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In 1994, British researchers began an international randomized trial of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms (NEJM JW Gen Med Oct 7 2005). After 1 year, patients in the coiling group experienced lower risk for death or dependency; after 5 years, patients in this group had more-frequent rebleeding from target aneurysms but with no substantial effects on survival or dependency. Now, using national registries and annual questionnaires, the authors have accrued data from 10 to 18 years of follow-up in 1644 patients from U.K. centers.
Ten years after intervention, significantly more patients in the coiling group were still alive (83% vs. 79%), roughly 80% of survivors in each gro…