The relative merits of clipping and endovascular coiling to treat ruptured intracranial aneurysms are the subject of an ongoing debate. The latest results from the International Subarachnoid Aneurysm Trial offer reassurance regarding the long-term outcomes of coiling and provide support for an individualized approach.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Molyneux, A. J. et al. Risk of recurrent subarachnoid haemorrhage, death, ordependence and standardised mortality ratios after clipping orcoiling of an intracranial aneurysm in the International Subarachnoid Aneurysm Trial (ISAT): long-term follow-up. Lancet Neurol. 8, 427–433 (2009).
Molyneux, A. J. et al. International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2,143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 366, 809–817 (2005).
Ryttlefors, M., Enblad, P., Kerr, R. S. & Molyneux, A. J. International subarachnoid aneurysm trial of neurosurgical clipping versus endovascular coiling: subgroup analysis of 278 elderly patients. Stroke 39, 2720–2726 (2008).
Campi, A. et al. Re-treatment of ruptured cerebral aneurysms in patients randomized by coiling or clipping in the International Subarachnoid Aneurysm Trial (ISAT). Stroke 38, 1538–1544 (2007).
Mitchell, P., Kerr, R., Mendelow, A. D. & Molyneux, A. Could late rebleeding overturn the superiority of cranial aneurysm coil embolization over clip ligation seen in the International Subarachnoid Aneurysm Trial? J. Neurosurg. 108, 437–442 (2008).
Bederson, J. B. et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage. A statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke 40, 994–1025 (2009).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
Connolly, E., Meyers, P. To clip or to coil? That is no longer the question. Nat Rev Neurol 5, 412–413 (2009). https://doi.org/10.1038/nrneurol.2009.106
Issue Date:
DOI: https://doi.org/10.1038/nrneurol.2009.106