Cargando…

Endovascular coiling versus neurosurgical clipping in patients with unruptured intracranial aneurysm: a systematic review

BACKGROUND: To compare the effects of endovascular coiling and neurosurgical clipping in patients with unruptured intracranial aneurysm. METHODS: Sixteen electronic databases were searched for articles published between 1950 and July 2010 to compare clinical outcomes of clipping and coiling. Researc...

Descripción completa

Detalles Bibliográficos
Autores principales: Hwang, Jin Seub, Hyun, Min Kyung, Lee, Hyun Joo, Choi, Ji Eun, Kim, Jong Hee, Lee, Na Rae, Kwon, Jin-Won, Lee, EnJu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519507/
https://www.ncbi.nlm.nih.gov/pubmed/22998483
http://dx.doi.org/10.1186/1471-2377-12-99
_version_ 1782252675529703424
author Hwang, Jin Seub
Hyun, Min Kyung
Lee, Hyun Joo
Choi, Ji Eun
Kim, Jong Hee
Lee, Na Rae
Kwon, Jin-Won
Lee, EnJu
author_facet Hwang, Jin Seub
Hyun, Min Kyung
Lee, Hyun Joo
Choi, Ji Eun
Kim, Jong Hee
Lee, Na Rae
Kwon, Jin-Won
Lee, EnJu
author_sort Hwang, Jin Seub
collection PubMed
description BACKGROUND: To compare the effects of endovascular coiling and neurosurgical clipping in patients with unruptured intracranial aneurysm. METHODS: Sixteen electronic databases were searched for articles published between 1950 and July 2010 to compare clinical outcomes of clipping and coiling. Researchers reviewed all searched articles and extracted data independently. The quality of studies and evidence were evaluated using MINORS and GRADEprofiler, respectively. The odds ratio (OR) was calculated using the inverse variance meta-analysis method for each study outcome. To assess heterogeneity of ORs across cohorts, Cochran’s Q statistic and I(2) were used. RESULTS: Of 4160 studies, 24 were identified (n  =  31865). Clipping resulted in significantly higher disability using the Glasgow Outcome Scale (OR, 2.38; 95% CI, 1.33–4.26) and Modified Rankin Scale (OR, 2.83; 95% CI, 1.42–5.63) when compared with coiling. ORs for complications were also higher with clipping (ORs for neurological and cardiac complications were 1.94 with a 95% confidence interval [CI] of 1.09–3.47 and 2.51 with a 95% CI of 1.15–5.50). Clipping resulted in significantly greater disability in the short term (≤6 m)(OR on the Glasgow Outcome Scale, 2.72; 95% CI, 1.16–6.34), but not in the long term (>6 m)(OR for Glasgow Outcome Scale, 2.12; 95% CI, 0.93–4.84). CONCLUSIONS: Coiling was a better procedure for treatment of unruptured intracranial aneurysm in terms of disability, complications, especially in the short term. Because of the limitations of the reviewed studies, further studies are required to support the present results.
format Online
Article
Text
id pubmed-3519507
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-35195072012-12-12 Endovascular coiling versus neurosurgical clipping in patients with unruptured intracranial aneurysm: a systematic review Hwang, Jin Seub Hyun, Min Kyung Lee, Hyun Joo Choi, Ji Eun Kim, Jong Hee Lee, Na Rae Kwon, Jin-Won Lee, EnJu BMC Neurol Research Article BACKGROUND: To compare the effects of endovascular coiling and neurosurgical clipping in patients with unruptured intracranial aneurysm. METHODS: Sixteen electronic databases were searched for articles published between 1950 and July 2010 to compare clinical outcomes of clipping and coiling. Researchers reviewed all searched articles and extracted data independently. The quality of studies and evidence were evaluated using MINORS and GRADEprofiler, respectively. The odds ratio (OR) was calculated using the inverse variance meta-analysis method for each study outcome. To assess heterogeneity of ORs across cohorts, Cochran’s Q statistic and I(2) were used. RESULTS: Of 4160 studies, 24 were identified (n  =  31865). Clipping resulted in significantly higher disability using the Glasgow Outcome Scale (OR, 2.38; 95% CI, 1.33–4.26) and Modified Rankin Scale (OR, 2.83; 95% CI, 1.42–5.63) when compared with coiling. ORs for complications were also higher with clipping (ORs for neurological and cardiac complications were 1.94 with a 95% confidence interval [CI] of 1.09–3.47 and 2.51 with a 95% CI of 1.15–5.50). Clipping resulted in significantly greater disability in the short term (≤6 m)(OR on the Glasgow Outcome Scale, 2.72; 95% CI, 1.16–6.34), but not in the long term (>6 m)(OR for Glasgow Outcome Scale, 2.12; 95% CI, 0.93–4.84). CONCLUSIONS: Coiling was a better procedure for treatment of unruptured intracranial aneurysm in terms of disability, complications, especially in the short term. Because of the limitations of the reviewed studies, further studies are required to support the present results. BioMed Central 2012-09-22 /pmc/articles/PMC3519507/ /pubmed/22998483 http://dx.doi.org/10.1186/1471-2377-12-99 Text en Copyright ©2012 Hwang et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Hwang, Jin Seub
Hyun, Min Kyung
Lee, Hyun Joo
Choi, Ji Eun
Kim, Jong Hee
Lee, Na Rae
Kwon, Jin-Won
Lee, EnJu
Endovascular coiling versus neurosurgical clipping in patients with unruptured intracranial aneurysm: a systematic review
title Endovascular coiling versus neurosurgical clipping in patients with unruptured intracranial aneurysm: a systematic review
title_full Endovascular coiling versus neurosurgical clipping in patients with unruptured intracranial aneurysm: a systematic review
title_fullStr Endovascular coiling versus neurosurgical clipping in patients with unruptured intracranial aneurysm: a systematic review
title_full_unstemmed Endovascular coiling versus neurosurgical clipping in patients with unruptured intracranial aneurysm: a systematic review
title_short Endovascular coiling versus neurosurgical clipping in patients with unruptured intracranial aneurysm: a systematic review
title_sort endovascular coiling versus neurosurgical clipping in patients with unruptured intracranial aneurysm: a systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519507/
https://www.ncbi.nlm.nih.gov/pubmed/22998483
http://dx.doi.org/10.1186/1471-2377-12-99
work_keys_str_mv AT hwangjinseub endovascularcoilingversusneurosurgicalclippinginpatientswithunrupturedintracranialaneurysmasystematicreview
AT hyunminkyung endovascularcoilingversusneurosurgicalclippinginpatientswithunrupturedintracranialaneurysmasystematicreview
AT leehyunjoo endovascularcoilingversusneurosurgicalclippinginpatientswithunrupturedintracranialaneurysmasystematicreview
AT choijieun endovascularcoilingversusneurosurgicalclippinginpatientswithunrupturedintracranialaneurysmasystematicreview
AT kimjonghee endovascularcoilingversusneurosurgicalclippinginpatientswithunrupturedintracranialaneurysmasystematicreview
AT leenarae endovascularcoilingversusneurosurgicalclippinginpatientswithunrupturedintracranialaneurysmasystematicreview
AT kwonjinwon endovascularcoilingversusneurosurgicalclippinginpatientswithunrupturedintracranialaneurysmasystematicreview
AT leeenju endovascularcoilingversusneurosurgicalclippinginpatientswithunrupturedintracranialaneurysmasystematicreview