Subscribe to this journal
Advanced Search
 array:23 [
  "pii" => "S2529849618300364"
  "issn" => "25298496"
  "doi" => "10.1016/j.neucie.2018.09.002"
  "estado" => "S300"
  "fechaPublicacion" => "2018-11-01"
  "aid" => "344"
  "copyright" => "Sociedad Española de Neurocirugía"
  "copyrightAnyo" => "2018"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Neurocirugia. 2018;29:267-74"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S1130147318300691"
      "issn" => "11301473"
      "doi" => "10.1016/j.neucir.2018.07.001"
      "estado" => "S300"
      "fechaPublicacion" => "2018-11-01"
      "aid" => "344"
      "copyright" => "Sociedad Española de Neurocirugía"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Neurocirugia. 2018;29:267-74"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 72
        "formatos" => array:2 [
          "HTML" => 50
          "PDF" => 22
        ]
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Investigaci&#243;n cl&#237;nica</span>"
        "titulo" => "Resultados cl&#237;nicos y de costes del tratamiento endovascular frente al quir&#250;rgico en aneurismas incidentales"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "267"
            "paginaFinal" => "274"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Clinical results and costs of endovascular treatment in comparison with surgery in non ruptured aneurysms"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1754
                "Ancho" => 1461
                "Tamanyo" => 73864
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n del coste de los materiales endovasculares&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Angel Horcajadas, Isabel Ortiz, Ana M&#46; Jorques, Majed J&#46; Katati"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "Angel"
                "apellidos" => "Horcajadas"
              ]
              1 => array:2 [
                "nombre" => "Isabel"
                "apellidos" => "Ortiz"
              ]
              2 => array:2 [
                "nombre" => "Ana M&#46;"
                "apellidos" => "Jorques"
              ]
              3 => array:2 [
                "nombre" => "Majed J&#46;"
                "apellidos" => "Katati"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2529849618300364"
          "doi" => "10.1016/j.neucie.2018.09.002"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529849618300364?idApp=UINPBA00004B"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147318300691?idApp=UINPBA00004B"
      "url" => "/11301473/0000002900000006/v1_201810280605/S1130147318300691/v1_201810280605/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2529849618300352"
    "issn" => "25298496"
    "doi" => "10.1016/j.neucie.2018.09.001"
    "estado" => "S300"
    "fechaPublicacion" => "2018-11-01"
    "aid" => "343"
    "copyright" => "Sociedad Espa&#241;ola de Neurocirug&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Neurocirugia. 2018;29:275-95"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Clinical Research</span>"
      "titulo" => "3D microsurgical anatomy of the cortico-spinal tract and lemniscal pathway based on fibre microdissection and demonstration with tractography"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "275"
          "paginaFinal" => "295"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Anatom&#237;a microquir&#250;rgica en 3 D del tracto corticoespinal y de la v&#237;a del lemnisco basada en microdisecci&#243;n de fibras y demostraci&#243;n a trav&#233;s de tractograf&#237;a"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0015"
          "etiqueta" => "Fig&#46; 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 2189
              "Ancho" => 4200
              "Tamanyo" => 1419475
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">&#40;A and B&#41; Dissection of the cerebral peduncle and basilar part of the pons reveals the substantia nigra and sensory fibres that occupy the anterior surface of the pontine tegmentum and include the medial lemniscus&#44; lateral spinothalamic tract and lateral lemniscus&#46; &#40;C&#41; On continuing the dissection of the lateral and deep fibres of the medullary pyramid&#44; the relationship between the organisation and arrangement of the corticospinal and lemniscal fibres is seen along their entire trajectory in the brainstem&#46; &#40;D and E&#41; On a different specimen&#44; after the dissection of all the fibres of the medullary pyramid&#44; the basilar part of the pons and the cerebral peduncle&#44; the main medial and lateral lemniscal fibres and spinothalamic tract are observed&#46; &#40;F and G&#41; After dissecting the internal capsule&#44; the lateral surface of the thalamus is exposed&#44; with its main thalamocortical radiations&#46; H and <span class="elsevierStyleSmallCaps">I</span> correspond to images C and E in 3D&#44; respectively&#46;</p> <p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">ac&#58; anterior commissure&#59; cc&#58; corpus callosum&#59; cn&#58; caudate nucleus&#59; cp&#58; cerebral peduncle&#59; cst&#58; corticospinal tract&#59; dn&#58; dentate nucleus&#59; dscp&#58; decussation of the superior cerebellar peduncles&#59; fl&#58; frontal lobe&#59; flo&#58; flocculus&#59; ic&#58; inferior colliculus&#59; icp&#58; inferior cerebellar peduncle&#59; lgb&#58; lateral geniculate body&#59; lle&#59; lateral lemniscus&#59; mb&#58; mammillary body&#59; mcp&#58; middle cerebellar peduncle&#59; mle&#58; medial lemniscus&#59; na&#58; nucleus accumbens&#59; ol&#58; olive of the medulla oblongata&#59; pon&#58; pons&#59; py&#58; medullary pyramid&#59; scp&#58; superior cerebellar peduncle&#59; sn&#58; substantia nigra&#59; t&#58; thalamus&#59; tl&#58; temporal lobule&#59; tp-a&#58; anterior thalamic peduncle&#59; tp-p&#58; posterior thalamic peduncle&#59; tp-s&#58; superior thalamic peduncle&#59; ver&#58; cerebellar vermis&#46;</p> <p id="spar0085" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSmallCaps">II</span>&#58; optic nerve&#59; <span class="elsevierStyleSmallCaps">III</span>&#58; oculomotor nerve&#59; <span class="elsevierStyleSmallCaps">V</span>&#58; trigeminal nerve&#59; <span class="elsevierStyleSmallCaps">VII</span>&#58; facial nerve&#59; <span class="elsevierStyleSmallCaps">IX</span>-<span class="elsevierStyleSmallCaps">X</span>&#58; glossopharyngeal and vagus nerves&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ruben Rodr&#237;guez-Mena, Jos&#233; Piquer-Belloch, Jos&#233; Luis Ll&#225;cer-Ortega, Pedro Riesgo-Su&#225;rez, Vicente Rovira-Lillo"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Ruben"
              "apellidos" => "Rodr&#237;guez-Mena"
            ]
            1 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Piquer-Belloch"
            ]
            2 => array:2 [
              "nombre" => "Jos&#233; Luis"
              "apellidos" => "Ll&#225;cer-Ortega"
            ]
            3 => array:2 [
              "nombre" => "Pedro"
              "apellidos" => "Riesgo-Su&#225;rez"
            ]
            4 => array:2 [
              "nombre" => "Vicente"
              "apellidos" => "Rovira-Lillo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S113014731830068X"
        "doi" => "10.1016/j.neucir.2018.06.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S113014731830068X?idApp=UINPBA00004B"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529849618300352?idApp=UINPBA00004B"
    "url" => "/25298496/0000002900000006/v1_201810280620/S2529849618300352/v1_201810280620/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Clinical Research</span>"
    "titulo" => "Clinical results and costs of endovascular treatment in comparison with surgery in non ruptured aneurysms"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "267"
        "paginaFinal" => "274"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Angel Horcajadas, Isabel Ortiz, Ana M&#46; Jorques, Majed J&#46; Katati"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "Angel"
            "apellidos" => "Horcajadas"
            "email" => array:1 [
              0 => "angel&#46;horcajadas&#64;gmail&#46;com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Isabel"
            "apellidos" => "Ortiz"
          ]
          2 => array:2 [
            "nombre" => "Ana M&#46;"
            "apellidos" => "Jorques"
          ]
          3 => array:2 [
            "nombre" => "Majed J&#46;"
            "apellidos" => "Katati"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Neurocirug&#237;a&#44; Hospital Virgen de las Nieves&#44; Granada&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Resultados cl&#237;nicos y de costes del tratamiento endovascular frente al quir&#250;rgico en aneurismas incidentales"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1425
            "Ancho" => 2138
            "Tamanyo" => 173313
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Mean costs&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Incidental aneurysms are relatively common and their incidence has increased due to the widespread use and improvement of imaging techniques&#46; The indication for treatment is based on the risk of the procedure versus the risk of bleeding&#46; Treatment may be endovascular or surgical&#46; The former has seen a significant increase over the past decade due to the publication of various works that found it to have lower morbidity and mortality rates&#46; However&#44; one disadvantage is that endovascular treatment is less stable and recanalisation and retreatment are common&#44; making long-term follow-up with invasive testing necessary on occasions&#46; The results of surgical treatment carried out by experts equate to those of endovascular treatment&#44; particularly in anterior circulation aneurysms&#44; though surgery is more invasive&#46; The cost of embolisation materials is high and the development of new devices such as stents and flow diverters has increased it further&#46; The cost of surgery&#44; on the other hand&#44; is moderate&#44; so the surgical treatment of aneurysms could be more worthwhile from a financial perspective&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The objective of this article is to compare two series of patients with incidental aneurysms treated endovascularly &#40;EV&#41; and surgically &#40;SC&#41; based on clinical&#44; angiographic and financial results&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">We reviewed patients treated EV and SC for incidental aneurysms and analysed demographic data &#40;age and gender&#41;&#44; the anatomical characteristics of the aneurysm &#40;location and size&#41; and the results &#40;Glasgow Outcome Score &#91;GOS&#93; after 6 months&#41; of both series&#46; The hospital stay &#40;Intensive Care Unit and ward&#41;&#44; costs related to treatment and retreatment &#40;number of coils&#44; stents&#44; guide catheters&#44; balloons&#44; craniotomy&#44; clips&#44; etc&#46;&#41; and costs related to the follow-up of these patients &#40;control angiography&#44; MR angiography&#41; were recorded&#46; Costs of stays&#44; procedures and materials were obtained from hospital sources &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; A descriptive study of both series was carried out and they were compared in terms of age&#44; gender and clinical and radiological characteristics&#46; To calculate the costs&#44; those where follow-up was not suitably performed were excluded&#46; The follow-up carried out on patients who underwent surgery differed from those who underwent embolisation&#46; The patients who received surgical treatment for their cerebral aneurysm underwent one control angiography&#44; generally during the first admission&#44; and did not require other standardised control imaging tests&#46; The embolised patients&#44; however&#44; underwent one angiography after six months and another after 12 months&#44; continuing with yearly MR angiographies thereafter for at least five years if the treatment was deemed stable&#46; In the event an increase in the permeable remnant was observed&#44; they were scheduled for retreatment&#44; reinitiating the cycle of angiographies