Single centre experience of surgical and endovascular treatment 91 Coil placement was continued until complete angiographic obliteration was achieved or no more coils could be placed safely in the aneurysm. All patients received 5000 IU heparin during the procedure. Postoperative patients were treated with a therapeutic dose of low-molecular-weight heparin for 2 days. Thereafter, patients were prescribed antiplatelet therapy. Surgical treatment was performed by a neurosurgeon and consisted of direct clipping of the aneurysm neck. Wrapping and coagulation of the aneurysm were performed if the aneurysm neck was not suitable for clipping. Temporary clipping of the parent artery was performed at the discretion of the surgeon. Flow measurements were performed if possible. Series Four hundred and three patients harboring 443 treated aneurysms were included in this study; 173 patients harboring 199 aneurysms underwent surgical treatment. Clipping was performed in 190 aneurysms, 2 of which had additional wrapping; 9 underwent primary coagulation and wrapping without clips being placed. Two hundred and thirty patients harboring 244 aneurysms underwent endovascular treatment; the balloon-assisted technique was used in only 4 aneurysms, and the TriSpan coil, in 1 aneurysm. Table 1 shows the patient and aneurysm characteristics. The distribution of age, sex, number of aneurysms treated, size, and morphology was very similar in both groups. Aneurysm locations are given in Table 2. The MCA was the only location in which more cases were treated by surgery than by endovascular techniques. This was mainly because of the anatomic characteristics of these aneurysms, which often have wide necks and incorporation of MCA branches. Aneurysms of the posterior circulation, however, were treated more frequently by endovascular coiling than by surgery. Table 1. Patient and aneurysm characteristics Surgical group Endovascular group Number (%) Number (%) Number of patients 173 (42.9) 230 (57.1) Sex: male/female 52 (30.1)/121 (69.9) 68(29.6)/162(70.4) Age years (mean) 17-77 (53.1) 16-97 (53.6) Number of aneurysm treated 199 244 Number of aneurysms treated per patient 1 153 (88.4) 218(94.8) 2 16 (9.2) 10(4.3) 3 3 (1.7) 2(0.9) 5 1 (0.6) - Size of treated aneurysm - Small (<5 mm) 96 (48.2) 98 (40.2) - Medium (5-15 mm) 90 (45.2) 136 (55.7) - Large (15-25 mm) 13 (6.5) 10 (4.1) Aneurysm morphology - Saccular 198(99.5) 242(99.2) - Dissecting - 1(0.4) - Fusiform 1(0.5) 1(0.4)
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