Editorial: Coils and rebleeding

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With publication of the late results of the International Subarachnoid Aneurysm Trial (ISAT) study,2 and continued refinements of endovascular techniques, coil embolization is rapidly becoming the therapy of choice for the majority of patients with ruptured intracranial aneurysms in many neurovascular units worldwide. Despite the safety of the procedure and its undoubtedly less invasive nature when compared to surgical treatment, concerns remain about the durability of treatment. Moreover, in the ISAT study only a small proportion of the patients originally screened were eventually enrolled. This observation has generated questions whether the results of ISAT can indeed be generalized

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Please include this information when citing this paper: published online July 30, 2010; DOI: 10.3171/2010.4.JNS091893.

© AANS, except where prohibited by US copyright law.

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References

1

CARAT Investigators: Rates of delayed rebleeding from intracranial aneurysms are low after surgical and endovascular treatment. Stroke 37:143714422006

2

Molyneux AJKerr RSBirks JRamzi NYarnold JSneade M: Risk of recurrent subarachnoid haemorrhage, death, or dependence and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the International Subarachnoid Aneurysm Trial (ISAT): long-term follow-up. Lancet Neurol 8:4274332009

3

Plowman RSClarke AClarke MByrne JV: Sixteen-year single-surgeon experience with coil embolization for ruptured intracranial aneurysms: recurrence rates and incidence of late rebleeding. Clinical article. J Neurosurg [epub ahead of print July 30 2010. DOI: 10.3171/2010.6.JNS091058]

1

Byrne JVSohn MJMolyneux AJChir B: Five-year experience using coil embolization for ruptured intracranial aneurysms: outcome and incidence of late rebleeding. J Neurosurg 90:6566631999

2

Royal College of Surgeons of England Clinical Effectiveness Unit: National Study of Subarachnoid Haemorrhage: Final Report of an Audit Carried Out in 34 Neurosurgical Units in the UK and Ireland between 14 September 2001 to 13 September 2002 LondonRoyal College of Surgeons of England2006. (http://www.rcseng.ac.uk/rcseng/content/publications/docs/nat_study_subarachnoid_haem_feb2006.html) [Accessed June 22 2010]

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