Methods: patients with ruptured intracranial aneurysms, who were admitted to 42 neurosurgical centres, mainly in the UK and Europe, took part in the trial.
The primary outcome was death or dependence at 1 year defined by a modified Rankin scale of Secondary outcomes included rebleeding from the treated aneurysm and risk of seizures. Long-term follow up continues. Analysis was in accordance with the randomised treatment. Findings: We report the 1-year outcomes for of patients allocated to endovascular treatment, and of patients allocated to neurosurgical treatment.
Analysis was per protocol. Findings: of The relative and absolute risk reductions in dependency or death after allocation to an endovascular versus neurosurgical treatment were The risk of rebleeding from the ruptured aneurysm after 1 year was two per and zero per patient-years for patients allocated endovascular and neurosurgical treatment, respectively.
Interpretation: In patients with a ruptured intracranial aneurysm, for which endovascular coiling and neurosurgical clipping are therapeutic options, the outcome in terms of survival free of disability at 1 year is significantly better with endovascular coiling. The data available to date suggest that the long-term risks of further bleeding from the treated aneurysm are low with either therapy, although somewhat more frequent with endovascular coiling.
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