SynthesisNeurosurgical review2022
Microsurgical clipping versus newer endovascular techniques in treatment of unruptured anterior communicating artery-complex aneurysms: a meta-analysis and systematic review.
Synthesis in Neurosurgical review, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Flow diverting stents for anterior communicating artery aneurysms: A systematic review and meta-analysis of safety, efficacy, and anatomic determinants.Neurosurgical review · 2026Pooled it
- Preventive clipping versus coiling in unruptured intracranial aneurysms: A comprehensive meta-analysis and systematic review to explore safety and efficacy.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Pooled it
- Intra-procedural complications, success rate, and need for retreatment of endovascular treatments in anterior communicating artery aneurysms: a systematic review and meta-analysis.Neurosurgical review · 2022Pooled it
- Outcomes of Microsurgical Treatment for Unruptured Intracranial Aneurysms: A 7-Year Institutional Review.Neurosurgery practice · 2026Article
- Comparative Effectiveness of Surgical, Endovascular, and Conservative Strategies for Unruptured Intracranial Aneurysms.Stroke (Hoboken, N.J.) · 2026Article
- Comparative outcomes of microsurgical and endovascular treatment for ruptured and unruptured anterior communicating artery aneurysms.Neurosurgical review · 2026Article
- Multidimensional Comparison of Microsurgical Clipping and Endovascular Techniques for Anterior Communicating Artery Aneurysms: Balancing Occlusion Rates and Periprocedural Risks.Medicina (Kaunas, Lithuania) · 2025Article
- Clinical use of 3D printed models for anterior communicating artery aneurysm clipping: a prospective cohort study.Frontiers in surgery · 2025Article
- Complex intracranial aneurysms: a DELPHI study to define associated characteristics.Acta neurochirurgica · 2024Article
- Current state of endovascular treatment of anterior cerebral artery aneurysms.Frontiers in neurology · 2024Review
- An overview of decision-making in cerebrovascular treatment strategies: Part I - unruptured aneurysms.Brain & spine · 2024Review
- The impact of selection bias in the treatment for ruptured anterior communicating artery aneurysms: different results or different patients?World neurosurgery: X · 2024Article
- Intrasaccular Flow Disruptor-Assisted Coiling of Intracranial Aneurysms Using the Novel Contour Neurovascular Systems and NEQSTENT: A Single-Center Safety and Feasibility Study.Brain sciences · 2022Article
Corrections and comments
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Authors and funding
9 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The aim of this study is to compare occlusion rate, complication rate, and clinical outcome of microsurgical clipping (MC) and advanced endovascular techniques (EVT) in unruptured anterior communicating artery-complex aneurysms (ACoCAs). We reviewed the scientific literature reporting occlusion rate, time of occlusion assessment, and clinical outcome of MC and EVT in patients with unruptured ACoCAs, from January 2009 to December 2019. We included in our analysis 25 studies and 872 patients with unruptured ACoCAs (434 treated with endovascular techniques and 438 with MC). Ninety-three (10.7%), 320 (36.7%), 21 (2.4%), and 438 (50.2%) were treated with flow diverter (FD), stent-assisted coiling (SAC), endosaccular devices (ES), and microsurgical clipping (MC) respectively. FD, SAC, ES, and MC subgroups presented minor complications in 11.8%, 3.8%, 14.3%, and 7.1% of cases (p=.016), and major complications in 3.2%, 4.4%, 0%, and 7.1% (p=.136) of patients. A total occlusion rate post-treatment has been achieved in 4.3%, 87.1%, 47.6%, and 98.2% of cases (p=.000), while at 12 months' follow-up in 50%, 66%, 83.3%, and 80% of patients (p=.001). FD, SAC, ES, and MC subgroups had a good clinical outcome at 12 months in 93.5%, 90.5%, 100%, and 67.8% of cases. MC is associated with higher post-treatment total occlusion rate, but higher complication and lower good clinical outcome rates. EVT are promising in treating unruptured anterior cerebral artery aneurysms with high margin of safety and good clinical outcome, despite the lower total occlusion rate.
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