Turkish Neurosurgery
Outcomes of surgical and endovascular treatment of intracranial aneurysms: a single-center analysis of 1183 patients
Baris Peker1, Ilyas Dolas1, Tugrul Cem Unal1, Cafer Ikbal Gulsever1, Duran Sahin1, Musa Samet Ozata1, Metehan Ozturk1, Mustafa Selim Sahin1, Eren Andic1, Gorkem Alkir2, Onur Ozturk3, Pulat Akin Sabanci1, Aydin Aydoseli1, Altay Sencer1, Ali Nail Izgi1, Yavuz Aras1
1Istanbul University, Istanbul Faculty of Medicine, Neurosurgery, Istanbul,
2Bakirkoy Dr Sadi Konuk Training and Research Hospital, Neurosurgery, Istanbul,
3Acibadem Taksim Hospital, Neurosurgery, Istanbul,
DOI: 10.5137/1019-5149.JTN.44988-23.3
Aim:Both surgical and endovascular methods are used to treat intracranial aneurysms. In this study, we aimed to compare the treatment outcomes of these methods in patients with intracranial aneurysms.Material and Methods:A total of 1183 patients (722 [61%] female and 461 [39%] male) with intracranial aneurysms, including 615 with subarachnoid hemorrhage (SAH) and 568 without hemorrhage, were retrospectively reviewed.Results:The mean age of patients was 51.3 ± 12.4 years. Male patients were significantly more likely to have aneurysmal hemorrhage at admission (p < 0.001). Surgical intervention was performed in 462 (39.1%) patients, and endovascular methods were used in 541 (45.7%) patients. Sixty-five (5.5%) patients were treated with both methods. The World Federation of Neurosurgical Societies grade was found to have a strong negative effect on the Glasgow Outcome Scale (GOS) score (Wald = 21.81). The GOS scores were significantly higher in the surgical treatment group than in the endovascular treatment group for aneurysms in the anterior communicating artery. Based on follow-up digital subtraction angiography, the complete occlusion rate of the aneurysm was significantly higher with the surgical method than with the endovascular method (p < 0.001). The complete closure rate of aneurysms following endovascular treatment was significantly lower than that after surgical treatment (p < 0.001). However, we found no significant difference between the two methods in terms of residual aneurysms requiring reintervention.Conclusion:Treatment of intracranial aneurysms should be decided jointly by an experienced team of neurovascular surgeons, neuroradiologists, and anesthesiologists.
Corresponding author : Cafer Ikbal Gulsever