and MR angiographies&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">To compare age between the groups&#44; the Student&#39;s <span class="elsevierStyleItalic">t</span>-test was used&#46; The Mann&#8211;Whitney test was employed for aneurysm size&#44; since this did not pass the normal hypothesis test&#44; and Pearson&#39;s chi-squared test was used for gender&#46; IBM SPSS Statistics 19 Program was used&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0025" class="elsevierStylePara elsevierViewall">89 incidental aneurysm patients were treated between January 2010 and December 2015&#44; 66 EV &#40;EV group 74&#37;&#41; and 23 SC &#40;SC group 26&#37;&#41;&#46; Two of the patients who underwent surgery had double aneurysms which were clipped during the procedure&#46; The mean follow-up for the series was 36&#46;1 months &#40;6&#8211;72&#41;&#44; which was slightly higher in the EV group &#40;37&#46;6 versus 32&#46;43 months&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The ages of the patients ranged from 22 to 75 years&#44; with a mean age of 53&#46;6 years&#44; which was slightly higher in the SC group &#40;54 versus 53&#46;4 years&#41;&#46; As regard gender&#44; female patients predominated&#44; constituting 59&#37; of the cases&#44; and was similar in both groups &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">In terms of the aneurysm characteristics&#44; they were mostly located in the anterior circulation &#40;88&#46;7&#37;&#41;&#46; The most common location in the series overall was the middle cerebral artery &#40;MCA&#41; &#40;30&#46;3&#37;&#41;&#46; The others were distributed across various locations &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; In the SC group&#44; there is a clear MCA predominance &#40;82&#46;6&#37;&#41;&#44; while in the EV group the locations are more diverse&#44; with the internal carotid artery &#40;33&#46;3&#37;&#41; and anterior communicating artery &#40;24&#46;2&#37;&#41; being most predominant&#46; As for size&#44; 23&#46;6&#37; of the aneurysms were smaller than 5<span class="elsevierStyleHsp" style=""></span>mm&#44; 58&#46;4&#37; measured 5&#8211;10<span class="elsevierStyleHsp" style=""></span>mm and 18&#37; were greater than 10<span class="elsevierStyleHsp" style=""></span>mm&#46; The embolised aneurysms were slightly larger than those treated surgically &#40;7&#46;8<span class="elsevierStyleHsp" style=""></span>mm versus 7<span class="elsevierStyleHsp" style=""></span>mm&#44; on average&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">There were no statistically significant differences between the series regarding age&#44; gender or aneurysm size&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The clinical and angiographic results are summarised in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#46; As regard the clinical results after six months&#44; measured in relation to the GOS&#44; 90&#37; of the patients had a GOS of 5&#44; 6&#37; had a GOS of 4 and 4&#37; had a GOS of 3&#46; The results were very similar in both groups&#46; There was no treatment-related mortality&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">As regard the angiographic results of the treatment&#44; a control angiography was conducted in 100&#37; of cases&#46; The complete closure of the aneurysm was achieved in the first treatment in 65&#37; of patients&#44; with the rest presenting neck remnants&#46; Complete occlusion was notably higher in the SC group &#40;96&#37; versus 55&#37;&#41;&#46; Of the cases treated EV&#44; 24&#37; required retreatment &#40;a quarter of these on two occasions&#41;&#46; The retreatment rates of anterior circulation aneurysms were also higher &#40;27&#37;&#41; than in posterior circulation aneurysms &#40;10&#37;&#41;&#46; 50&#37; of posterior communicating artery aneurysms&#44; 36&#46;5&#37; of MCA aneurysms and 25&#37; of anterior communicating artery aneurysms treated EV required retreatment&#46; The mean size of the retreated aneurysms was also greater than the mean &#40;9<span class="elsevierStyleHsp" style=""></span>mm versus 7&#46;6<span class="elsevierStyleHsp" style=""></span>mm&#41;&#44; and 38&#46;5&#37; of the aneurysms larger than 10<span class="elsevierStyleHsp" style=""></span>mm required retreatment&#46; The mean number of coils used per patient in the first treatment was five and in the retreatments six&#46; Similarly&#44; the use of stents and flow diverters was more common in the retreatments&#46; There were four complications related to EV treatment&#44; none of which had subsequent sequelae&#58; two angiographic vasospasms&#44; one internal carotid artery dissection and one anaphylactic reaction&#44; accounting for 6&#37;&#46; One year after a flow diverter was inserted in a complex internal carotid artery aneurysm&#44; one patient presented complete occlusion following a cholecystectomy that resulted in death&#46; Surgery-related complications included a wound infection &#40;4&#46;5&#37;&#41; and a pseudomeningocele &#40;4&#46;5&#37;&#41;&#44; both of which were resolved with medical treatment and no sequelae&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">As regard hospital stays&#44; the mean length of hospitalisation among the patients was 7&#46;7 days&#46; The embolised patients had a mean stay of six days&#44; while the surgical patients&#8217; stay was more than twice as long &#40;12&#46;7 days&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Given that both groups had a different follow-up protocol&#44; the patients treated with embolisation following a subarachnoid haemorrhage &#40;SAH&#41; had a mean of 2&#46;5 angiographies per patient versus one control angiography in the surgical patients&#46; The mean number of MR angiographies was 2&#46;1 per patient &#40;2&#46;5 in the EV group and 1 in the SC group&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The total cost generated by the patients was &#8364;1&#44;848&#44;300&#46;00&#44; with the EV group accounting for 83&#37; of this amount&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Meanwhile&#44; in the SC group&#44; 88&#37; of the cost was generated during the first admission&#59; in the EV group this figure was 62&#37;&#46; Retreatment constituted 18&#37; of the cost in the EV group&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Taking into account only the first admission&#44; and despite the fact that the hospitalisation cost was more than double in the SC group&#44; endovascular treatment is 14&#37; more expensive than surgical treatment upon discharge&#46; This is due to the price of the embolisation materials used&#44; which account for 60&#37; of the cost upon discharge&#46; Around half of the embolisation material costs can be attributed to coils&#44; with flow diverters also constituting a significant expense &#40;one quarter of the total&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The cost of the embolisation materials alone amounts to 46&#37; of the total cost in the EV group&#46; The difference in costs increases when follow-up and retreatment costs are included&#44; which make endovascular treatment 31&#37; and 61&#37; more expensive&#44; respectively&#44; than surgery&#44; ultimately amounting to &#8364;22&#44;908 per patient versus &#8364;14&#44;264 for surgical treatment &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0080" class="elsevierStylePara elsevierViewall">Incidental aneurysms may be discovered by chance during radiological examinations or in the context of a SAH&#44; accompanied by a ruptured aneurysm&#46; Their detection is relatively common and their incidence has increased in recent years due to the improvement and widespread use of imaging techniques&#46; They are more common among women and the over 30<span class="elsevierStyleHsp" style=""></span>s&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">1</span></a> and there are a series of risk factors that predispose patients to cerebral aneurysms&#44; some of which are non-modifiable &#40;genetic&#41; and others that are modifiable &#40;smoking&#44; hypertension and excessive alcohol consumption&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">2</span></a> Based on these data&#44; the incidence of incidental aneurysms in the over 50s with no risk factors is estimated at 3&#46;2&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">2</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Indication for treatment is based on the rupture risk&#44; as well as the patient&#39;s age and the characteristics of the aneurysm&#46; Some studies&#44; such as the International Study of Unruptured Intracranial Aneurysms &#40;ISUIA&#41;&#44; have highlighted a rupture risk of 0&#46;5&#37; per year&#44; with this risk being greater in large &#40;&#62;10<span class="elsevierStyleHsp" style=""></span>mm&#41; and posterior circulation aneurysms&#46; The Unruptured Cerebral Aneurysm Study &#40;UCAS&#41; on Japanese patients showed a slightly higher rupture risk &#40;0&#46;95&#37;&#41;&#44; also related to the size and location of the aneurysm&#44; as well as the presence of sac irregularities&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">3</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Since the International Subarachnoid Aneurysm Trial &#40;ISAT&#41;&#44; there has been a progressive increase in indications for endovascular treatment versus surgery&#46; As a result&#44; endovascular treatment has now overtaken surgery in the context of both ruptured and incidental aneurysms&#46; This widespread use of endovascular treatments has led to a significant increase in indications for treatment &#40;and the resulting costs&#41; in incidental aneurysms&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">4</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Each treatment has its own advantages and disadvantages&#46; One advantage of endovascular treatment would be its less aggressive nature&#44; while a disadvantage is that it is less stable than surgical treatment&#44; meaning that rates of incomplete occlusion&#44;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">5&#8211;7</span></a> recanalisation&#44; retreatment<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">8&#8211;10</span></a> and rebleeding<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">5&#44;8&#44;9&#44;11</span></a> are far greater than with surgery&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">If symptomatic and ruptured aneurysms are excluded&#44; both forms of treatment generally yield results with low morbidity and mortality &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46; In the studies published to date featuring larger populations&#44; the surgical mortality related to this procedure ranges from 0&#46;6&#37; to 2&#46;6&#37;&#44; with a morbidity of 4&#46;1&#37; to 10&#46;9&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">12&#8211;21</span></a> Morbidity and mortality have been on the decline thanks to improvements in the surgical technique and the introduction of aids such as indocyanine green &#40;ICG&#41;&#46; Moreover&#44; there are large series with morbidity and mortality rates of 0&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">22&#44;23</span></a> Nevertheless&#44; in general&#44; endovascular treatment has lower mortality &#40;between 0&#46;5&#37; and 1&#46;7&#37;&#41; and morbidity &#40;between 1&#37; and 7&#46;5&#37;&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">14&#8211;18&#44;24</span></a> The only prospective study on endovascular treatment outcomes in incidental aneurysms was published by Pierot et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">25</span></a> on 649 patients and 1100 aneurysms treated across 27 sites&#46; In this study&#44; there was 0&#46;9&#37; mortality and 15&#46;4&#37; treatment-related adverse events&#44; with a mortality of 1&#46;4&#37; and an overall morbidity of 1&#46;7&#37; one month after treatment&#46; There was a 5&#46;4&#37; rate of symptomatic cerebral embolisms&#44; 2&#46;6&#37; of which were permanent and 0&#46;9&#37; resulted in patient death&#46; Three of the deaths