Unruptured Cerebral Aneurysms: Evaluation and Management

Table 5

Summary of large studies evaluating the treatment risk of unruptured cerebral aneurysms.

Study	Important findings
Alshekhlee et al. [24]: review of a cohort of 3,738 clipped unruptured aneurysms versus 3,498 coiled unruptured aneurysms from the National Inpatient Sample Database from 2000 to 2006	(i) Mortality rate was 1.61% (for clipped aneurysms) versus 0.57% for coiled aneurysms ( < 0.0001); (ii) Rate of acute ischemic stroke was 6.71% (for clipped aneurysms) versus 2.92% for coiled aneurysms ( < 0.0001); (iii) Rate of intracerebral hemorrhage was 2.38% (for clipped aneurysms) versus 1.37% for coiled aneurysms ( < 0.002)
McDonald et al. [25]: review of a cohort of 1,388 clipped unruptured aneurysms versus 3,551 coiled unruptured aneurysms from Premier Perspective Database from 2006 to 2011	(i) Mortality rates were similar in both clipping and coiling with odds ratio of 1.43 ( < 0.47); (ii) Clipping had a higher likelihood of unfavorable outcomes: odds ratio (OR) for discharge to long term care was 4.78 ( < 0.0001); OR for ischemic complications was 3.42 ( < 0.0001); OR for postoperative neurological complications was 3.39 ( < 0.0001); OR for hemorrhagic complications was 2.16 ( < 0.0001); OR for ventriculostomy was 2.10 ( < 0.032)