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A Long-Term Comparative Analysis of Endovascular Coiling and Clipping for Ruptured Cerebral Aneurysms: An Individual Patient-Level Meta-Analysis Assessing Rerupture Rates
by
Güresir, Erdem
, Vychopen, Martin
, Güresir, Agi
, Nestler, Ulf
, Wach, Johannes
, Guranda, Alexandru
in
Aneurysms
/ Blood vessels
/ Care and treatment
/ Chi-square test
/ Comparative analysis
/ Complications and side effects
/ Decision-making
/ Diseases
/ Females
/ Hemorrhage
/ Intracranial aneurysms
/ Medical research
/ Medicine, Experimental
/ Meta-analysis
/ Patients
/ Relapse
/ Stroke (Disease)
/ Surgery
/ Systematic Review
2024
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A Long-Term Comparative Analysis of Endovascular Coiling and Clipping for Ruptured Cerebral Aneurysms: An Individual Patient-Level Meta-Analysis Assessing Rerupture Rates
by
Güresir, Erdem
, Vychopen, Martin
, Güresir, Agi
, Nestler, Ulf
, Wach, Johannes
, Guranda, Alexandru
in
Aneurysms
/ Blood vessels
/ Care and treatment
/ Chi-square test
/ Comparative analysis
/ Complications and side effects
/ Decision-making
/ Diseases
/ Females
/ Hemorrhage
/ Intracranial aneurysms
/ Medical research
/ Medicine, Experimental
/ Meta-analysis
/ Patients
/ Relapse
/ Stroke (Disease)
/ Surgery
/ Systematic Review
2024
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A Long-Term Comparative Analysis of Endovascular Coiling and Clipping for Ruptured Cerebral Aneurysms: An Individual Patient-Level Meta-Analysis Assessing Rerupture Rates
by
Güresir, Erdem
, Vychopen, Martin
, Güresir, Agi
, Nestler, Ulf
, Wach, Johannes
, Guranda, Alexandru
in
Aneurysms
/ Blood vessels
/ Care and treatment
/ Chi-square test
/ Comparative analysis
/ Complications and side effects
/ Decision-making
/ Diseases
/ Females
/ Hemorrhage
/ Intracranial aneurysms
/ Medical research
/ Medicine, Experimental
/ Meta-analysis
/ Patients
/ Relapse
/ Stroke (Disease)
/ Surgery
/ Systematic Review
2024
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A Long-Term Comparative Analysis of Endovascular Coiling and Clipping for Ruptured Cerebral Aneurysms: An Individual Patient-Level Meta-Analysis Assessing Rerupture Rates
Journal Article
A Long-Term Comparative Analysis of Endovascular Coiling and Clipping for Ruptured Cerebral Aneurysms: An Individual Patient-Level Meta-Analysis Assessing Rerupture Rates
2024
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Overview
Background: Although the initial functional outcome findings of the International Subarachnoid Aneurysm Trial (ISAT) study favored coiling at one year after aneurysmal subarachnoid hemorrhage (aSAH), concerns arose regarding limited long-term rerupture data. This meta-analysis is the first to analyze longitudinal individual patient data (IPD) of target aneurysm rerupture in terms of treatment modality. Methods: The present meta-analysis included studies that compared clipping with coiling of ruptured aneurysms regarding long-term rerupture. Rerupture rates’ individual patient data (IPD) were extracted from published Kaplan–Meier curves utilizing the R package IPDfromKM in R Version 4.3.1. Results: A total of 3153 patients from two studies were included. The clipping arm included 1755 patients, whereas the coiling arm included 1398 patients. Median reconstructed follow-up was 6.1 years (IQR = 0.5–11.7). The rerupture rates in the clipping arm and the coiling arm were 0.5% and 1.5%, respectively (p = 0.002). Kaplan–Meier chart analysis of the 3153 patients revealed a shortened time to rerupture in the coiling arm (log-rank test: p = 0.01). The hazard ratio (HR) for coiling compared with clipping regarding rerupture was 3.62 (95% CI:1.21–10.86, p = 0.02). Conclusion: Target aneurysm rerupture was rare beyond the initial year. Pooled long-term IPD from the 3153 patients revealed that reruptures of target aneurysms are more common after coiling and might be considered in the pretherapeutic decision-making process for aSAH.
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