Turkish Neurosurgery
Mortality outcomes of endovascular treatment and surgical clipping in patients with cerebral aneurysms: a single-center study
Abdullah Sukun1, Mustafa Cetin2, Ahmet Alparslan2, Ramazan Uyar3, Tolga Gediz3, Bülent Cekic2, Mert Koroglu2
1Kars Harakani State Hospital, Radiology, Kars,
2Antalya Education and Research Hospital, Radiology, Antalya,
3Antalya Education and Research Hospital, Neurosurgery, Antalya,
DOI: 10.5137/1019-5149.JTN.33877-21.2
Aim:Cerebral aneurysms are commonly treated using endovascular methods or surgical clipping. We aimed to compare the two treatment methods in terms of mortality. Material and Methods:The study included 187 patients who had undergone aneurysm treatment. The patients were divided into four groups according to their treatment modality and subarachnoid hemorrhage status: patients with endovascular treatment and bleeding aneurysms (EVG-b), patients with endovascular treatment and non-bleeding aneurysms (EVG-nb), patients with surgical clipping and bleeding aneurysms (SCG-b), and patients with surgical clipping and non-bleeding aneurysms (SCG-nb). The Hunt–Hess scores, Fisher grade, aneurysm morphology, and length of stay (LOS) were compared between groups. Results:There was no significant difference in the mortality rate between EVG-b and SCG-b at the end of the first year (23.5% and 39.7%, respectively; p > 0.05). A significantly shorter LOS was observed in EVG-b than in SCG-b (11.5 days and 15 days, respectively; p = 0.027). Fusiform aneurysms were associated with higher patient mortality, whereas saccular aneurysms were associated with a 1.9-fold higher survival (p < 0.037; 95% confidence interval: 0.83–4.74). The rate of closure of non-bleeding aneurysms was 93.4%. Complete embolization was verified in all bleeding aneurysms. In EVG-nb, the morbidity rate was 5%, the mortality rate was 3%, and the mean LOS was 2.86 days.Conclusion:Both treatment methods showed similar mortality rates, but hospital stays were shorter after endovascular treatment.
Corresponding author : Abdullah Sukun