Open AccessEndovascular coiling versus surgical clipping in the treatment of ruptured anterior communicating artery aneurysm in Cairo University Hospitals
Author(s) -
Ayman Z. Ahmed,
Ahmed M. Zohdi,
Mohamed S. Zaghloul,
Amr K. Elsamman
Publication year - 2013
Publication title -
the egyptian journal of radiology and nuclear medicine /the egyptian journal of radiology and nuclear medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.19
H-Index - 13
eISSN - 2090-4762
pISSN - 0378-603X
DOI - 10.1016/j.ejrnm.2013.06.007
Subject(s) - medicine , endovascular coiling , surgery , clipping (morphology) , subarachnoid hemorrhage , aneurysm , anterior communicating artery , neurosurgery , endovascular treatment , linguistics , philosophy
Aneurysmal Subarachnoid Hemorrhage (SAH) remains a devastating and often fatal form of stroke. The aneurysm is targeted for obliteration to prevent re-bleeding and to manage the possible complications from the event. Endovascular coiling has emerged as a less invasive alternative to conventional surgical clipping to treat aneurysms.Patients and methodsThis study was done prospectively in the Cairo University (Kasr El-Eini) hospitals to evaluate the outcome of both modalities used in the treatment of ruptured anterior communicating artery (Acom) aneurysm. 30 patients with Hunt and Hess grade I, II or III. were classified into two groups of microsurgical clipping (Endoscopic assistance used in five cases) and endovascular coiling.ResultsMortality rate was higher in the clipping group (26.7%) compared to the coiling group while recurrence rate was high in the coiling group (26.7%). Complications including hydrocephalus, hemiparesis and failed procedures occurred in (6.7%).ConclusionWe concluded that coiling is better for treating cases of ruptured Acom aneurysms being less invasive and achieving a favorable outcome compared to surgery. While Endoscope-Assisted Microsurgical Clipping (EAM) gives better control during clipping provided that a well-trained, competent and experienced neurosurgeon is available