were due to an intraoperative aneurysm rupture&#44; a phenomenon that occurred in 16&#46;7&#37; of patients&#44; half of whom were asymptomatic&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">Endovascular treatment has a lower complete occlusion rate&#44; with some series&#44; such as that of Naggara et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a> recording 86&#37; &#40;in the series by Pierot et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">25</span></a> this figure is 59&#37; and in the meta-analysis by Ruan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">21</span></a> it is 82&#37;&#41;&#46; Complete occlusion rates in the series subjected to surgical treatment for incidental aneurysms&#44; on the other hand&#44; stand at over 90&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">13&#44;20&#44;21&#44;26</span></a> Although the likelihood of recanalisation is greater in ruptured than incidental aneurysms&#44;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">27</span></a> it remains high in the latter and retreatment is required in 10&#37; of patients&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">Certain factors influence the outcome of surgical treatment on incidental aneurysms&#58; location in the posterior circulation&#44; size greater than 12<span class="elsevierStyleHsp" style=""></span>mm and an age of over 50 years&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">15&#44;25</span></a> The fact that recanalisation occurs fairly regularly prompts some authors to opt for surgery in anterior circulation aneurysms&#44; particularly in patients who are under 40 years of age&#46;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">10&#44;28&#44;29</span></a> Another factor influencing the outcome is the number of aneurysms treated by the site<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">30</span></a> and surgeon&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">31</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Several studies comparing the outcomes of endovascular and surgical treatment from a financial perspective<a class="elsevierStyleCrossRefs" href="#bib0360"><span class="elsevierStyleSup">32&#8211;39</span></a> have been published &#40;<a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a>&#41;&#46; The majority do not include follow-up or retreatment costs&#44; so endovascular treatment costs are in fact underestimated&#46; In almost all of the studies&#44; endovascular treatment proves more expensive than surgery&#46; Although the mean hospital stay is generally longer in patients who undergo surgery&#44; the costs generated by embolisation materials exceed the money saved by a shorter initial admission for endovascular treatment&#46; This factor is most evident in the research carried out by Familiarli et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">32</span></a> based on giant aneurysms&#44; where the use of a stent or flow diverter is often required&#44; making endovascular treatment 153&#37; more expensive than surgery&#46; It is interesting to point out that both techniques involved similar mean stays&#44; despite the fact that 94&#37; of the patients who underwent surgery required complex revascularisation techniques&#46; This fact indicates that this type of surgery should only be performed at sites with vast experience and a high number of cases&#46; Similar conclusions can be drawn from the work of Zweifel&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a> where a proper surgical technique resulted in a mean hospital stay that was only one day longer in the surgical group&#44; as well as better clinical and angiographic outcomes &#40;67&#37; occlusion in the EV group versus 97&#37; in the SC group&#41;&#46; In this series&#44; the costs of the endovascular group were more than twice those of the surgery group&#44; excluding follow-up and retreatments&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">The only study to include follow-up and retreatments<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">34</span></a> reveals that the costs of the first admission are very similar in both types of treatment&#44; but that endovascular follow-up and retreatments &#40;which in this study was 16&#46;7&#37;&#41; drove up the final cost&#44; with endovascular treatment proving 8&#37; more expensive than surgery&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The study by Duan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">39</span></a> also shows endovascular treatment to be 28&#37; more expensive than surgery&#44; excluding follow-up and retreatments&#44; particularly among patients under 60 years of age and in anterior circulation aneurysms and aneurysms larger than 7<span class="elsevierStyleHsp" style=""></span>mm&#46; If&#44; alongside the financial saving&#44; we note that the clinical outcomes of treating aneurysms in this population subgroup are generally better&#44; there would be solid criteria for indicating surgery over endovascular treatment&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The following conclusions can be reached from the current series&#58; &#40;1&#41; the clinical results of both techniques are comparable&#59; &#40;2&#41; the angiographic results are superior with the surgical clipping technique&#59; &#40;3&#41; treatment stability is greater in clipped aneurysms&#59; &#40;4&#41; retreatments are more common in anterior circulation and large aneurysms&#59; &#40;5&#41; hospital stays are longer with surgical treatment but the costs generated by embolisation offset the hospitalisation saving&#59; and &#40;6&#41; the cost of the endovascular procedure is more expensive than surgery upon discharge &#40;14&#37; higher due to the price of embolisation materials&#41;&#44; and even more so over time due to the costs derived from follow-up and the retreatments it usually requires &#40;61&#37; more expensive in the end&#41;&#46; These results are corroborated by most of the published studies&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">In large incidental anterior circulation aneurysms in young patients requiring treatment&#44; surgery should be the first line therapy due to the positive clinical and angiographic outcomes that are usually yielded&#44; as well as the savings obtained&#46; However&#44; it should be noted that this treatment should always be carried out by experienced neurosurgeons at sites with a high volume of patients&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The series presented has limitations&#46; The first is that it is a small series&#46; The second is that it is a retrospective study and the cost estimates have been calculated based on a number of sources and&#44; on occasions&#44; using indirect methods&#46; The third limitation is that it does not evaluate potential differences between the treatments as regard return-to-work rates or so-called lost profits&#44; which could have an impact on the savings generated by one technique or the other&#44; and which according to one study would make endovascular treatment favourable&#46;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">40</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusions</span><p id="par0145" class="elsevierStylePara elsevierViewall">In the series presented&#44; the results obtained regarding morbidity and mortality for surgery and embolisation are similar&#46; Moreover&#44; the angiographic and stability outcomes pertaining to surgery are superior to those for endovascular treatment&#44; with higher complete occlusion rates and fewer retreatments required&#46; Although endovascular treatment requires a shorter hospital stay than surgery&#44; the total mean cost is considerably higher&#44; largely due to the price of embolisation materials&#44; the retreatment rate and the follow-up required&#46; The careful selection of patients who are candidates for endovascular or surgical treatment might improve the angiographic outcomes and retreatment rate and lower costs without affecting morbidity and mortality&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicts of interest</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres1100244"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objective"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Material and methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1041355"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1100245"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Objetivo"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Material y m&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1041354"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Material and methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conclusions"
        ]
        9 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Conflicts of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2018-04-11"
    "fechaAceptado" => "2018-07-03"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1041355"
          "palabras" => array:4 [
            0 => "Subarachnoid hemorrhage"
            1 => "Cost effectiveness"
            2 => "Coil"
            3 => "Brain aneurysm"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1041354"
          "palabras" => array:4 [
            0 => "Hemorragia subaracnoidea"
            1 => "Efectividad-coste"
            2 => "Coil"
            3 => "Aneurisma cerebral"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To evaluate the results and costs of surgical treatment against endovascular in non-ruptured aneurysms&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective study of consecutive series non-ruptured aneurysms from a single-centre treated endovascularly &#40;EV&#41; and surgically &#40;SC&#41;&#46; A descriptive study of demographic &#40;age&#44; sex&#41;&#44; characteristics of the patients and the radiological aspects of the aneurysms have been carried out&#46; Clinical results &#40;GOS at 6 months&#41;&#44; angiographic data &#40;occlusion classification&#41; and economic costs have been evaluated in both globally&#44; and in each of the groups&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">89 patients treated between 2010 and 2015 were reviewed&#46; Most of them were treated endovascularly &#40;74&#37;&#41;&#46; There were no statistically significant differences between EV and SC groups&#46; 89&#37; of the patients presented favourable GOS &#40;4&#8211;5&#41; at six months&#44; being this percentage similar in both groups&#46; Complete occlusion was much higher in SC group &#40;96&#37;&#41; than in EV &#40;55&#37;&#41;&#46; Retreatment rate was 24&#37; in EV group and 0&#37; in SC group&#46; The retreatments were more frequent in anterior circulation aneurysms and bigger aneurysms &#40;&#62;10<span class="elsevierStyleHsp" style=""></span>mm&#41;&#46; The expenses in the SC group come mainly from hospital stay&#44; meanwhile in the EV group is due to embolisation materials&#46; The average length of stay &#40;ALOS&#41; is higher in SC group but costs of first admission are higher in EV group &#40;14&#37; more&#41;&#46; When the costs of retreatments and follow up are included the costs of endovascular treatment is much higher than the surgical &#40;61&#37; more expensive&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">results of both types of treatment are comparable&#46; The grade of aneurysmal occlusion of the SC group was higher than the EV&#44; as well as the stability of the treatment&#44; requiring fewer retreatments&#46; Although the ALOS in SC group were longer&#44; the costs of the EV group were significantly higher than the SC group due to the costs of embolisation materials&#44; follow up that they need and the rate of retreatment&#46; Adequate selection of candidates for endovascular coiling could improve angiographic outcomes&#44; reduce retraction rates&#44; and save costs&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Evaluar los resultados cl&#237;nicos y angiogr&#225;ficos&#44; as&#237; como los costes del tratamiento quir&#250;rgico frente al endovascular&#44; en