ArticleNeurosurgical review2025
Microsurgical clipping remains a viable option for the treatment of coilable ruptured middle cerebral artery aneurysms in the endovascular era.
Article in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.
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Who cites it
6 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Untangling the debate: a meta-analysis comparing clipping versus coiling in ruptured middle cerebral artery aneurysms.Neurosurgical review · 2026Pooled it
- Endovascular coiling vs. microsurgical clipping for ruptured anterior circulation aneurysms: an updated meta-analysis with meta-regression.Neuroradiology · 2026Pooled it
- Effectiveness and safety of the Sugita clip for ruptured and unruptured intracranial aneurysms: A retrospective cohort study.Surgical neurology international · 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
- Towards Realistic 3D-Printed Phantoms for Aneurysm Clipping: Mechanical Characterisation of Basilar Arteries.Bioengineering (Basel, Switzerland) · 2025Article
- Ruptured Posterior Inferior Cerebellar Artery Aneurysms: Integrating Microsurgical Expertise, Endovascular Challenges, and AI-Driven Risk Assessment.Journal of clinical medicine · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
Although many institutions increasingly perform endovascular coiling instead of microsurgical clipping as the primary treatment for ruptured aneurysms, there remains ongoing debate regarding the optimal treatment strategy for ruptured middle cerebral artery (MCA) aneurysms. Therefore, we compared the outcomes of clipping and coiling for treating ruptured MCA aneurysms. A total of 155 ruptured MCA aneurysms that were deemed eligible for both clipping and coiling were retrospectively reviewed. We compared patient characteristics, radiological results, clinical outcomes, and perioperative complications between patients who received clipping and those receiving coiling. Furthermore, we analyzed the potential risk factors for perioperative complications that differed between the two groups. 59 (38.1%) aneurysms were treated using coiling, and 96 (61.9%) received clipping. The clipping group showed a significantly higher rate of immediate complete occlusion and a lower rate of neck remnants compared with the coiling group (p = 0.006). These radiological results persisted at the 12-month angiographic follow-up, with a significantly higher complete occlusion rate (p = 0.038) and a lower recanalization rate (p = 0.033) in the clipping group. The clinical outcomes were comparable between the two groups. Patients treated with coiling showed a higher rate of permanent shunting than those treated with clipping (18.6% vs. 8.3%, p = 0.058). Coiling was independently associated with shunt-dependent hydrocephalus in multivariate analysis. Microsurgical clipping provides comparable clinical outcomes, better occlusion, and superior durability for treating ruptured MCA aneurysms compared with endovascular coiling. Therefore, clipping remains a viable option for treating ruptured MCA aneurysms, even in aneurysms suitable for coiling.
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Registered trials
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 Socratic graph.