Ruptured Intracranial Aneurysms: Acute Endovascular Treatment with Electrolytically Detachable Coils—A Prospective Randomized Study

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Abstract
PURPOSE: To compare the use of electrolytically detachable coils versus surgical ligation for the management of acutely ruptured intracranial aneurysm. MATERIALS AND METHODS: A prospective randomized study included 109 patients with acute (<72 hours) subarachnoid hemorrhage caused by a ruptured aneurysm (Hunt and Hess grade I–II [n = 67], grade III [n = 26], or grade IV–V [n = 16]). All patients were suitable candidates for both endovascular and surgical treatment and were randomly assigned to undergo coil embolization (n = 52) or surgical ligation (n = 57). RESULTS: Significantly better primary angiographic results were achieved after surgery in patients with anterior cerebral artery aneurysm (n = 55, P = .005) and after endovascular treatment in those with posterior circulation aneurysm (n = 11, P = .045). No significant differences were seen in middle cerebral artery (n = 19) or internal carotid artery (n = 24) aneurysms. Early rebleeding occurred in one patient after incomplete coil embolization. The ...