Trial reportTrials2013
International Subarachnoid Aneurysm Trial - ISAT part II: study protocol for a randomized controlled trial.
Trial report in Trials, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Clipping versus coiling for aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis of prospective studies.Neurosurgical review · 2022Pooled it
- Angiographic results of surgical or endovascular treatment of intracranial aneurysms: a systematic review and inter-observer reliability study.Neuroradiology · 2021Pooled it
- Endovascular coiling versus neurosurgical clipping for people with aneurysmal subarachnoid haemorrhage.The Cochrane database of systematic reviews · 2018Pooled it
- Trial
- Trial
- Hydrogel versus Bare Platinum Coils in Patients with Large or Recurrent Aneurysms Prone to Recurrence after Endovascular Treatment: A Randomized Controlled Trial.AJNR. American journal of neuroradiology · 2017Trial
- Results of Endovascular Treatment of Ruptured Intracranial Aneurysms and Recanalization Rate After a Five-Year Follow-Up Period.Journal of clinical medicine · 2026Article
- Individualized Upfront Treatment Selection for Aneurysmal Subarachnoid Hemorrhage and Functional Outcomes: A Single-Center Retrospective Before-and-After Cohort Study.Neurology international · 2026Article
- Safety and efficacy of stent-assisted coiling with the pEGASUS-HPC stent in wide-necked intracranial aneurysms: a multicenter retrospective analysis.Journal of neurointerventional surgery · 2026Article
- Stent-assisted coiling using the pEGASUS-HPC stent for acutely ruptured wide-necked intracranial aneurysms: A multicenter retrospective study.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Complex Anatomy, Advanced Techniques: Microsurgical Clipping of a Ruptured Hypophyseal Artery Aneurysm.Journal of clinical medicine · 2025Article
- Risk factors for poor outcome after aneurysmal subarachnoid hemorrhage in patients with initial favorable neurological status.Acta neurochirurgica · 2024Article
- ClippingInterventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2024Review
- Clinical management of a ruptured intracranial aneurysm.Frontiers in stroke · 2024Review
- Ultra-early endovascular treatment improves prognosis in High grade aneurysmal subarachnoid hemorrhage: A single-center retrospective study.Frontiers in neurology · 2022Article
- Noninvasive Angiographic Results of Clipped or Coiled Intracranial Aneurysms: An Inter- and Intraobserver Reliability Study.AJNR. American journal of neuroradiology · 2021Article
- Aneurysmal Subarachnoid Hemorrhage: the Last Decade.Translational stroke research · 2021Review
- Article
- Measuring clinical uncertainty and equipoise by applying the agreement study methodology to patient management decisions.BMC medical research methodology · 2020Article
- Clinical outcome of endovascular coil embolization for cerebral aneurysms in Asian population in relation to risk factors: a 3-year retrospective analysis.BMC surgery · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundThe International Subarachnoid Aneurysm Trial (ISAT) demonstrated improved one-year clinical outcomes for patients with ruptured intracranial aneurysms treated with endovascular coiling compared to surgical clipping. Patients included in ISAT were mostly good grade subarachnoid hemorrhage (SAH) patients with small anterior circulation aneurysms. The purported superiority of coiling is commonly extrapolated to patients not studied in the original trial or to those treated using new devices not available at the time. Conversely, many patients are treated by clipping despite ISAT, because they are thought either to be better candidates for surgery, or to offer more durable protection from aneurysm recurrences. These practices have never been formally validated. Thus, for many ruptured aneurysm patients the question of which treatment modality leads to a superior clinical outcome remains unclear. METHODS/TRIAL
designISAT II is a pragmatic, multicenter, randomized trial comparing clinical outcomes for non-ISAT patients with subarachnoid hemorrhage allocated to coiling or clipping. Inclusion criteria are broad. The primary end-point is the incidence of poor clinical outcome (defined as mRS >2) at one year, just as in ISAT. Secondary end-points include measures of treatment safety for a number of pre-specified subgroups, with efficacy end-points including the presence of a major recurrence at one year; 1,896 patients (862 each arm plus 10% losses) are required to demonstrate a significant difference between coiling and clipping, hypothesizing 23% and 30% poor clinical outcome rates, for coiling and clipping, respectively. The trial should involve at least 50 international centers, and will take approximately 12 years to complete. Analysis will be by intention-to-treat.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.