Introduction: Because of the improvement of the cerebral MRI in the screening for any neurological disease, the diagnosis of unruptured intracranial aneurysms is becoming much more frequent than in the past. In our study we analyze the results of surgical and endovascular treatment.
Methods: We studied 300 patients harboring 314 unruptured aneurysms. They were treated between 1998 and 2011 at Department of Neurosurgery of the Catholic University, Rome. All the cases were treated by the same neurosurgeon and the same interventional neuroradiologist. A questionary was submitted to all the patients one year after the treatment . The scale we obtained ranges from 0 Death to 5 Normal.
Results: 73% of the aneurysm were treated surgically and 27% by endovascular procedure. Based on our scale we documented a 1,69% of mortality rate for surgery and 0 for endovascular treatment. Considering the highest scores (4-5) we found 83% for surgery and 92% for endovascular procedure. A non complete exclusion of the aneurysm at the immediate post-treatment control was documented in 29% of the endovascular group ( with a further treatment in the 8% of the cases) and 4% of the surgical one (with no need of a new treatment). A late riperfusion of the aneurysm was found in 9,7% of the endovascular group and in 1,7% of surgical group.
Conclusions: Considering only the data obtained by our scale, the endovascular procedure reaches better results, but if we analyze also the percentage of immediate incomplete exclusion and of the late recurrence, the surgical procedure is more reliable.
Patient Care: Identifying the best treatment of unruptured intracranical aneurysm
Learning Objectives: Discuss the treatment of unruptured intracranial aneurysm