In Europe only few neurosurgeons are trained in both open surgical clipping as well as in
endovascular techniques for treatment of
intracranial aneurysms. To investigate the safety and efficacy of performing both techniques we, two dual trained neurosurgeons, analyzed our results in repairing ruptured
intracranial aneurysms. Prospectively collected data from 356 patients that underwent open surgical or endovascular repair of a ruptured
intracranial aneurysm at the Neurosurgical Centre Nijmegen from 2006 to 2012 by two dual trained neurosurgeons were retrospectively analyzed. Complication rates, occlusion rates, and
retreatment rates were obtained. Combined procedural persistent neurological morbidity and mortality after endovascular treatment and open surgical clipping were 2.1 % and 1.4 %, respectively. Overall procedure-related clinical complication rate for endovascular treatment was 5.9 % in 285 procedures for 295
aneurysms. Overall procedure-related clinical complication rate for open treatment was 9.9 % in 71 procedures for 72
aneurysms. Follow-up was available for 255 out of 295 coiled
aneurysms, 48
aneurysms recurred and 34 needed
retreatment. For clipping 54 out of 72 treated
aneurysms had follow-up; four
aneurysms were incompletely clipped. One
aneurysm was retreated. Treatment of ruptured
intracranial aneurysms by neurosurgeons that perform both open surgical clipping as well as
endovascular techniques is safe and effective. Developing training programs in Europe for hybrid neurosurgeons that can provide comprehensive patient care should be considered.