Clinical outcomes of surgical and endovascular treatment of ruptured aneurysms in the anterior cerebral circulation: A single-center experience

Purpose: The purpose of this study was to compare the clinical outcomes of surgical clipping and endovascular coiling of ruptured aneurysms in the anterior cerebral circulation. Materials and Methods: In a 4-year period, a total of 85 patients with ruptured aneurysms at the anterior circulation in our institution underwent microsurgical or endovascular treatment and had up to 1-year clinical follow-up at our institute. We retrospectively analyzed patient demographics, aneurysm characteristics, details of coil embolization, and clinical outcomes in the clipping group versus coiling group. P <0.05 was considered statistically significant. Results: Fifty-five patients underwent clipping and coiling in 30. Patients with initial Glasgow Coma Scale 3–5 (P = 0.009) and World Federation of Neurosurgical Societies grade scale 3 or 5 (P = 0.007) were more often treated using clipping. Patients waited more days for coiling than clipping (3 days vs. 1 day; P = 0.006). Coiling required less operation time than clipping (3.0 h vs. 7.0 h; P < 0.001). There was no intergroup difference regarding aneurysm characteristics or other clinical outcomes, including hospital stay. Conclusion: Endovascular coiling required less operation time than surgical clipping. There was no statistically significant difference of other clinical outcomes between clipping and coiling in the management of ruptured anterior cerebral aneurysms.