Coiling or clipping? Treatment of intracranial aneurysms

Until recently the preferred treatment option for patients with intracranial aneurysms was a surgical repair intervention, during which the skull was opened and a clip was placed on the bulge in the threatened artery. This so called ‘clipping operation’ has been shown effective in preventing (recurrent) life threatening ruptures and subarachnoid hemorrhage. However, in the mean time a new treatment modality has been introduced, the so called ‘coiling procedure’, in which a catheter is inserted via an incision in the groin and pushed up into the aneurysm, where a platinum coil is placed in position. A big advantage of this endovascular approach is the avoidance of open surgery of the cranium. However, not yet every type of aneurysm can be effectively treated in this way.