TENC Neurocirurgia Practice Questions - TENC - Título De Especialista Em Neurocirurgia (Sociedade Brasileira De Neurocirurgia AMB) Exam

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The landmark International Subarachnoid Aneurysm Trial (ISAT) randomized patients with ruptured intracranial aneurysms suitable for both treatments to either microsurgical clipping or endovascular coiling. What was the primary finding of ISAT regarding 1-year clinical outcomes?

Microsurgical clipping produced a statistically significant reduction in 1-year all-cause mortality compared to endovascular coiling. Endovascular coiling was associated with a statistically significant 23.9% relative reduction (6.9% absolute risk reduction) in 1-year dependency or death compared to microsurgical clipping. Endovascular coiling resulted in a significantly lower rate of late aneurysm recurrence and rebleeding compared to microsurgical clipping. There was no statistically significant difference in 1-year functional dependency, but microsurgical clipping resulted in shorter intensive care unit stays.

Correct Answer:

Endovascular coiling was associated with a statistically significant 23.9% relative reduction (6.9% absolute risk reduction) in 1-year dependency or death compared to microsurgical clipping.

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