A decade after International Subarachnoid Aneurysm Trial: Coiling as a first choice treatment in the management of intracranial aneurysms - Technical feasibility and early management outcomes.

The expertise of the neurosurgeons involved and the fact that nearly 70% of eligible patients were enrolled in the BRAT trial has further dwarfed the arguments against ISAT results.[ 30 ] The 3 year results of BRAT trial showed that the outcomes of all patients assigned to coil embolization showed a favorable 5.8% absolute difference compared with outcomes of those assigned to clip occlusion although this difference did not reach statistical significance ( P = 0.25).[ 31 ] A recent meta-analysis of three major randomized controlled trials comparing coiling and surgical clipping showed that the rate of poor outcome at 1-year was significantly lower in patients allocated to coil embolization (risk ratio, 0.75; 95% confidence interval [CI], 0.65-0.87).

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