Comparison of outcomes between clipping and endovascular coiling in anterior choroidal artery aneurysm: a systematic review

• Published in: Neurosurgical review Vol. 46; no. 1; p. 276
• Main Authors: Al Fauzi, Asra, Rahmatullah, M. Irfan, Suroto, Nur Setiawan, Utomo, Budi, Fahmi, Achmad, Bajamal, Abdul Hafid, Wahid, Billy Dema Justia, Wisnawa, I Wayan Weda
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 20-10-2023
• Subjects: Aneurysm, Ruptured - surgery; Carotid Artery, Internal; Embolization, Therapeutic - methods; Endovascular Procedures - methods; Humans; Intracranial Aneurysm - complications; Medicine; Medicine & Public Health; Neurosurgery; Subarachnoid Hemorrhage - complications; Treatment Outcome; Anterior choroidal artery aneurysm; Retreatment; Rebleeding; Endovascular coiling; Post procedure complications; Mortality
• ISSN: 1437-2320; 1437-2320
• DOI: 10.1007/s10143-023-02179-x

SAH (subarachnoid hemorrhage) caused by aneurysm rupture has the greatest mortality rate, with nearly 50% of patients unable to survive beyond 1 month after the attack. Anterior choroidal artery (AChA) aneurysms are one of the most difficult to treat among the numerous types of aneurysms. Until now, some neurosurgeons employed shearing while others employed coiling. In this trial, researchers will compare surgical clipping and endovascular coiling treatments for anterior choroidal artery aneurysms in terms of mortality, rebleeding, retreatment, and post-procedure outcomes. Using the PubMed electronic database, the Cochrane library, the Medline Database, the Directory of Open Access Journals, and EBSCHOHOST, a systematic review compared surgical clipping and endovascular coiling in all cases of choroidal artery aneurysm. There were 17 studies that met the eligibility requirements, with a total of 1486 patients divided into groups that underwent clipping (1106) or endovascular coiling (380). The mortality rate for clipping is 1.8%, while the mortality rate for endovascular coiling is 2.34%. Rebleeding occurs in 0% of patients undergoing endovascular coiling and 0.73% of patients undergoing clipping. Retreatment of clipping was 0.27%, while endovascular coiling was 3.42%. Post-complication procedures occurred in 11.12% of patients undergoing endovascular clipping and 15.78% of patients undergoing endovascular coiling. The intervention technique of clipping has a reduced rate of mortality, reoperation, and post-operative complications. Endovascular coiling results in a reduced rate of rebleeding than clipping.