el tratamiento de los aneurismas incidentales&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo de una serie consecutiva de 89 pacientes de un solo centro tratados endovascularmente &#40;EV&#41; y quir&#250;rgicamente &#40;SC&#41;&#46; Se realiza estudio descriptivo de aspectos demogr&#225;ficos &#40;edad&#44; sexo&#41; y de las caracter&#237;sticas de los aneurismas as&#237; como se eval&#250;an resultados cl&#237;nicos &#40;GOS a 6 meses&#41;&#44; angiogr&#225;ficos &#40;grado de oclusi&#243;n&#41; y de costes econ&#243;micos tanto globalmente como de cada uno de los grupos&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Ochenta y nueve pacientes tratados entre 2010 y 2015&#46; Un 74&#37; de los pacientes recibieron tratamiento endovascular y un 26&#37; quir&#250;rgico&#46; No hubo diferencias significativas en cuanto a edad o sexo entre los grupos EV y SC&#46; Un 89&#37; de los pacientes presentaron GOS a los 6 meses favorable &#40;4-5&#41;&#44; sin diferencias entre ambos grupos&#46; La oclusi&#243;n completa del aneurisma fue mayor en el grupo SC &#40;96&#37; versus 55&#37;&#41;&#44; as&#237; como la estabilidad del tratamiento &#40;24&#37; de retratamientos en el grupo EV versus 0&#37; en el grupo SC&#41;&#46; Los retratamientos son m&#225;s frecuentes en aneurismas de circulaci&#243;n anterior &#40;27&#37;&#41; y de mayor tama&#241;o &#40;un 38&#44;5&#37; de los mayores de 10 mm&#41;&#46; El gasto en el grupo SC viene derivado fundamentalmente de la estancia hospitalaria en tanto que en grupo EV tiene m&#225;s importancia el coste de los materiales de embolizaci&#243;n&#46; Las estancias medias son notablemente superiores en el grupo SC pero el coste medio del primer ingreso es un 14&#37; superior en el grupo EV debido al precio de los materiales de embolizaci&#243;n&#46; El gasto total es notablemente superior en el grupo EV &#40;un 61&#37;&#41; debido a los gastos derivados del seguimiento y de los retratamientos&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los resultados cl&#237;nicos de ambos tipo de tratamiento son comparables&#46; El grado de oclusi&#243;n aneurism&#225;tica del grupo SC es superior al del EV&#44; as&#237; como la estabilidad del tratamiento&#44; precisando menos retratamientos&#46; A pesar de que el tratamiento quir&#250;rgico genera estancias m&#225;s largas&#44; los costes del grupo EV son notablemente superiores a los del grupo SC debido al precio de los materiales de embolizaci&#243;n&#44; el seguimiento que precisan y la tasa de retratamientos&#46; Una adecuada selecci&#243;n de los casos candidatos a coiling o pinzamiento podr&#237;a mejorar los resultados angiogr&#225;ficos&#44; reducir la tasa de retratamientos y ahorrar costes&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0006">Please cite this article as&#58; Horcajadas A&#44; Ortiz I&#44; Jorques AM&#46;&#44; Katati MJ&#46; Anatom&#237;a microquir&#250;rgica en 3 D del tracto corticoespinal y de la v&#237;a del lemnisco basada en microdisecci&#243;n de fibras y demostraci&#243;n a trav&#233;s de tractograf&#237;a&#46; Neurocirug&#237;a&#46; 2018&#59;29&#58;267&#8211;274&#46;</p>"
      ]
    ]
    "multimedia" => array:8 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1754
            "Ancho" => 1461
            "Tamanyo" => 75537
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribution of endovascular material costs&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1425
            "Ancho" => 2138
            "Tamanyo" => 173313
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Mean costs&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Item&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Price &#40;&#8364;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Day in ICU&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Day on ward&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">650&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Craniotomy<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Embolisation<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cerebral angiography&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">700&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">MR angiography&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Clip&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Coil&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">900&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Guide catheter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Balloon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Stent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Flow diverter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1881709.png"
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Craniotomy includes the costs of surgical time&#44; the materials &#40;excluding clips&#41; and human resources&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Embolisation includes the costs of angiography&#44; anaesthesia and human resources&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Cost guide&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">SC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&#46;5 &#40;22&#8211;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&#46;5 &#40;22&#8211;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54 &#40;34&#8211;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Gender &#40;F&#59; M&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#59; 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#59; 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#59; 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Follow-up &#40;months&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38 &#40;7&#8211;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38 &#40;7&#8211;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;6&#8211;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Aneurysm location</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ant&#46; circ&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Post&#46; circ&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Size</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;5<span class="elsevierStyleHsp" style=""></span>mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5&#8211;10<span class="elsevierStyleHsp" style=""></span>mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;10<span class="elsevierStyleHsp" style=""></span>mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1881704.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Clinical and angiographic characteristics of the series&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">ACA&#58; anterior cerebral artery&#59; AChA&#58; anterior choroidal artery&#59; ACoA&#58; anterior communicating artery&#59; AICA&#58; anterior inferior cerebellar artery&#59; ICA&#58; internal carotid artery&#59; MCA&#58; middle cerebral artery&#59; PCA&#58; posterior cerebral artery&#59; PCoA&#58; posterior communicating artery&#59; PICA&#58; posterior inferior cerebellar artery&#59; SCA&#58; superior cerebellar artery&#59; VB&#58; vertebrobasilar artery&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">SC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Anterior circulation</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ICA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PCoA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ACoA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ACA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>AChA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>MCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Posterior circulation</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>VB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PICA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>SCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1881708.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Location of the aneurysms&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Tot&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">SC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Mean stay &#40;days&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">GOS at 6 months</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">90&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Angiography</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Complete occlusion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Neck remnant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Retreatment</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1881706.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Mean stay&#44; clinical and angiographic outcomes&#46;</p>"
        ]
      ]
      6 => array:8 [
        "identificador" => "tbl0025"
        "etiqueta" => "Table 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at5"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Study&#44; year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col">No&#46; of cases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Mortality &#40;&#37;&#41;</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Morbidity &#40;&#37;&#41;</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">SC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">SC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">King<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">12</span></a>&#44; 1994<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">733&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Johnston<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">40</span></a>&#44; 1999&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2412&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Raymakers<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">13</span></a>&#44; 1998&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2460&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Barker<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">14</span></a>&#44; 2004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3929&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ISUIA<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">15</span></a>&#44; 2003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2368&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lanterna<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">24</span></a>&#44; 2004<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1379&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Higashida<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">16</span></a>&#44; 2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2535&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pierot<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">25</span></a>&#44; 2008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alskhlee<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">17</span></a>&#44; 2010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3738&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Brinjikii<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">18</span></a>&#44; 2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;940&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">McDonald<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">19</span></a>&#44; 2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4899&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kotowski<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">20</span></a>&#44; 2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9845&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Duan<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">39</span></a>&#44; 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">125&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;3<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ruan<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">21</span></a>&#44; 2015<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3135&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Zweifel<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a>&#44; 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">209&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Current study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1881707.png"
