BACKGROUND Publication bias and/or true heterogeneity can skew aggregate impressions from scientific literature. To better determine aggregate measures for unruptured intracranial aneurysm (UIA) treatment, we analyzed adverse outcome rates of surgical clipping and endovascular coil embolization. METHODS Two independent reviewers searched MEDLINE for studies publishing adverse outcome rates fo...

BACKGROUND AND PURPOSE Both CT angiography and digital subtraction angiography are used to detect aneurysms in patients with subarachnoid hemorrhage. We examined a large multihospital data base to determine how practice is evolving with regard to the use of CT angiography and DSA in patients with ruptured cerebral aneurysm. MATERIALS AND METHODS The Premier Perspective data base was used to i...

PURPOSE The optimal management of geometrically complex aneurysms remains challenging. The aim of this retrospective study was to evaluate the safety and feasibility of branch-selective technique (BT) in wide-necked aneurysms with an acute angle branch incorporated into the sac. MATERIALS AND METHODS Eight consecutive patients harboring wide-necked cerebral aneurysms with an incorporated, acu...

BACKGROUND AND PURPOSE Practice patterns vary widely among centers with regard to the treatment of unruptured aneurysms. The purpose of the current study was to correlate outcome data with practice patterns, specifically the proportion of unruptured aneurysms treated with neurosurgical clipping versus endovascular coiling. MATERIALS AND METHODS Using the NIS, we evaluated outcomes of patients...

Objectives. To measure umbilical coiling index (UCI) postnatally and to study the association of normocoiling, hypocoiling and hypercoiling to maternal and perinatal outcome. Method(s). One thousand antenatal women who went into labour were studied and umbilical coiling index calculated at the time of delivery. UCI was determined by dividing the total number of coils by the total umbilical cord...

OBJECTIVES To compare endovascular coiling with neurosurgical clipping of ruptured basilar bifurcation aneurysms. METHODS Patient and aneurysm characteristics, procedural complications, and clinical and anatomical results were compared retrospectively in 44 coiled patients and 44 patients treated by clipping. The odds ratios for poor outcome (Glasgow outcome scale 1, 2, 3) adjusted for age, c...

From observations on the partial disintegration of isolated human metaphase chromosomes we propose that human metaphase chromatids have a rather simple organization based on the folding and coiling of a long, regular, hollow cylindrical structure with a diameter of about 4000 A. This cylindrical structure, the unit fiber, is postulated to be a super-solenoid formed by the coiling of a 300 A sol...

Coil migration is a severe complication in endovascular treatment. We report our experience of prompt surgical extraction of migrated coils via excised proximal A1 following endovascular embolization of intracranial aneurysms in two patients. Both patients had to undergo coiling or stent-assisted coiling for cerebral aneurysms, and while operating the coils protruded and migrated to the bifurca...

Subarachnoid hemorrhage is a serious disease with a case fatality of approximately 50%. Aneurysms are the cause of SAH in 85% of cases. Rebleeding is the most imminent concern; therefore, the first aim is occlusion of the ruptured aneurysm. In our institution with 150 –200 SAHs annually, 3 interventional neuroradiologists, and 13 neurosurgeons (3 with vascular expertise), the diagnostic and the...

BACKGROUND The International Subarachnoid Aneurysm Trial (ISAT) demonstrated improved one-year clinical outcomes for patients with ruptured intracranial aneurysms treated with endovascular coiling compared to surgical clipping. Patients included in ISAT were mostly good grade subarachnoid hemorrhage (SAH) patients with small anterior circulation aneurysms. The purported superiority of coiling i...