Endovascular and Surgical Treatment of Unruptured MCA Aneurysms: Meta-Analysis and Review of the Literature
Introduction. The best treatment for unruptured middle cerebral artery (MCA) aneurysms is unclear. We perform a meta-analysis of recent publications to evaluate the results of unruptured MCA aneurysms treated with surgical clipping and endovascular coiling. Methods. A PubMed search for articles publ...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2014/348147 |
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| author | Spiros L. Blackburn Abdelrahman M. Abdelazim Andrew B. Cutler Kevin T. Brookins Kyle M. Fargen Brian L. Hoh Yasha Kadkhodayan |
| author_facet | Spiros L. Blackburn Abdelrahman M. Abdelazim Andrew B. Cutler Kevin T. Brookins Kyle M. Fargen Brian L. Hoh Yasha Kadkhodayan |
| author_sort | Spiros L. Blackburn |
| collection | DOAJ |
| description | Introduction. The best treatment for unruptured middle cerebral artery (MCA) aneurysms is unclear. We perform a meta-analysis of recent publications to evaluate the results of unruptured MCA aneurysms treated with surgical clipping and endovascular coiling. Methods. A PubMed search for articles published between January 2004 and November 2013 was performed. The R statistical software package was used to create a random effects model for each desired incidence rate. Cochran’s Q test was used to evaluate possible heterogeneity among the rates observed in each study. Results. A total of 1891 unruptured MCA aneurysms, 1052 clipped and 839 coiled, were included for analysis. The complete occlusion rate at 6–9 months mean follow-up was 95.5% in the clipped group and 67.8% in the coiled group (P<0.05). The periprocedural thromboembolism rate in the clipping group was 1.8% compared with 10.7% in the aneurysms treated by coiling (P<0.05). The recanalization rate was 0% for clipping and 14.3% for coiling (P=0.05). Modified Rankin scores of 0–2 were obtained in 98.9% of clipped patients compared to 95.5% of coiled (NS). Conclusions. This review weakly supports clipping as the preferred treatment of unruptured MCA aneurysms. Clinical outcomes did not differ significantly between the two groups. |
| format | Article |
| id | doaj-art-7e99f32c72824f75bcb53fee0ddef389 |
| institution | Kabale University |
| issn | 2090-8105 2042-0056 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-7e99f32c72824f75bcb53fee0ddef3892025-02-03T05:47:22ZengWileyStroke Research and Treatment2090-81052042-00562014-01-01201410.1155/2014/348147348147Endovascular and Surgical Treatment of Unruptured MCA Aneurysms: Meta-Analysis and Review of the LiteratureSpiros L. Blackburn0Abdelrahman M. Abdelazim1Andrew B. Cutler2Kevin T. Brookins3Kyle M. Fargen4Brian L. Hoh5Yasha Kadkhodayan6University of Florida, Department of Neurosurgery, P.O. Box 100265, Gainesville, FL 32610-0265, USAUniversity of Florida, Department of Neurosurgery, P.O. Box 100265, Gainesville, FL 32610-0265, USAUniversity of Florida, College of Medicine, Gainesville, FL 32603, USAUniversity of Florida, College of Medicine, Gainesville, FL 32603, USAUniversity of Florida, Department of Neurosurgery, P.O. Box 100265, Gainesville, FL 32610-0265, USAUniversity of Florida, Department of Neurosurgery, P.O. Box 100265, Gainesville, FL 32610-0265, USADivision of Interventional Neuroradiology, Abbott Northwestern Hospital, Minneapolis, MN 55407, USAIntroduction. The best treatment for unruptured middle cerebral artery (MCA) aneurysms is unclear. We perform a meta-analysis of recent publications to evaluate the results of unruptured MCA aneurysms treated with surgical clipping and endovascular coiling. Methods. A PubMed search for articles published between January 2004 and November 2013 was performed. The R statistical software package was used to create a random effects model for each desired incidence rate. Cochran’s Q test was used to evaluate possible heterogeneity among the rates observed in each study. Results. A total of 1891 unruptured MCA aneurysms, 1052 clipped and 839 coiled, were included for analysis. The complete occlusion rate at 6–9 months mean follow-up was 95.5% in the clipped group and 67.8% in the coiled group (P<0.05). The periprocedural thromboembolism rate in the clipping group was 1.8% compared with 10.7% in the aneurysms treated by coiling (P<0.05). The recanalization rate was 0% for clipping and 14.3% for coiling (P=0.05). Modified Rankin scores of 0–2 were obtained in 98.9% of clipped patients compared to 95.5% of coiled (NS). Conclusions. This review weakly supports clipping as the preferred treatment of unruptured MCA aneurysms. Clinical outcomes did not differ significantly between the two groups.http://dx.doi.org/10.1155/2014/348147 |
| spellingShingle | Spiros L. Blackburn Abdelrahman M. Abdelazim Andrew B. Cutler Kevin T. Brookins Kyle M. Fargen Brian L. Hoh Yasha Kadkhodayan Endovascular and Surgical Treatment of Unruptured MCA Aneurysms: Meta-Analysis and Review of the Literature Stroke Research and Treatment |
| title | Endovascular and Surgical Treatment of Unruptured MCA Aneurysms: Meta-Analysis and Review of the Literature |
| title_full | Endovascular and Surgical Treatment of Unruptured MCA Aneurysms: Meta-Analysis and Review of the Literature |
| title_fullStr | Endovascular and Surgical Treatment of Unruptured MCA Aneurysms: Meta-Analysis and Review of the Literature |
| title_full_unstemmed | Endovascular and Surgical Treatment of Unruptured MCA Aneurysms: Meta-Analysis and Review of the Literature |
| title_short | Endovascular and Surgical Treatment of Unruptured MCA Aneurysms: Meta-Analysis and Review of the Literature |
| title_sort | endovascular and surgical treatment of unruptured mca aneurysms meta analysis and review of the literature |
| url | http://dx.doi.org/10.1155/2014/348147 |
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