To clarify current treatment status of ruptured cerebral aneurysms in Japan, a prospective multicenter observational study on the treatment results for aneurysmal subarachnoid hemorrhage was conducted over calendar year 2005 and final 1-year outcomes were collected. Studied centers were selected from among institutes of committee member of Japanese stroke surgery organization or symposium of vasospasm in Japan. A total of 927 patients were enrolled in this study and treatment policies were left to each institution according to the patients’ background and aneurysmal characteristics. The observational protocol was similar to those of ISAT, especially the categorization of aneurysms, follow-up timing at 2 months and 1 year, patient outcome evaluation and recording of incomplete treatment results.
Finally, 770 patients were treated, and clipping was performed on 79% of them. Coil embolization was preferred in aged or vertebro-basilar artery aneurysm patients, and the 2-month outcome was identical in both the clipping and coil-treated groups. The 1-year outcome was better in the clipping group, but the initial patient condition in the clipping group was definitely better. The completeness of treatment was better in clipping, but post-treatment bleeding, hydrocephalus and epilepsy were identical in each group.
Evaluation of overall management outcome is mandatory to elucidate the contribution of endovascular treatment on the treatment result for ruptured cerebral aneurysms.