ArticleNeurosurgical review2022
Clipping versus coiling for treatment of middle cerebral artery aneurysms: a retrospective Italian multicenter experience.
Article in Neurosurgical review, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
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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.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Untangling the debate: a meta-analysis comparing clipping versus coiling in ruptured middle cerebral artery aneurysms.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
- M1 segment morphology is associated with far lateral lenticulostriate arteries in middle cerebral artery bifurcation surgery: a cadaveric and clinical anatomic study.Neurosurgical review · 2026Article
- Long-term Cerebrovascular Risk after Microsurgical Clipping of Unruptured Anterior Circulation Aneurysms: Low Subarachnoid Hemorrhage Incidence and Persistent Stroke Susceptibility over 7,600 Patient-years.Neurologia medico-chirurgica · 2026Article
- Local Recurrence after Microsurgical Clipping of Unruptured Intracranial Aneurysms: Incidence, Timing, and Risk Factors over 20 Years.Neurologia medico-chirurgica · 2026Article
- Comparison of feasibility and efficacy of microsurgery and interventional techniques in the management of unruptured middle cerebral artery aneurysms with a history of transient ischemic attack.Frontiers in surgery · 2026Article
- Early T2-weighted magnetic resonance imaging changes after microsurgical clipping of unruptured aneurysms: Biomarkers of corridor-related tissue impact.Surgical neurology international · 2026Article
- Unruptured middle cerebral artery bifurcation aneurysms: long-term outcomes of endovascular techniques from an 'endovascular-first' policy center.Neuroradiology · 2025Article
- Unilateral approach to bilateral middle cerebral artery aneurysms: a large series and a proposed grading system to predict technical difficulties.Neurosurgical review · 2025Article
- Microsurgical clipping remains a viable option for the treatment of coilable ruptured middle cerebral artery aneurysms in the endovascular era.Neurosurgical review · 2025Article
- Are There Left-Right Differences in Ruptured Middle Cerebral Artery Bifurcation Aneurysms? A Single-Center Retrospective Study and Review of the Literature.Asian journal of neurosurgery · 2024Article
- Microsurgical Clipping of Unruptured Middle Cerebral Artery Bifurcation Aneurysms: A Single-Center Experience.Brain sciences · 2024Article
- Geometry and Symmetry of Willis' Circle and Middle Cerebral Artery Aneurysms Development.Journal of clinical medicine · 2024Article
- Changes in treatment of intracranial aneurysms during the last decade in a large European neurovascular center.Acta neurochirurgica · 2024Observational
- Systematic Review and Meta-Analysis of Endovascular Therapy Effectiveness for Unruptured Saccular Intracranial Aneurysms.Stroke (Hoboken, N.J.) · 2024Article
- Clipping first policy for middle cerebral artery aneurysm: A single-center cohort study.Surgical neurology international · 2024Article
- Unruptured intracranial aneurysms: Why should we focus on small aneurysms? A comprehensive update of recent findings.Polish journal of radiology · 2024Review
- Clinical Outcomes of Endovascular Coil Embolization for Ruptured Middle Cerebral Artery Aneurysms.Journal of neuroendovascular therapy · 2024Article
- Long-term outcomes of surgical clipping of saccular middle cerebral artery aneurysms: a consecutive series of 92 patients.Neurosurgical review · 2023Review
- Endovascular treatment of middle cerebral artery aneurysms: current status and future prospects.Frontiers in neurology · 2023Review
Corrections and comments
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Authors and funding
17 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Endovascular treatment has emerged as the predominant approach in intracranial aneurysms. However, surgical clipping is still considered the best treatment for middle cerebral artery (MCA) aneurysms in referral centers. Here we compared short- and long-term clinical and neuroradiological outcomes in patients with MCA aneurysms undergoing clipping or coiling in 5 Italian referral centers for cerebrovascular surgery. We retrospectively reviewed 411 consecutive patients admitted between 2015 and 2019 for ruptured and unruptured MCA aneurysm. Univariate and multivariate analyses of the association between demographic, clinical, and radiological parameters and ruptured status, type of surgical treatment, and clinical outcome at discharge and follow-up were performed. Clipping was performed in 340 (83%) cases, coiling in 71 (17%). Clipping was preferred in unruptured aneurysms and in those showing collateral branches originating from neck/dome. Surgery achieved a higher rate of complete occlusion at discharge and follow-up. Clipping and coiling showed no difference in clinical outcome in both ruptured and unruptured cases. In ruptured aneurysms age, presenting clinical status, intracerebral hematoma at onset, and treatment-related complications were significantly associated with outcome at both short- and long-term follow-up. The presence of collaterals/perforators originating from dome/neck of the aneurysms also worsened the short-term clinical outcome. In unruptured cases, only treatment-related complications such as ischemia and hydrocephalus were associated with poor outcome. Clipping still seems superior to coiling in providing better short- and long-term occlusion rates in MCA aneurysms, and at the same time, it appears as safe as coiling in terms of clinical outcome.
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