6/28/23, 11:38 PM ISAT 1 Pathway Feedback Search Clinical Topics Home Studies ISAT 1 ISAT 1 Disease Subarachnoid hemorrhage Trial question What is the role of endovascular detachable coil treatment in patients with ruptured intracranial aneurysms? Study design Multi-center Double blinded RCT Population Characteristics of study participants 63.0% female N = 2143 37.0% male 2143 patients (1344 female, 799 male) Inclusion criteria: patients with ruptured intracranial aneurysms Key exclusion criteria: subarachnoid hemorrhage occurred > 28 days before randomisation, patient unsuitable for one or both treatments, consent was refused, patient participating in another randomised clinical trial of a treatment for subarachnoid hemorrhage Interventions N=1073 endovascular treatment (endovascular treatment by detachable platinum coils) N=1070 neurosurgical treatment (clipping the neck of the aneurysm) Primary outcome Dependency or death at 1 year 30.6 30.6 % 23 7 https://web.pathway.md/studies/recuVegJp4Wu6Iuqc 1/2 6/28/23, 11:38 PM ISAT 1 Pathway 23.7 23.0 % 15.3 % Significant decrease 7.7 % NNT = 14 0.0 % Endovascular treatment Neurosurgical treatment Significant decrease in dependency or death at 1 year (23.7% vs. 30.6%; RR 0.77, 95% CI 0.66 to 0.91) Safety outcomes No significant difference in frequency of preprocedural rebleeding. Significant difference in risk of rebleeding from ruptured aneurysm after 1 year (0.16% vs. 0%). Conclusion In patients with ruptured intracranial aneurysms, endovascular treatment was superior to neurosurgical treatment with respect to dependency or death at 1 year. Reference Andrew Molyneux, Richard Kerr, Irene Stratton et al. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet. 2002 Oct 26;360(9342):1267-74. Open reference URL https://web.pathway.md/studies/recuVegJp4Wu6Iuqc 2/2