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Meta-analysis&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Morbidity at 2 months&#46; The initial morbidity was 18&#46;8&#37; in SC and 9&#46;8&#37; in EV&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Morbidity and mortality of incidental aneurysm treatment&#46;</p>"
        ]
      ]
      7 => array:8 [
        "identificador" => "tbl0030"
        "etiqueta" => "Table 6"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at6"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">EV&#58; endovascular&#59; FU&#58; follow-up&#59; incr&#58; increase&#59; R&#58; ruptured aneurysm&#59; Rett&#58; retreatment&#59; SC&#58; surgical&#59; UR&#58; unruptured aneurysm&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Author&#44; year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">No&#46; of cases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Aneurysm type&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">More expensive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; cost incr&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">FU included&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Rett&#46; included&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Halkes<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">33</span></a>&#44; 2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">R and UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hoh<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">34</span></a>&#44; 2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">565&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">R and UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#37;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hoh<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">35</span></a>&#44; 2010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9347&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">R and UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#37;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lad<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">38</span></a>&#44; 2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4504&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#37;<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Duan<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">39</span></a>&#44; 2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">125&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kim<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">36</span></a>&#44; 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">410&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Familiarli<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">32</span></a>&#44; 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">153&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Zweifel<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a>&#44; 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">209&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">114&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chang<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">37</span></a>&#44; 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&#44;422&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Current study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1881705.png"
              ]
            ]
          ]
          "notaPie" => array:4 [
            0 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Matched case series&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Percentage only for unruptured aneurysms&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0035"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Results after 5 years of follow-up&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0040"
              "etiqueta" => "d"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0040">Cases of giant aneurysms&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Summary of the studies published on the costs of incidental aneurysm treatment&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:40 [
            0 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of unruptured intracranial aneurysms&#44; with emphasis on sex&#44; age&#44; comorbidity&#44; country and time period&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;H&#46; Vlak"
                            1 => "A&#46; Algra"
                            2 => "R&#46; Brandenburg"
                            3 => "G&#46;J&#46; Rinkel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1474-4422(11)70109-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Neurol"
                        "fecha" => "2011"
                        "volumen" => "10"
                        "paginaInicial" => "626"
                        "paginaFinal" => "636"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21641282"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines for the management of patients with unruptured intracranial aneurysms&#58; a guidelines for healthcare professionals from the American Heart Association&#47;American Stroke Association"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:1 [
                            0 => "B&#46;G&#46; Thompson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STR.0000000000000070"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2015"
                        "volumen" => "46"
                        "paginaInicial" => "2368"
                        "paginaFinal" => "2400"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26089327"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The natural course of unruptured cerebral aneurysms in a Japanese cohort"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "The UCAS Japan Investigators"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1113260"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2012"
                        "volumen" => "366"
                        "paginaInicial" => "2474"
                        "paginaFinal" => "2482"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22738097"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recent trends in the treatment of cerebral aneurysms&#58; analysis of a nationwide inpatient database"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46; Andaluz"
                            1 => "M&#46; Zuccarello"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/JNS/2008/108/6/1163"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2008"
                        "volumen" => "108"
                        "paginaInicial" => "1163"
                        "paginaFinal" => "1169"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18518722"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictors of rehemorrhage after treatment of ruptured intracranial aneurysms&#58; the cerebral aneurysm rerupture after treatment &#40;CARAT&#41; study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;C&#46; Johnston"
                            1 => "C&#46;F&#46; Dowd"
                            2 => "R&#46;T&#46; Higashida"
                            3 => "M&#46;T&#46; Lawton"
                            4 => "G&#46;R&#46; Duckwiler"
                            5 => "D&#46;R&#46; Gress"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STROKEAHA.107.495747"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2008"
                        "volumen" => "39"
                        "paginaInicial" => "120"
                        "paginaFinal" => "125"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18048860"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guglielmi detachable coil embolization of cerebral aneurysms&#58; 11 years&#8217; experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Murayama"
                            1 => "Y&#46;L&#46; Nien"
                            2 => "G&#46; Duckwiler"
                            3 => "Y&#46;P&#46; Gobin"
                            4 => "R&#46; Jahan"
                            5 => "J&#46; Frazee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.2003.98.5.0959"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2003"
                        "volumen" => "98"
                        "paginaInicial" => "959"
                        "paginaFinal" => "966"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12744354"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sixteen-year single-surgeon experience with coil embolization for ruptured intracranial aneurysms&#58; recurrence rates and incidence of late rebleeding&#46; Clinical article"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;S&#46; Plowman"
                            1 => "A&#46; Clarke"
                            2 => "M&#46; Clarke"
                            3 => "J&#46;V&#46; Byrne"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/2010.6.JNS091058"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2011"
                        "volumen" => "114"
                        "paginaInicial" => "863"
                        "paginaFinal" => "874"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20672900"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rates of delayed rebleeding from intracranial aneurysms are low after surgical and endovascular treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "CARAT Investigators"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.STR.0000221331.01830.ce"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2006"
                        "volumen" => "37"
                        "paginaInicial" => "1437"
                        "paginaFinal" => "1442"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16627789"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of recurrent subarachnoid haemorrhage&#44; death&#44; or dependence and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the international subarachnoid aneurysm trial &#40;ISAT&#41;&#58; long-term follow-up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;J&#46; Molyneux"
                            1 => "R&#46;S&#46; Kerr"
                            2 => "J&#46; Birks"
                            3 => "N&#46; Ramzi"
                            4 => "J&#46; Yarnold"
                            5 => "M&#46; Sneade"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1474-4422(09)70080-8"
                      "Revista" => array:7 [
                        "tituloSerie" => "Lancet Neurol"
                        "fecha" => "2009"
                        "volumen" => "8"
                        "paginaInicial" => "427"
                        "paginaFinal" => "433"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19329361"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1470204508701785"
                          "estado" => "S300"
                          "issn" => "14702045"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of recurrent subarachnoid haemorrhage&#44; death&#44; or dependence and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the international subarachnoid aneurysm trial &#40;ISAT&#41;&#58; long-term follow-up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;J&#46; Molyneux"
                            1 => "R&#46;S&#46; Kerr"
                            2 => "J&#46; Birks"
                            3 => "N&#46; Ramzi"
                            4 => "J&#46; Yarnold"
                            5 => "M&#46; Sneade"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1474-4422(09)70080-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Neurol"
                        "fecha" => "2009"
                        "volumen" => "8"
                        "paginaInicial" => "427"
