calcification, between clipping and coiling: a single institution experience.
abstract: OBJECTIVE
  The aim of the study was to compare the perioperative complications, obliteration rates, discharge dispositions, clinic-radiological outcomes, and the role of calcification between the microsurgical and endovascular treatment of unruptured intracranial aneurysms.
  
  
  METHODS
  Retrospective data of the patients treated with microsurgical clipping and those treated by endovascular coiling from January 2007 to August 2012 was collected from the database.
  
  
  RESULTS
  Intraoperative rupture was not different in both the treatment groups (4.05% vs. 1.5% clip vs. coil). A total of 9.4% of the patients in the clipping group and 4.5% of the patients in the coiling group suffered postoperative stroke. At last follow up, 89% of the patients in the clipping group and 93% of the patients in the coiling group had favorable outcomes. The mean length of stay was more in clipping group (6.1 vs. 2.7, clip vs. coil, P < 0.05). Patients discharged to home without assistance/rehabilitation services were more in coiling ( P = 0.001). A total of 28.4% (23/81) of the coiled aneurysms were found to have residue neck on postoperative angiograms as compared with 12.6% (10/79) of the clipped aneurysms ( P = 0.01). Calcification within the aneurysm was strongly correlated to the size, perioperative complications, and the outcome ( P < 0.05). However, on excluding the calcified cases the size and outcome do not show a significant correlation.
  
  
  CONCLUSIONS
  With appropriate patient selection, the majority of the UIAs can be managed by either of the treatment modalities with very low mortality and morbidity. Both the treatment modalities should be employed synergistically.
authors.affiliation: Department of Neurosurgery, Louisiana State University Health Science Center, Shreveport, Louisiana 71130-3932, USA.
authors.forename: Mayur
authors.initials: M
authors.lastname: Sharma
authors.forename: Benjamin
authors.initials: B
authors.lastname: Brown
authors.forename: Venkatesh
authors.initials: V
authors.lastname: Madhugiri
authors.forename: Hugo
authors.initials: H
authors.lastname: Cuellar-Saenz
authors.forename: Ashish
authors.initials: A
authors.lastname: Sonig
authors.forename: Sudheer
authors.initials: S
authors.lastname: Ambekar
authors.forename: Anil
authors.initials: A
authors.lastname: Nanda
mesh_terms: D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery / Q000628:therapy*; D007431:Intraoperative Complications / Q000453:epidemiology*; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000706:statistics & numerical data*; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome