Hybrid Neurosurgeon: Panacea to Debate on Coiling versus Clipping

How to choose clipping versus coiling in treating intracranial aneurysms.

BACKGROUND After the decision is made to treat an intracranial aneurysm, clinicians must choose between two competing treatment options; open surgery or endovascular therapy. The rationale underlying the choice of treatment modality is usually unclear, as there is little good quality evidence available. METHODS We discuss the patient and aneurysm-related factors cited in the neurovascular lit...

Best evidence: comments on meta-analysis of coiling versus clipping.

Impact of Clipping versus Coiling on Postoperative Hemodynamics and Pulmonary Edema after Subarachnoid Hemorrhage

Volume management is critical for assessment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH). This multicenter prospective cohort study compared the impact of surgical clipping versus endovascular coiling on postoperative hemodynamics and pulmonary edema in patients with SAH. Hemodynamic parameters were measured for 14 days using a transpulmonary thermodilution system. The ...

Functional outcome of microsurgical clipping compared to endovascular coiling.

Endovascular coiling has been used increasingly as an alternative to neurosurgical clipping for treating subarachnoid hemorrhage secondary to aneurysm rupture. In a retrospective cohort review on the treatment methods of aneurysm rupture in Hospital Kuala Lumpur over the period of five years (2005-2009) a total of 268 patients were treated. These patients were broadly categorized into two group...

Current options in clipping versus coiling of intracranial aneurysms: to clip, to coil, to wait and watch.

Treatment of intracranial aneurysms involves many factors: patient preference and demographics; aneurysm size, site, geometry, access, and intrinsics; practitioner experience and availability; facility; technology; and ancillaries. Volume counts, teamwork enhancement, and management should be individualized.