                        "paginaFinal" => "433"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19329361"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Late rebleeding of ruptured intracranial aneurysms treated with detachable coils"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Sluzewski"
                            1 => "W&#46;J&#46; van Rooij"
                            2 => "G&#46;N&#46; Beute"
                            3 => "P&#46;C&#46; Nijssen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "AJNR Am J Neuroradiol"
                        "fecha" => "2005"
                        "volumen" => "26"
                        "paginaInicial" => "2542"
                        "paginaFinal" => "2549"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16286399"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Morbidity and mortality from elective surgery for asymptomatic&#44; unruptured&#44; intracranial aneurysms&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;T&#46; King Jr&#46;"
                            1 => "J&#46;A&#46; Berlin"
                            2 => "E&#46;S&#46; Flamm"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1994.81.6.0837"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1994"
                        "volumen" => "81"
                        "paginaInicial" => "837"
                        "paginaFinal" => "842"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7965113"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0735109715046215"
                          "estado" => "S300"
                          "issn" => "07351097"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mortality and morbidity of surgery for unruptured intracranial aneurysms&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46;W&#46; Raaymakers"
                            1 => "G&#46;J&#46; Rinkel"
                            2 => "M&#46; Limburg"
                            3 => "A&#46; Algra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "1998"
                        "volumen" => "29"
                        "paginaInicial" => "1531"
                        "paginaFinal" => "1538"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9707188"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Age-dependent differences in short term outcome after surgical or endovascular treatment of unruptured intracranial aneurysms in the United States&#44; 1996&#8211;2000"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;G&#46; Barker 2nd"
                            1 => "S&#46; Amin-Hanjani"
                            2 => "W&#46;E&#46; Butler"
                            3 => "B&#46;L&#46; Hoh"
                            4 => "J&#46;D&#46; Rabinov"
                            5 => "J&#46;C&#46; Pryor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2004"
                        "volumen" => "54"
                        "paginaInicial" => "18"
                        "paginaFinal" => "28"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14683537"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Unruptured intracranial aneurysms&#58; natural history&#44; clinical outcome&#44; and risks of surgical and endovascular treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;O&#46; Wiebers"
                            1 => "J&#46;P&#46; Whistnant"
                            2 => "J&#46; Huston"
                            3 => "I&#46; Meissner"
                            4 => "R&#46;D&#46; Brown"
                            5 => "D&#46;G&#46; Piepgras"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2003"
                        "volumen" => "362"
                        "paginaInicial" => "103"
                        "paginaFinal" => "110"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12867109"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of unruptured intracranial aneurysms&#58; a nationwide assessment of effectiveness"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46;T&#46; Higashida"
                            1 => "B&#46;J&#46; Lahue"
                            2 => "M&#46;T&#46; Torbey"
                            3 => "L&#46;N&#46; Hopkins"
                            4 => "E&#46; Leip"
                            5 => "D&#46;F&#46; Hanley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "AJNR"
                        "fecha" => "2007"
                        "volumen" => "28"
                        "paginaInicial" => "146"
                        "paginaFinal" => "215"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17213445"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hospital mortality and complications of electively clipped or coiled unruptured intracranial aneurysm"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Alshekhlee"
                            1 => "S&#46; Mehta"
                            2 => "R&#46;C&#46; Edgell"
                            3 => "N&#46; Vora"
                            4 => "E&#46; Feen"
                            5 => "A&#46; Mohammadi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STROKEAHA.110.580647"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2010"
                        "volumen" => "41"
                        "paginaInicial" => "1471"
                        "paginaFinal" => "1476"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20522817"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of age on outcomes of treatment of unruptured cerebral aneurysms&#58; a study of the National Inpatient Sample 2001&#8211;2008"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "W&#46; Brinjikji"
                            1 => "A&#46;A&#46; Rabinstein"
                            2 => "G&#46; Lanzino"
                            3 => "D&#46;F&#46; Kallmes"
                            4 => "H&#46;J&#46; Cloft"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STROKEAHA.110.607986"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2011"
                        "volumen" => "42"
                        "paginaInicial" => "1320"
                        "paginaFinal" => "1324"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21441142"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative effectiveness of unruptured cerebral aneurysm therapies&#58; propensity score analysis of clipping versus coiling"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;S&#46; McDonald"
                            1 => "R&#46;J&#46; McDonald"
                            2 => "J&#46; Fan"
                            3 => "D&#46;F&#46; Kallmes"
                            4 => "G&#46; Lanzino"
                            5 => "H&#46;J&#46; Cloft"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STROKEAHA.111.000196"
                      "Revista" => array:7 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2013"
                        "volumen" => "44"
                        "paginaInicial" => "988"
                        "paginaFinal" => "994"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23449260"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1470204514704528"
                          "estado" => "S300"
                          "issn" => "14702045"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Safety and occlusion rates of surgical treatment of unruptured intracranial aneurysms&#58; a systematic review and meta-analysis of the literature from 1990 to 2011"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Kotowski"
                            1 => "O&#46; Naggara"
                            2 => "T&#46;E&#46; Darsaut"
                            3 => "S&#46; Nolet"
                            4 => "G&#46; Gevry"
                            5 => "E&#46; Kouznetsov"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/jnnp-2011-302068"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Neurol Neurosurg Psychiatry"
                        "fecha" => "2013"
                        "volumen" => "84"
                        "paginaInicial" => "42"
                        "paginaFinal" => "48"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23012447"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0190962212004525"
                          "estado" => "S300"
                          "issn" => "01909622"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endovascular coiling vs&#46; surgical clipping for unruptured intracranial aneurysm&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Ruan"
                            1 => "H&#46; Long"
                            2 => "H&#46; Sun"
                            3 => "M&#46; He"
                            4 => "K&#46; Yang"
                            5 => "H&#46; Zhang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3109/02688697.2015.1023771"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Neurosurg"
                        "fecha" => "2015"
                        "volumen" => "29"
                        "paginaInicial" => "485"
                        "paginaFinal" => "492"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26037936"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment-related morbidity of unruptured intracranial aneurysms&#58; results of a prospective single-centre series with an interdisciplinary approach over a 6-year period &#40;1999-2005&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Gerlach"
                            1 => "J&#46; Beck"
                            2 => "M&#46; Setzer"
                            3 => "H&#46; Vatter"
                            4 => "J&#46; Berkefeld"
                            5 => "R&#46; Du Mesnii de Rochemont"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/jnnp.2006.106823"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurol Neurosurg Psychiatry"
                        "fecha" => "2007"
                        "volumen" => "78"
                        "paginaInicial" => "864"
                        "paginaFinal" => "871"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17210624"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The interdisciplinary treatment of unruptured intracranial aneurysms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46; Seifert"
                            1 => "R&#46; Gerlach"
                            2 => "A&#46; Raabe"
                            3 => "E&#46; G&#252;resir"
                            4 => "J&#46; Beck"
                            5 => "A&#46; Szel&#233;nyi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3238/arztebl.2008.0449"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dtsch Arztebl Int"
                        "fecha" => "2008"
                        "volumen" => "105"
                        "paginaInicial" => "449"
                        "paginaFinal" => "456"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19626180"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of unruptured cerebral aneurysms by embolization withGu glielmi detachable coils&#58; case-fatality&#44; morbidity&#44; and effectiveness in preventing bleeding &#8211; a systematic review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;A&#46; Lanterna"
                            1 => "G&#46; Tredici"
                            2 => "B&#46;D&#46; Dimitrov"
                            3 => "F&#46; Biroli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2004"
                        "volumen" => "55"
                        "paginaInicial" => "767"
                        "paginaFinal" => "775"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15458585"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immediate clinical outcome of patients harboring unruptured intracranial aneurysms treated by endovascular approach&#58; results of the ATENA study"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "ATENA Investigators"
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Pierot"
                            1 => "L&#46; Spelle"
                            2 => "F&#46; Vitry"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STROKEAHA.107.512756"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2008"
                        "volumen" => "39"
                        "paginaInicial" => "2497"
