Endovascular coiling versus microsurgical clipping for ruptured intracranial aneurysms:a meta-analysis and systematic review

作     者：Chao Peng Yu-hang Diao Shi-fei Cai Xin-yu Yang 

作者机构：Department of NeurosurgeryTianjin Medical University General HospitalTianjinThe People’s Republic of China 

出 版 物：《Chinese Neurosurgical Journal》 (中华神经外科杂志（英文）)

年 卷 期：2022年第8卷第4期

页      面：268-283页

核心收录：

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

主　　题：Ruptured intracranial aneurysms Coiling Clipping Meta-analysis 

摘      要：Background:The purpose of this analysis is to evaluate the current evidence with regard to the effectiveness and safety between coiling and clipping in patients with ruptured intracranial aneurysms(RIAs).Methods:We performed a meta-analysis that compared clipping with coiling between July 2000 and September ***,EMBASE,and the Cochrane Library were searched for related articles *** the treatment efficacy and postoperative complications were ***:We identified three randomized controlled trials and thirty-seven observational studies involving 60,875 patients with ruptured cerebral *** summary results showed that coiling was related a better quality of life(mRS0-2;OR=1.327;CI=1.093-1.612;p0.05),a higher risk of mortality(OR=1.116;CI=1.054-1.180;p0.05),higher rate of rebleeding(RR=1.410;CI=1.092-1.822;p0.05),lower incidence of vasospasm(OR=0.787;CI=0.649-0.954;p0.05),higher risk of hydrocephalous(RR=1.143;CI=1.043-1.252;p0.05),lower risk of cerebral infarction(RR=0.669;CI=0.596-0.751;p0.05),lower risk of neuro deficits(RR=0.720;CI=0.582-0.892;p0.05),and a lower rate of complete occlusion(OR=0.495;CI=0.280-0.876;p0.05).Conclusion:Coiling was significantly associated with a better life quality(mRS0-2),a lower incidence of postoperative complications,and a higher rate of mortality,rebleeding,hydrocephalous,and a lower rate of complete occlusion than clipping.