Romanian Neurosurgery (Dec 2024)
Endovascular treatments, predictors and outcomes of cerebral aneurysm
Abstract
Background: Recent studies in surgical techniques have significantly transformed therapeutic approaches, leading to substantial decreases in morbidity and mortality rates. Differential diagnosis plays a pivotal role in determining the most suitable surgical strategies for addressing aneurysms. Historically, clipping has been considered a longstanding tradition in the vascular field between 1937 and 1975, pioneered by Microneurosurgery pioneers Yasargil and Fox. Methods: This study followed the PRISMA (Preferred Reporting Items for Systematic Reviews), and the statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26.0 (released 2020; IBM Corp., Armonk, New York, United States). And EXCEL: A comprehensive review of neurosurgical care for cerebral aneurysms in controlling subarachnoid haemorrhage through endovascular clipping and coiling was conducted by the followers’ methods used on aneurysm patients. Databases like Science Direct and PubMed were utilized, and articles were searched from the earliest available dates up to January 2024. Tables 1-2-3 are shown. The search focused primarily on publications in English, adhering to PRISMA guidelines. The search process for scientific papers, including meta-analysis, centred on PubMed and Science Direct. Results: A total of 45,223.00 patients with aneurysms who underwent endovascular procedures or surgical methods involving clipping or colling are displayed in Table 1. Of these, 2769 patients had ruptured aneurysms associated with subarachnoid haemorrhage, while 985.00 patients did not rupture. In Table 2, 6090.14 patients with aneurysms are evaluated, and in Table 3, 36,251.00 patients with coils 31,502.00 and clips 28,803.00 were assessed. Conclusion: From the synthesis of various reviewed studies, effective management strategies involve early detection of bleeding using diagnostic tests like MRI or CT angiography, considering neurological functioning levels assessed through scales such as the Fisher scale or the Hunt and Hess scale for subarachnoid haemorrhage or potential stroke.
