Fotakopoulos George, Tsianaka Eleni, Fountas Kostas, Makris Demosthenes, Spyrou Michael, Hernesniemi Juha
Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Larissa, Thessaly, Greece.
Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Larissa, Thessaly, Greece.
World Neurosurg. 2017 Aug;104:482-488. doi: 10.1016/j.wneu.2017.05.040. Epub 2017 May 16.
To evaluate open surgical versus endovascular repair of anterior circulation ruptured intracranial aneurysms based on operative mortality, permanent neurologic deficit, late mortality, and need for reintervention.
This meta-analysis included articles published since December 6, 2016, that compared outcomes of the 2 methods. Extracted data were organized in a standard table format, including first author, country, covered study period, publication year, number of patients and patients at follow-up, operative mortality rate (with 30 days from treatment), permanent neurologic deficit (appearing after surgery), late mortality (after 1 month), and reintervention (surgery or coiling) for both groups of patients. Follow-up was at least 1 year.
There were 8 articles that matched our study criteria. The study population was 628 patients; 374 were treated with surgical clipping, and 254 were treated with endovascular coiling. Pooled results showed no statistically significant difference between the 2 groups in terms of operative mortality, permanent neurologic deficit, late mortality, and need for reintervention.
Selection of the appropriate procedure must be made on the basis of the special characteristics of each case.
基于手术死亡率、永久性神经功能缺损、晚期死亡率及再次干预需求，评估前循环破裂颅内动脉瘤的开放手术与血管内修复效果。
本荟萃分析纳入自2016年12月6日以来发表的比较这两种方法疗效的文章。提取的数据以标准表格形式整理，包括第一作者、国家、涵盖的研究时期、发表年份、患者数量及随访患者数量、手术死亡率（治疗后30天内）、永久性神经功能缺损（手术后出现）、晚期死亡率（1个月后）以及两组患者的再次干预（手术或栓塞）情况。随访时间至少为1年。
有8篇文章符合我们的研究标准。研究对象为628例患者；374例行手术夹闭治疗，254例行血管内栓塞治疗。汇总结果显示，两组在手术死亡率、永久性神经功能缺损、晚期死亡率及再次干预需求方面无统计学显著差异。
必须根据每个病例的特殊情况选择合适的手术方式。
