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Comparison of outcomes between clipping and endovascular coiling in anterior choroidal artery aneurysm: a systematic review

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Abstract

SAH (subarachnoid hemorrhage) caused by aneurysm rupture has the greatest mortality rate, with nearly 50% of patients unable to survive beyond 1 month after the attack. Anterior choroidal artery (AChA) aneurysms are one of the most difficult to treat among the numerous types of aneurysms. Until now, some neurosurgeons employed shearing while others employed coiling. In this trial, researchers will compare surgical clipping and endovascular coiling treatments for anterior choroidal artery aneurysms in terms of mortality, rebleeding, retreatment, and post-procedure outcomes. Using the PubMed electronic database, the Cochrane library, the Medline Database, the Directory of Open Access Journals, and EBSCHOHOST, a systematic review compared surgical clipping and endovascular coiling in all cases of choroidal artery aneurysm. There were 17 studies that met the eligibility requirements, with a total of 1486 patients divided into groups that underwent clipping (1106) or endovascular coiling (380). The mortality rate for clipping is 1.8%, while the mortality rate for endovascular coiling is 2.34%. Rebleeding occurs in 0% of patients undergoing endovascular coiling and 0.73% of patients undergoing clipping. Retreatment of clipping was 0.27%, while endovascular coiling was 3.42%. Post-complication procedures occurred in 11.12% of patients undergoing endovascular clipping and 15.78% of patients undergoing endovascular coiling. The intervention technique of clipping has a reduced rate of mortality, reoperation, and post-operative complications. Endovascular coiling results in a reduced rate of rebleeding than clipping.

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Acknowledgements

We would like to express our sincere appreciation to all individuals and organizations who have contributed to the completion of this meta-analysis, titled Comparison Of Outcomes Between Clipping and Coiling in Anterior Choroidal Artery Aneurysm: A Systematic Review for submission to Neurosurgical Review. We extend our heartfelt thanks to the authors of the primary studies included in this analysis for their valuable research and data. We are grateful for the support and guidance received from our colleagues and mentors, whose expertise has shaped the methodology and interpretation of the findings. We also acknowledge the editorial board and reviewers of Neurosurgical Review for their time and valuable feedback. Finally, we would like to thank the institutions and funding bodies that have provided financial support, as well as the patients and participants whose data have contributed to the evidence-based insights presented in this meta-analysis.

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Authors and Affiliations

  1. Department of Neurosurgery, Faculty of Medicine Universitas Airlangga, Dr Soetomo General Academic Hospital, Surabaya, Indonesia

    Asra Al Fauzi, M. Irfan Rahmatullah, Nur Setiawan Suroto, Achmad Fahmi, Abdul Hafid Bajamal, Billy Dema Justia Wahid & I Wayan Weda Wisnawa

  2. Department of Public Health, Faculty of Medicine Universitas Airlangga, Dr Soetomo General Academic Hospital, Surabaya, Indonesia

    Budi Utomo

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  1. Asra Al Fauzi
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Contributions

AAF, MIR, NSS: data collection, analysis, writing manuscript, revising manuscript. MIR, BDJW, IWWW: data analysis, revising manuscript. IWWW, AF, AHB, and AAF revised and finalization of the manuscript.

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Correspondence to Asra Al Fauzi.

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Al Fauzi, A., Rahmatullah, M.I., Suroto, N.S. et al. Comparison of outcomes between clipping and endovascular coiling in anterior choroidal artery aneurysm: a systematic review. Neurosurg Rev 46, 276 (2023). https://doi.org/10.1007/s10143-023-02179-x

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