title: The role of endovascular treatment for ruptured distal anterior cerebral artery aneurysms: comparison with microsurgical clipping.
abstract: OBJECTIVE
  The purpose of this study was to compare clinical outcomes and treatment-related complications between coiling and clipping for ruptured distal anterior cerebral artery (DACA) aneurysms.
  
  
  METHODS
  Eighty-four consecutive patients (M:F = 36:48; mean 53.8 years) with ruptured DACA aneurysms were treated by either clipping (n = 46, 54.8%) or coiling (n = 38, 45.2%). The clinical outcomes and procedure-related complications were evaluated and compared between the two groups.
  
  
  RESULTS
  Procedure-related complications tend to occur more frequently in the clipping (n = 6, 13.0%) than coiling group (n = 1, 2.6%) (P = .121). At discharge, 51 patients (60.7%) had favorable outcomes (Glasgow outcome scale [GOS], 4 or 5). There was no significant difference between the two groups in favorable outcome (63.2% vs. 58.7%; P = .677). Hunt and Hess (HH) grade (P < .001; 95% CI, 3.354-29.609) and treatment modality (P = .044; 95% CI, 1.039-16.325) were independent risk factors for poor outcome (GOS, 1-3).
  
  
  CONCLUSIONS
  Coiling was more favorable to clipping in clinical outcomes and incidence of treatment-related complications for ruptured DACA aneurysms.
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Keun Young
authors.initials: KY
authors.lastname: Park
authors.forename: Byung Moon
authors.initials: BM
authors.lastname: Kim
authors.forename: Yong Cheol
authors.initials: YC
authors.lastname: Lim
authors.forename: Joonho
authors.initials: J
authors.lastname: Chung
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Kim
authors.forename: Jin Yang
authors.initials: JY
authors.lastname: Joo
authors.forename: Seung Kon
authors.initials: SK
authors.lastname: Huh
authors.forename: Dong Ik
authors.initials: DI
authors.lastname: Kim
authors.forename: Kyu Chang
authors.initials: KC
authors.lastname: Lee
authors.forename: Jae Whan
authors.initials: JW
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods; D002548:Cerebral Revascularization / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D025321:Surgery, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome
keywords: Intracranial aneurysm; complications; distal anterior cerebral artery; outcome; ruptured; treatment