Aneurysm Treatment: Endovascular Coiling, Surgical Clipping Face Off

In these two studies, investigators attempted to determine which procedure is safer and more effective for treating ruptured saccular aneurysms: surgical clipping or endovascular coiling. The International Subarachnoid Aneurysm Trial (ISAT) was a large, prospective study of 2143 patients with subarachnoid hemorrhage (SAH) due to a ruptured aneurysm who were randomized to either clipping or coiling. The two treatment groups had comparable demographics, SAH characteristics, and characteristics of the aneurysms, most of which were smaller than 10 mm in diameter. Because of a significant outcome difference at a one-year interim …