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International Subarachnoid Aneurysm Trial : ウィキペディア英語版
International Subarachnoid Aneurysm Trial
The International Subarachnoid Aneurysm Trial (ISAT) was a large multicentre, prospective randomised clinical medical trial, comparing the safety and efficacy of endovascular coil treatment and surgical clipping for the treatment of brain aneurysms. The study began in 1994. The first results were published in ''The Lancet'' in 2002, and the 10 year data were published again in ''The Lancet'' in early September 2005. 2,143 study participants were mostly drawn from U.K. hospitals with the rest drawn from North American and European hospitals.
The study found better results with endovascular coil treatment compared to surgical clipping, however subsequent studies have questioned this conclusion.〔AJNR Am J Neuroradiol. 2005 Feb;26(2):367-72.〕 The study was criticised by many clinicians and not well accepted by surgeons.〔Michael Forsting, Isabel Wanke, ''Intracranial Vascular Malformations and Aneurysms: From Diagnostic Work-Up to Endovascular Therapy'', Springer 2008, ISBN 3-540-32919-6.〕 Primary criticisms were related to the study's patient population's generalisability to the wider population, and the long term prognosis of coil embolisation.〔Michael J. Alexander, Robert Friedrich Spetzler, ''Pediatric neurovascular disease: surgical, endovascular, and medical management'', Thieme: 2006, ISBN 1-58890-368-0, page 145.〕
==Study design and results==
ISAT sought to measure outcomes of cerebral aneurysm patients at 2 and 12 months using a type of a Rankin scale.〔Michael S. Horowitz, Elad I. Levy, ''Neuroendovascular surgery'', Karger Publishers, 2005, ISBN 3-8055-7781-8.〕 The study was halted in 2002 after the oversight committee found increased morbidity with clipping over endovascular coiling.〔

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