Boston Scientific Corp., citing the results of a long-term study, said patients treated with endovascular coil embolization for ruptured intracranial aneurysms are 23 percent less likely to die within five years, compared with patients treated by surgical clipping of the aneurysm.
The results, published in The Lancet Neurology (registration required), are part of a five-year review of the long-term International Subarachnoid Aneurysm Trial comparing the efficacy of treating brain aneurysms using the embolization procedure and surgical clipping.
The study, of 2,143 patients, looks at the risk of death and re-bleeding after each type of treatment. Endovascular coiling is a minimally invasive procedure in which platinum Guglielmi detachable coils are deployed into an aneurysm using a catheter. The coils alter blood flow within the aneurysm, causing a clot and preventing it from rupturing. In surgical clipping, neurosurgeons open the skull, locate the aneurysm and attach a clip to its base.
Eleven percent (112 of 1046) of endovascular patients and 14 percent (144 of 1041) of neurosurgical patients were dead at the five-year mark, making the risk of death at five years significantly lower in the coiling group.
But the proportion of survivors at five years who were independent did not differ (83 percent (626 of 755) for endovascular and 82 percent (584 of 713) for neurosurgical).
And the endovascular treatment carried a small but increased risk of recurrent bleeding.
Boston Scientific said patients in the endovascular group were primarily treated with its early-generation GDC products.