                        "paginaFinal" => "2504"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18617659"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "26"
              "referencia" => array:2 [
                0 => null
                1 => null
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of ruptured vs unruptured aneurysms in recanalization after coil embolization"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46;N&#46; Nguyen"
                            1 => "B&#46;L&#46; Hoh"
                            2 => "S&#46; Amin-Hanjani"
                            3 => "J&#46;C&#46; Pryor"
                            4 => "C&#46;S&#46; Ogilvy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.surneu.2006.10.021"
                      "Revista" => array:6 [
                        "tituloSerie" => "Surg Neurol"
                        "fecha" => "2007"
                        "volumen" => "68"
                        "paginaInicial" => "19"
                        "paginaFinal" => "23"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17586214"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Could late rebleeding overturn the superiority of cranial aneurysm coil embolization over clip ligation seen in the international subarachnoid aneurysm trial&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46; Mitchell"
                            1 => "R&#46; Kerr"
                            2 => "A&#46;D&#46; Mendelow"
                            3 => "A&#46; Molyneux"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/JNS/2008/108/3/0437"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2008"
                        "volumen" => "108"
                        "paginaInicial" => "437"
                        "paginaFinal" => "442"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18312088"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "International subarachnoid aneurysm trial analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46;C&#46; Heros"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/JNS/2008/108/3/0433"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2008"
                        "volumen" => "108"
                        "paginaInicial" => "433"
                        "paginaFinal" => "435"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18312086"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "In-hospital mortality and morbidity alter surgical treatment of unruptured intracranial aneurysms in the United States&#44; 1996&#8211;2000&#58; the effect of hospital and surgeon volume"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "F&#46;G&#46; Barker 2nd"
                            1 => "S&#46; Amin-Hanjani"
                            2 => "W&#46;E&#46; Butler"
                            3 => "C&#46;S&#46; Ogylvy"
                            4 => "B&#46;S&#46; Carter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2003"
                        "volumen" => "52"
                        "paginaInicial" => "995"
                        "paginaFinal" => "1007"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12699540"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Functional outcome after repair of unruptured intracranial aneurysms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46; Chyatte"
                            1 => "R&#46; Porterfield"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.2001.94.3.0417"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2001"
                        "volumen" => "94"
                        "paginaInicial" => "417"
                        "paginaFinal" => "421"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11235945"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cost comparison of surgical and endovascular treatment of unruptured giant intracranial aneurysms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Familiari"
                            1 => "N&#46; Maldaner"
                            2 => "A&#46; Kursumovic"
                            3 => "S&#46;A&#46; Rath"
                            4 => "P&#46; Vajkoczy"
                            5 => "A&#46; Raco"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1227/NEU.0000000000000917"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2015"
                        "volumen" => "77"
                        "paginaInicial" => "733"
                        "paginaFinal" => "741"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26225854"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Direct costs of surgical clipping and endovascular coiling of unruptured intracranial aneurysms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46;H&#46; Halkes"
                            1 => "M&#46;J&#46; Wermer"
                            2 => "G&#46;J&#46; Rinkel"
                            3 => "E&#46; Buskens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000092336"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cerebrovasc Dis"
                        "fecha" => "2006"
                        "volumen" => "22"
                        "paginaInicial" => "40"
                        "paginaFinal" => "45"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16567936"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Length of stay and total hospital charges of clipping versus coiling for ruptured and unruptured adult cerebral aneurysms in the Nationwide Inpatient Sample database 2002 to 2006"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46;L&#46; Hoh"
                            1 => "Y&#46;Y&#46; Chi"
                            2 => "M&#46;F&#46; Lawson"
                            3 => "J&#46; Mocco"
                            4 => "Barker F&#46;G&#46; 2nd"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STROKEAHA.109.569269"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2010"
                        "volumen" => "41"
                        "paginaInicial" => "337"
                        "paginaFinal" => "342"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20044522"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of coiling versus clipping of ruptured and unruptured cerebral aneurysms on length of stay&#44; hospital cost&#44; hospital reimbursement&#44; and surgeon reimbursement at the University of Florida"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46;L&#46; Hoh"
                            1 => "Y&#46;Y&#46; Chi"
                            2 => "M&#46;A&#46; Dermott"
                            3 => "P&#46;J&#46; Lipori"
                            4 => "S&#46;B&#46; Lewis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1227/01.NEU.0000340784.75352.A4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2009"
                        "volumen" => "64"
                        "paginaInicial" => "614"
                        "paginaFinal" => "619"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19197221"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative cost analysis for surgical and endovascular treatment on unruptured intracranial aneurysms in South Korea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Kim"
                            1 => "J&#46; Park"
                            2 => "J&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3340/jkns.2015.57.6.455"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Korean Neurosurg Soc"
                        "fecha" => "2015"
                        "volumen" => "57"
                        "paginaInicial" => "455"
                        "paginaFinal" => "459"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26180615"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0385"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cost-effectiveness analysis of endovascular coiling versus neurosurgical clipping for intracranial aneurysms in Republic of Korea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46;W&#46; Chang"
                            1 => "S&#46;H&#46; Shin"
                            2 => "S&#46;H&#46; Suh"
                            3 => "B&#46;S&#46; Kim"
                            4 => "M&#46;H&#46; Rho"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5469/neuroint.2016.11.2.86"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurointervention"
                        "fecha" => "2016"
                        "volumen" => "11"
                        "paginaInicial" => "86"
                        "paginaFinal" => "91"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27621944"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0390"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term economic impact of coiling vs clipping for unruptured intracranial aneurysms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;P&#46; Lad"
                            1 => "R&#46; Babu"
                            2 => "M&#46;S&#46; Rhee"
                            3 => "R&#46;L&#46; Franklin"
                            4 => "B&#46; Ugiliweneza"
                            5 => "J&#46; Hodes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1227/01.neu.0000429284.91142.56"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2013"
                        "volumen" => "72"
                        "paginaInicial" => "1000"
                        "paginaFinal" => "1011"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23612602"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0395"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Analysis of short-term total hospital costs and current primary cost drivers of coiling versus clipping for unruptured intracranial aneurysms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Y&#46; Duan"
                            1 => "K&#46; Blackham"
                            2 => "J&#46; Nelson"
                            3 => "W&#46; Selman"
                            4 => "N&#46; Bambakidis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/neurintsurg-2014-011249"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurointerv Surg"
                        "fecha" => "2015"
                        "volumen" => "7"
                        "paginaInicial" => "614"
                        "paginaFinal" => "618"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24891453"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0400"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endovascular and surgical treatment of unruptured cerebral aneurysms&#58; comparison of risks"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;C&#46; Johnston"
                            1 => "C&#46;B&#46; Wilson"
                            2 => "V&#46;V&#46; Halbach"
                            3 => "R&#46;T&#46; Higashida"
                            4 => "C&#46;F&#46; Dowd"
                            5 => "M&#46;W&#46; McDermott"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Neurol"
                        "fecha" => "2000"
                        "volumen" => "48"
                        "paginaInicial" => "11"
                        "paginaFinal" => "19"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10894211"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/25298496/0000002900000006/v1_201810280620/S2529849618300364/v1_201810280620/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "65581"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Clinical research"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/25298496/0000002900000006/v1_201810280620/S2529849618300364/v1_201810280620/en/main.pdf?idApp=UINPBA00004B&text.app=https://revistaneurocirugia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529849618300364?idApp=UINPBA00004B"
]
Share
Current Issue
Journal Information
Back to article

Statistics

Follow this link to access the full text of the article

Clinical Research
Clinical results and costs of endovascular treatment in comparison with surgery in non ruptured aneurysms
Resultados clínicos y de costes del tratamiento endovascular frente al quirúrgico en aneurismas incidentales
Angel Horcajadas
Corresponding author
angel.horcajadas@gmail.com

Corresponding author.
