COMPARATIVE ANALYSIS OF SURGICAL AND ENDOVASCULAR TREATMENT OF INTRACRANIAL ANEURYSMS

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With a prevalence of about 2.3%, intracranial aneurysms represent the most common cause of spontaneous subarachnoid hemorrhage. Many studies compared currently most common therapeutic options-neurosurgical clipping and endovascular embolization, but so far no single solution in which therapeutic method should have an advantage has been found. The aim was to compare the outcome of treatment on discharge, among patients treated with clipping or embolization. The data of 62 patients treated at the Neurosurgery Clinic of the Clinical Center of Serbia, were obtained through discharge lists. The analysis included data on sex, age, Glasgow coma scale, aneurysm rupture, Hunt & Hess scale, localization, number of aneurysms, length of overall and postoperative stay as well as the existence of complications. The condition on discharge was assessed using the Glasgow outcome scale. In our study 37 subjects (59.7%) had a subarachnoid hemorrhage, while 25 (41.9%) patients were without bleeding. 30 patients underwent surgery, while 32 were treated by embolization. No significant relationship between the treatment modality and outcome on discharge was observed (p=0.115). Patients without bleeding had a significantly better outcome on discharge when treated by endovascular method (p<0.001), whereas in the group with a rupture no differences were found (p=0.35). Complications were significantly more common after surgery (p=0.026). No difference among the groups in the length of the total hospital stay was found (p=0.246), while a significantly longer postprocedural period was recorded following neurosurgical treatment (p=0.029). Groups treated with different modalities did not differ in the outcome on discharge. However, the percentage of complications was greater in the group of patients undergoing surgery, as well as the length of postoperative hospital stay. We believe that furthe detailed analyzes offering information on the condition of patients after a long period of follow-up iare required.