Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr Soetomo General Academic Hospital, Surabaya, Indonesia.
Department of Public Health, Faculty of Medicine Universitas Airlangga, Dr Soetomo General Academic Hospital, Surabaya, Indonesia.
Neurosurg Rev. 2023 Oct 20;46(1):276. doi: 10.1007/s10143-023-02179-x.
SAH (subarachnoid hemorrhage) caused by aneurysm rupture has the greatest mortality rate, with nearly 50% of patients unable to survive beyond 1 month after the attack. Anterior choroidal artery (AChA) aneurysms are one of the most difficult to treat among the numerous types of aneurysms. Until now, some neurosurgeons employed shearing while others employed coiling. In this trial, researchers will compare surgical clipping and endovascular coiling treatments for anterior choroidal artery aneurysms in terms of mortality, rebleeding, retreatment, and post-procedure outcomes. Using the PubMed electronic database, the Cochrane library, the Medline Database, the Directory of Open Access Journals, and EBSCHOHOST, a systematic review compared surgical clipping and endovascular coiling in all cases of choroidal artery aneurysm. There were 17 studies that met the eligibility requirements, with a total of 1486 patients divided into groups that underwent clipping (1106) or endovascular coiling (380). The mortality rate for clipping is 1.8%, while the mortality rate for endovascular coiling is 2.34%. Rebleeding occurs in 0% of patients undergoing endovascular coiling and 0.73% of patients undergoing clipping. Retreatment of clipping was 0.27%, while endovascular coiling was 3.42%. Post-complication procedures occurred in 11.12% of patients undergoing endovascular clipping and 15.78% of patients undergoing endovascular coiling. The intervention technique of clipping has a reduced rate of mortality, reoperation, and post-operative complications. Endovascular coiling results in a reduced rate of rebleeding than clipping.
颅内出血（SAH）由动脉瘤破裂引起，死亡率最高，近 50%的患者在发病后 1 个月内无法存活。前交通动脉（AChA）动脉瘤是众多动脉瘤中最难治疗的一种。到目前为止，一些神经外科医生采用夹闭，而另一些则采用线圈栓塞。在这项试验中，研究人员将比较手术夹闭和血管内线圈栓塞治疗前交通动脉动脉瘤的死亡率、再出血、再治疗和术后结果。研究人员使用 PubMed 电子数据库、Cochrane 图书馆、Medline 数据库、开放获取期刊目录和 EBSCHOHOST 对所有脉络膜动脉瘤病例进行了系统评价，比较了手术夹闭和血管内线圈栓塞。有 17 项研究符合入选标准，共有 1486 名患者分为夹闭组（1106 名）和血管内线圈栓塞组（380 名）。夹闭组的死亡率为 1.8%，而血管内线圈栓塞组的死亡率为 2.34%。血管内线圈栓塞组无再出血病例，而夹闭组有 0.73%的患者再出血。夹闭组的再治疗率为 0.27%，而血管内线圈栓塞组为 3.42%。血管内线圈栓塞组术后并发症发生率为 11.12%，夹闭组为 15.78%。夹闭的干预技术具有较低的死亡率、再手术和术后并发症发生率。血管内线圈栓塞的再出血率低于夹闭。
