Turkish Neurosurgery 2022 , Vol 32 , Num 2
Mortality Outcomes of Endovascular Treatment and Surgical Clipping in Patients with Cerebral Aneurysms: A Single-Center Study
Abdullah SUKUN1,Mustafa CETIN2,Ahmet ALPARSLAN2,Ramazan UYAR3,Tolga GEDIZ3,Bulent CEKIC2,Mert KOROGLU2
1Kars Harakani State Hospital, Department of Radiology, Kars, Turkey
2Antalya Education and Research Hospital, Department of Radiology, Antalya Turkey
3Antalya Education and Research Hospital, Department of Neurosurgery, Antalya Turkey
DOI : 10.5137/1019-5149.JTN.33877-21.2 AIM: To compare endovascular and surgical treatment methods for cerebral aneurysms focusing on mortality.

MATERIAL and METHODS: The study included 187 patients who had undergone aneurysm treatment. The patients were divided into four groups according to their treatment modality and subarachnoid hemorrhage status: patients with endovascular treatment and bleeding aneurysms (EVG-b), patients with endovascular treatment and non-bleeding aneurysms (EVG-nb), patients with surgical clipping and bleeding aneurysms (SCG-b), and patients with surgical clipping and non-bleeding aneurysms (SCG-nb). The Hunt?Hess scores, Fisher grade, aneurysm morphology, and length of stay (LOS) were compared between groups.

RESULTS: There was no significant difference in the mortality rate between EVG-b and SCG-b at the end of the first year (23.5% and 39.7%, respectively; p>0.05). A significantly shorter LOS was observed in EVG-b than in SCG-b (11.5 days and 15 days, respectively; p=0.027). Fusiform aneurysms were associated with higher patient mortality, whereas saccular aneurysms were associated with a 1.9-fold higher survival (p=0.037; 95% confidence interval: 0.83?4.74). The rate of closure of non-bleeding aneurysms was 93.4%. Complete embolization was verified in all bleeding aneurysms. In EVG-nb, the morbidity rate was 5%, the mortality rate was 3%, and the mean LOS was 2.86 days.

CONCLUSION: Both treatment methods showed similar mortality rates, but hospital stays were shorter after endovascular treatment. Keywords : Cerebral aneurysm, Surgical clipping, Endovascular treatment, SAH

Corresponding author : Abdullah SUKUN, abdullah.sukun@gmail.com