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For patients in good clinical condition with ruptured aneurysms of either the anterior or posterior circulation, we have firm evidence that if the aneurysm is considered suitable for surgical clipping and endovascular treatment, coiling is associated with a better outcome. For patients in poor clinical grades, there is no reliable randomized evidence comparing the risks and benefits of coiling versus clipping. Because coiling is less invasive than surgery, also in patients with poor clinical condition, coiling seems the preferred option. A disadvantage of coiling is that aneurysms are more often incompletely treated (90% to 100% obliteration) and carry a risk for reopening. The long-term follow-up (>1 year after SAH) of coiled patients, with regard to renewed filling of the aneurysm, is an unknown but important issue that needs further study. |
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aneurysm
aneurysm,clipping
aneurysm,intracranial
aneurysm,intracranial,treatment of
aneurysm,ruptured
controversies in neurology
embolization,therapeutic
embolization,therapeutic,coils
endovascular therapy
review article
subarachnoid hemorrhage
treatment of neurologic disorder
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