Clipping versus Coiling for Intracranial Aneurysms: Recent Trends

摘要: Background: Cerebral aneurysms are relevant conditions, and the best therapeutic approach in a patient with Ruptured Unruptured Intracranial Aneurysm has been debated last decades. Coil Embolization therapy increasingly gained popularity over Surgical Clipping. Objectives: The aim of this analysis was to review surgical endovascular strategies for intracranial aneurysms, find out if one intervention is more suitable than other. Methods: A literature carried identifying studies published from 2002-2017 through Pubmed using keywords listed below. 75 articles were selected write review. Results: International Subarachnoid Trial contributed change practice Aneurysms. Endovascular Coiling reduced 7,4% proportion patients who died or became dependent, even incidence late rebleeding higher at 1 year compared Neurosurgery (2,9% vs. 0,9%). At 18 years excess risk not resulted significant worse outcome. treatment usually anterior posterior circulating aneurysms. Middle cerebral generally treated clipping. Asymptomatic Aneurysms smaller 7 mm benefit simple observation. Despite its benign natural history number increased overtime. Higher mortality associated strategy. Anaesthesia applied clipping similar endovascular. most common approaches general anaesthesia conscious sedation. Conclusions: There strong evidence indicate that embolization better outcomes Neurosurgical Clipping amenable either major technical advances imaging still efficient medial artery