RT Journal Article
SR Electronic
T1 Endovascular coiling versus neurosurgical clipping in patients with a ruptured basilar tip aneurysm
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 591
OP 593
DO 10.1136/jnnp.73.5.591
VO 73
IS 5
A1 E Lusseveld
A1 E H Brilstra
A1 P C G Nijssen
A1 W J J van Rooij
A1 M Sluzewski
A1 C A F Tulleken
A1 D Wijnalda
A1 R L L A Schellens
A1 Y van der Graaf
A1 G J E Rinkel
YR 2002
UL http://jnnp.bmj.com/content/73/5/591.abstract
AB Objectives: 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.