Mortality Outcomes of Endovascular Treatment and Surgical Clipping in Patients with Cerebral Aneurysms: A Single-Center Study

Abstract

Aim: To compare endovascular and surgical treatment methods for cerebral aneurysms focusing on mortality.

Material and methods: The study included 187 patients who had undergone aneurysm treatment. The patients were divided into four groups according to their treatment modality and subarachnoid hemorrhage status: patients with endovascular treatment and bleeding aneurysms (EVG-b), patients with endovascular treatment and non-bleeding aneurysms (EVG-nb), patients with surgical clipping and bleeding aneurysms (SCG-b), and patients with surgical clipping and non-bleeding aneurysms (SCG-nb). The Hunt?Hess scores, Fisher grade, aneurysm morphology, and length of stay (LOS) were compared between groups.

Results: There was no significant difference in the mortality rate between EVG-b and SCG-b at the end of the first year (23.5% and 39.7%, respectively; p > 0.05). A significantly shorter LOS was observed in EVG-b than in SCG-b (11.5 days and 15 days, respectively; p=0.027). Fusiform aneurysms were associated with higher patient mortality, whereas saccular aneurysms were associated with a 1.9-fold higher survival (p=0.037; 95% confidence interval: 0.83?4.74). The rate of closure of non-bleeding aneurysms was 93.4%. Complete embolization was verified in all bleeding aneurysms. In EVG-nb, the morbidity rate was 5%, the mortality rate was 3%, and the mean LOS was 2.86 days.

Conclusion: Both treatment methods showed similar mortality rates, but hospital stays were shorter after endovascular treatment.