Evidence map›Paper›PMID 34870768›Full record

SynthesisNeurosurgical review2022

Clipping versus coiling for aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis of prospective studies.

Wenjun Zhu, Xiaoxiao Ling, Jindong Ding Petersen, Jinyu Liu, Anqi Xiao, Jiayan Huang

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

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 27 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 6 pooled it
3.0field-weighted citation impact, top 7% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 6 syntheses or guidelines pooled it, 44 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 3 countries.

Wenjun ZhuSchool of Public Health, Fudan University, Shanghai, 200433, China.
Xiaoxiao LingDepartment of Statistical Science, University College London, London, WC1E 6BT, UK.
Jindong Ding PetersenDepartment of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Jinyu LiuSchool of Public Health, Fudan University, Shanghai, 200433, China.
Anqi XiaoSchool of Public Health, Fudan University, Shanghai, 200433, China.
Jiayan HuangSchool of Public Health, Fudan University, Shanghai, 200433, China. jiayanhuang@fudan.edu.cn.ORCID http://orcid.org/0000-0003-4166-6119
Fudan University · CNUniversity College London · GBUniversity of Copenhagen · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Neurosurgical clipping and endovascular coiling are both standard therapies to prevent rebleeding after aneurysmal subarachnoid hemorrhage (aSAH). However, controversy still exists about which is the optimal treatment. This meta-analysis aims to assess the effectiveness and safety of two treatments with high-quality evidence. Web of Science, Cochrane Library, EMBASE, Pubmed, Sinomed, China National Knowledge Infrastructure, and Wanfang Data databases were systematically searched on August 5, 2021. Randomized controlled trials (RCTs) and prospective cohort studies that evaluated the effectiveness and safety of clipping versus coiling in aSAH patients at discharge or within 1-year follow-up period were eligible. No restriction was set on the publication date. Meta-analyses were conducted to calculate the pooled estimates and 95% confidence intervals (CI) of relative risk (RR). Eight RCTs and 20 prospective cohort studies were identified. Compared to coiling, clipping was associated with a lower rebleeding rate at discharge (RR: 0.52, 95% CI: 0.29--0.94) and a higher aneurysmal occlusion rate (RR: 1.33, 95% CI: 1.19-1.48) at 1-year follow-up. In contrast, coiling reduced the vasospasm rate at discharge (RR: 1.45, 95% CI: 1.23-1.71) and 1-year poor outcome rate (RR: 1.27, 95% CI: 1.16-1.39). Subgroup analyses presented that among patients with a poor neurological condition at admission, no statistically significant outcome difference existed between the two treatments. The overall prognosis was better among patients who received coiling, but this advantage was not significant among patients with a poor neurological condition at admission. Therefore, the selection of treatment modality for aSAH patients should be considered comprehensively.

Indexed as

Endovascular ProceduresIntracranial AneurysmSubarachnoid HemorrhageDatabases, FactualHumansNeurosurgical ProceduresProspective StudiesTreatment OutcomeAneurysmal subarachnoid hemorrhageEffectivenessEndovascular coilingMeta-analysisNeurosurgical clippingSafety

Identifiers

PMID34870768
PMCPMC8976818
OpenAlexW4200573755

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.