Rate of postoperative cerebral ischemia is reduced with Endovascular coiling than with surgical clipping

Results

• Three hundred sixty-three aneurysms in 353 patients were included for analysis, 257 in the clipping group, and 106 in the coiling group.
• There was no difference between groups in terms of baseline characteristics. 
• The clipping group showed a higher incidence of postoperative cerebral ischemia (23.35% vs. 11.32%, p = 0.029).
• At discharge clipping group showed a significantly higher proportion of patients with a modified Rankin Scale score ≥ 2 (35.80% vs. 15.09%; p < 0.05) but not six months after discharge (15.56% vs. 8.49%; p > 0.05).
• In the clipping group, the mean age was significantly higher in patients who developed cerebral ischemia than in those who did not.
• In the coiling group, modified Fisher grade and incidence of fetal PCoA were significantly higher in patients who developed ischemia.  

This study was the first study to perform a detailed analysis of cerebral ischemia in PCoA aneurysm patients. As the causes and characteristics of postoperative cerebral ischemia after PCoA clipping and coiling are different management should be planned accordingly. 

Cai, Y., Zhang, T., Zhao, J. et al. Cerebral ischemia after treatment of posterior communicating artery aneurysms: clipping versus coiling. BMC Neurol 22, 436 (2022). https://doi.org/10.1186/s12883-022-02962-1