Neurosurgical And Endovascular Treatment Of Intracranial Ruptured Aneurysms Of Anterior Circulation

Objective: To analyze the effects of the neurosurgical and endovascular treatment of intracranial ruptured aneurysms of anterior circulation. Evaluating the treatment method of intracranial ruptured aneurysms of anterior circulation.Methods: A retrospective analysis of 113 patients with intracranial ruptured aneurysms of anterior circulation who were treated from June 2005 to December 2006 in the second hospital of ShanDong University, 11 patients were excluded. 50 patients were assigned to neurosurgical treatment,while 52 ones for endovascular treatment. The following clinical details were recorded: age, sex, date of SAH, clinical manifestation,bleeding times,the most serious CT Fisher grade of SAH, date of DSA and the presence of the aneurysm on angiography, Hunt-Hess of SAH before treatment,date of treatment. At discharge,the patients' clinical outcome was determined with the Glasgow outcome scale. Data were analyzed using t, x~2,rank sum and ANOVA tests.82.4% patients were at Hunt-Hess â… -â…¡, while 92.9% with aneurysms less than 10mm in diameter.Results:39 of 50(78%) patients allocated Surgical treatment were independent at discharge and 1(2%) dead,compared with 48 of 52 (92.3%) allocated endovascular and 1(2%) dead respectively. There is no significant difference in living rate after operation(p>0. 25) ,but there is significant difference in good recovery rate after operation(p<0.005).Conclusions: In patients with a ruptured intracranial aneurysm of anterior circulation. , early treatment can reduce rebleeding rate and inpatient time,but its efficient is worse than late treatment. If both endovascular coiling and neurosurgical clipping are therapeutic options, the outcome in terms of survival free of disability at discharge is significantly better with endovascular coiling,espetially for the patients with aneurysms less than 10mm in diameter and at Hunt-Hess â…  - â…¡. The long-term efficacy of endovascular treatment remains open.