International subarachnoid Aneurysm Trial (ISAT)
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Introduction
2143 patients.
Endovascular coiling with detachable platinum coil device vs surgical clipping of ruptured intracranial aneurysm.
At 1 year:
- 24% of coiled patients dead or dependent
- 31% of clipped patients dead or dependent
At 7 years mortality was higher in the clipping group.[2]
- rebleeding from the target aneurysm was similar in both groups during the 1st year, but the coiling group had more later rebleeds (7 vs 2)[2]
Fewer seizures occurred in the coiling group.
At 10 years, outcomes better in the coiling group (mortality 17% vs 21%)[3]
- more rebleeding in the coiling group, 13 vs 6 of 1644 patients, but only 6 of 13 vs 4 of 6 rebleeds resulted in death or dependency[3]
More general terms
References
- ↑ Journal Watch 23(1):2, 2003 International subarachnoid Aneurysm Trial (ISAT) Collaborative Group, Lancet 360:1267, 2002 Nichols DA et al, Lancet 360:1262, 2002
- ↑ 2.0 2.1 2.2 Molyneux AJ, Kerr RS, Yu LM, Clarke M, Sneade M, Yarnold JA, Sandercock P; International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group. International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet. 2005 Sep 3-9;366(9488):809-17. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16139655
Britz GW. ISAT trial: coiling or clipping for intracranial aneurysms? Lancet. 2005 Sep 3-9;366(9488):783-5. No abstract available. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16139637 - ↑ 3.0 3.1 3.2 Molyneux AJ et al. The durability of endovascular coiling versus neurosurgical clipping of ruptured cerebral aneurysms: 18 year follow-up of the UK cohort of the International Subarachnoid Aneurysm Trial (ISAT). Lancet 2014 Oct 28 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25465111 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960975-2/fulltext