Outcomes of Surgical and Endovascular Treatment of Intracranial Aneurysms: A Single-Center Analysis of 1183 Patients.

AIM: To compare the treatment outcomes of surgical and endovascular 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.