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Efficacy and safety of endovascular therapy versus surgical clipping for patients with unruptured middle cerebral artery bifurcation aneurysms
  1. Junjie Luo,
  2. Chengmou Wang,
  3. Yongjian Dai,
  4. Xin Chen,
  5. Xuecheng Tian,
  6. Yi Lin,
  7. Xinguo Qu
  1. Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
  1. Correspondence to Dr Xinguo Qu, Hubei University of Medicine, Shiyan, Hubei, China; 63380157{at}qq.com

Abstract

This study aims to evaluate the efficacy and safety of endovascular therapy versus neurosurgical clipping carried out for patients with unruptured middle cerebral artery bifurcation aneurysms (MCABAs). Patients diagnosed with MCABAs were enrolled in this prospective study according to the inclusion and exclusion standard. Enrolled patients were divided into a study group (endovascular therapy) and a control group (neurosurgical clipping), with 65 cases in each group. In terms of efficacy, we found that the proportion of Glasgow Outcome Scale (GOS) grade 1 after treatment in the study group was significantly higher than in the control group (p<0.001), while the proportion of GOS grades 2, 3, and 4 after treatment was significantly lower in the study group than in the control group (p<0.05). The postoperative brain injury indicators neuron-specific enolase and S100β in the study group were significantly lower than in the control group (p<0.001), and the postoperative life activity score of patients in the study group was significantly higher than in the control group (p<0.001). In terms of safety, the postoperative hospital stay of patients in the study group was significantly shorter than in the control group (p<0.001), and the incidence rate of postoperative pulmonary and intracranial infections in the study group was significantly lower than in the control group (p<0.05). Endovascular therapy for patients with unruptured MCABAs may be effective in improving outcomes and has better safety profile compared with neurosurgical clipping, but may increase the risk of postoperative recurrence.

  • vascular surgical procedures

Data availability statement

Data sharing not applicable as no datasets generated and/or analyzed for this study.

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Data availability statement

Data sharing not applicable as no datasets generated and/or analyzed for this study.

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Footnotes

  • JL and CW contributed equally.

  • Contributors Concept and design of the work: JL, CW. Acquisition: JL, CW, YD, XC, XT, YL, XQ. Analysis: JL, CW, YD, XC, XT, YL, XQ. Drafting the paper: JL, CW. Revising the paper: XQ. Guarantor: XQ.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.