The decision between endovascular coiling and surgical clipping depends on three main factors: the aneurysm's anatomy, its location, and the patient's overall clinical condition.
Endovascular coiling is preferred for most ruptured aneurysms where the anatomy is suitable, for aneurysms in deep or surgically difficult locations, and for patients whose medical condition makes open surgery higher risk.
Surgical clipping is preferred for aneurysms with a wide neck that cannot be securely coiled, aneurysms associated with a haematoma requiring surgical evacuation, and certain locations where direct surgical access is safer than a catheter-based approach.
I perform both procedures and evaluate each patient's aneurysm individually. A cerebrovascular surgeon who can only offer one technique cannot give an unbiased recommendation.
Written by Dr Robin Gupta, MBBS, MS General Surgery, MCh Neurosurgery (GB Pant Hospital and Maulana Azad Medical College, New Delhi), Consultant Neurosurgeon and Stroke Specialist, Neuroendovascular Surgeon, SPARSH Hospital, Infantry Road, Vasanth Nagar, Bengaluru.
