Short-term Outcome of Clipping vs. Coiling of Ruptured Intra-Cranial Aneurysms Treated by Dual-Trained Cerebrovascular Surgeon: Single Institution Experience

Abstract Objective Studies that showed endovascular coiling of ruptured intracranial aneurysms (RAs) to be superior to microsurgical clipping were comparing dedicated endovascular interventionalists vs. open cerebrovascular surgeons. This is the first study to evaluate outcomes of coiling vs. clipping of RAs treated by a dual trained cerebrovascular surgeon using a specific intervention protocol. Methods The prospectively maintained database was reviewed for all patients with RAs undergoing endovascular coiling (+/- stenting) or clipping by the senior author (dual trained vascular neurosurgeon) between July 2010 and April 2015. Results In 252 identified patients, 70 underwent clipping and 182 underwent endovascular treatment. The mean and median time to last follow-up were 179.6 and 176.5 days in the endovascular cohort, 203.9 and 154.0 days in the surgical cohort. There was no difference in age, gender, WFNS and Fisher grade, mean aneurysm size and LOS in the hospital/ICU. Clipping had a higher proportion of MCA aneurysms (37.1% vs. 8.8%; p