Evidence map›Paper›PMID 38985334›Full record

ArticleActa neurochirurgica2024

Partial coil embolization before surgical clipping of ruptured intracranial aneurysms.

Akshitkumar M Mistry, Janki Naidugari, Kimberly S Meyer, Ching-Jen Chen, Brian J Williams, Ryan P Morton, Isaac J Abecassis, Dale Ding

Abstract read
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In one paragraph

Article in Acta neurochirurgica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

8 authors.

Akshitkumar M MistryDepartment of Neurosurgery, University of Louisville, 220 Abraham Flexner Way, 15th Floor, Louisville, KY, 40202, USA. axitamm@gmail.com.ORCID 0000-0002-7918-5153
Janki NaidugariSchool of Medicine, University of Louisville, Louisville, KY, USA.
Kimberly S MeyerDepartment of Neurosurgery, University of Louisville, 220 Abraham Flexner Way, 15th Floor, Louisville, KY, 40202, USA.
Ching-Jen ChenDepartment of Neurosurgery, University of Texas Health Science Center, Houston, TX, USA.
Brian J WilliamsDepartment of Neurosurgery, University of Louisville, 220 Abraham Flexner Way, 15th Floor, Louisville, KY, 40202, USA.
Ryan P MortonDivision of Neurosurgery, Brooke Army Medical Center, San Antonio, TX, USA.
Isaac J AbecassisDepartment of Neurosurgery, University of Louisville, 220 Abraham Flexner Way, 15th Floor, Louisville, KY, 40202, USA.
Dale DingDepartment of Neurosurgery, University of Louisville, 220 Abraham Flexner Way, 15th Floor, Louisville, KY, 40202, USA.

Funding

StATins Use in intRacerebral hemorrhage patieNts (SATURN)U01NS102289 · NINDS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI Magdy H Selim · 2019 to 2026
$15.7M
StAtins Use in intRacereberal hemorrhage patieNts MRI (SATURN MRI) Ancillary StudyUF1NS120871 · NINDS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SELIM, MAGDY H, SHOAMANESH, ASHKAN · 2021 to 2021
$2.7M
NINDS NIH HHS U01 NS102289NINDS NIH HHS UF1 NS120871
6 · The paper itself

Abstract

objectiveIntraoperative rupture (IOR) is the most common adverse event encountered during surgical clip obliteration of ruptured intracranial aneurysms. Besides increasing surgeon experience and early proximal control, no methods exist to decrease IOR risk. Thus, our objective was to assess if partial endovascular coil embolization to protect the aneurysm before clipping decreases IOR.

methodsWe conducted a retrospective analysis of patients with ruptured intracranial aneurysms that were treated with surgical clipping at two tertiary academic centers. We compared patient characteristics and outcomes of those who underwent partial endovascular coil embolization to protect the aneurysm before clipping to those who did not. The primary outcome was IOR. Secondary outcomes were inpatient mortality and discharge destination.

resultsWe analyzed 100 patients. Partial endovascular aneurysm protection was performed in 27 patients. Age, sex, subarachnoid hemorrhage severity, and aneurysm location were similar between the partially-embolized and non-embolized groups. The median size of the partially-embolized aneurysms was larger (7.0 mm [interquartile range 5.95-8.7] vs. 4.6 mm [3.3-6.0]; P < 0.001). During surgical clipping, IOR occurred less frequently in the partially-embolized aneurysms than non-embolized aneurysms (2/27, 7.4%, vs. 30/73, 41%; P = 0.001). Inpatient mortality was 14.8% (4/27) in patients with partially-embolized aneurysms and 28.8% (21/73) in patients without embolization (P = 0.20). Discharge to home or inpatient rehabilitation was 74.0% in patients with partially-embolized aneurysms and 56.2% in patients without embolization (P = 0.11). A complication from partial embolization occurred in 2/27 (7.4%) patients.

conclusionsPreoperative partial endovascular coil embolization of ruptured aneurysms is associated with a reduced frequency of IOR during definitive treatment with surgical clip obliteration. These results and the impact of preoperative partial endovascular coil embolization on functional outcomes should be confirmed with a randomized trial.

Indexed as

Aneurysm, RupturedEmbolization, TherapeuticIntracranial AneurysmAdultAgedEndovascular ProceduresFemaleHumansIntraoperative ComplicationsMaleMiddle AgedNeurosurgical ProceduresRetrospective StudiesSurgical InstrumentsTreatment OutcomeAneurysmClipCoilRuptureSubarachnoid hemorrhage

Identifiers

PMID38985334

What OpenQuestion holds

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Registered trials

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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.