, Isabel Ortiz, Ana M. Jorques, Majed J. Katati
Neurocirugía, Hospital Virgen de las Nieves, Granada, Spain
Read
10
Times
was read the article
3
Total PDF
7
Total HTML
Share statistics
 array:23 [
  "pii" => "S2529849618300364"
  "issn" => "25298496"
  "doi" => "10.1016/j.neucie.2018.09.002"
  "estado" => "S300"
  "fechaPublicacion" => "2018-11-01"
  "aid" => "344"
  "copyright" => "Sociedad Espa&#241;ola de Neurocirug&#237;a"
  "copyrightAnyo" => "2018"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Neurocirugia. 2018;29:267-74"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S1130147318300691"
      "issn" => "11301473"
      "doi" => "10.1016/j.neucir.2018.07.001"
      "estado" => "S300"
      "fechaPublicacion" => "2018-11-01"
      "aid" => "344"
      "copyright" => "Sociedad Espa&#241;ola de Neurocirug&#237;a"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Neurocirugia. 2018;29:267-74"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 72
        "formatos" => array:2 [
          "HTML" => 50
          "PDF" => 22
        ]
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Investigaci&#243;n cl&#237;nica</span>"
        "titulo" => "Resultados cl&#237;nicos y de costes del tratamiento endovascular frente al quir&#250;rgico en aneurismas incidentales"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "267"
            "paginaFinal" => "274"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Clinical results and costs of endovascular treatment in comparison with surgery in non ruptured aneurysms"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1754
                "Ancho" => 1461
                "Tamanyo" => 73864
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n del coste de los materiales endovasculares&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Angel Horcajadas, Isabel Ortiz, Ana M&#46; Jorques, Majed J&#46; Katati"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "Angel"
                "apellidos" => "Horcajadas"
              ]
              1 => array:2 [
                "nombre" => "Isabel"
                "apellidos" => "Ortiz"
              ]
              2 => array:2 [
                "nombre" => "Ana M&#46;"
                "apellidos" => "Jorques"
              ]
              3 => array:2 [
                "nombre" => "Majed J&#46;"
                "apellidos" => "Katati"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2529849618300364"
          "doi" => "10.1016/j.neucie.2018.09.002"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529849618300364?idApp=UINPBA00004B"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147318300691?idApp=UINPBA00004B"
      "url" => "/11301473/0000002900000006/v1_201810280605/S1130147318300691/v1_201810280605/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2529849618300352"
    "issn" => "25298496"
    "doi" => "10.1016/j.neucie.2018.09.001"
    "estado" => "S300"
    "fechaPublicacion" => "2018-11-01"
    "aid" => "343"
    "copyright" => "Sociedad Espa&#241;ola de Neurocirug&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Neurocirugia. 2018;29:275-95"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Clinical Research</span>"
      "titulo" => "3D microsurgical anatomy of the cortico-spinal tract and lemniscal pathway based on fibre microdissection and demonstration with tractography"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "275"
          "paginaFinal" => "295"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Anatom&#237;a microquir&#250;rgica en 3 D del tracto corticoespinal y de la v&#237;a del lemnisco basada en microdisecci&#243;n de fibras y demostraci&#243;n a trav&#233;s de tractograf&#237;a"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0015"
          "etiqueta" => "Fig&#46; 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 2189
              "Ancho" => 4200
              "Tamanyo" => 1419475
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">&#40;A and B&#41; Dissection of the cerebral peduncle and basilar part of the pons reveals the substantia nigra and sensory fibres that occupy the anterior surface of the pontine tegmentum and include the medial lemniscus&#44; lateral spinothalamic tract and lateral lemniscus&#46; &#40;C&#41; On continuing the dissection of the lateral and deep fibres of the medullary pyramid&#44; the relationship between the organisation and arrangement of the corticospinal and lemniscal fibres is seen along their entire trajectory in the brainstem&#46; &#40;D and E&#41; On a different specimen&#44; after the dissection of all the fibres of the medullary pyramid&#44; the basilar part of the pons and the cerebral peduncle&#44; the main medial and lateral lemniscal fibres and spinothalamic tract are observed&#46; &#40;F and G&#41; After dissecting the internal capsule&#44; the lateral surface of the thalamus is exposed&#44; with its main thalamocortical radiations&#46; H and <span class="elsevierStyleSmallCaps">I</span> correspond to images C and E in 3D&#44; respectively&#46;</p> <p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">ac&#58; anterior commissure&#59; cc&#58; corpus callosum&#59; cn&#58; caudate nucleus&#59; cp&#58; cerebral peduncle&#59; cst&#58; corticospinal tract&#59; dn&#58; dentate nucleus&#59; dscp&#58; decussation of the superior cerebellar peduncles&#59; fl&#58; frontal lobe&#59; flo&#58; flocculus&#59; ic&#58; inferior colliculus&#59; icp&#58; inferior cerebellar peduncle&#59; lgb&#58; lateral geniculate body&#59; lle&#59; lateral lemniscus&#59; mb&#58; mammillary body&#59; mcp&#58; middle cerebellar peduncle&#59; mle&#58; medial lemniscus&#59; na&#58; nucleus accumbens&#59; ol&#58; olive of the medulla oblongata&#59; pon&#58; pons&#59; py&#58; medullary pyramid&#59; scp&#58; superior cerebellar peduncle&#59; sn&#58; substantia nigra&#59; t&#58; thalamus&#59; tl&#58; temporal lobule&#59; tp-a&#58; anterior thalamic peduncle&#59; tp-p&#58; posterior thalamic peduncle&#59; tp-s&#58; superior thalamic peduncle&#59; ver&#58; cerebellar vermis&#46;</p> <p id="spar0085" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSmallCaps">II</span>&#58; optic nerve&#59; <span class="elsevierStyleSmallCaps">III</span>&#58; oculomotor nerve&#59; <span class="elsevierStyleSmallCaps">V</span>&#58; trigeminal nerve&#59; <span class="elsevierStyleSmallCaps">VII</span>&#58; facial nerve&#59; <span class="elsevierStyleSmallCaps">IX</span>-<span class="elsevierStyleSmallCaps">X</span>&#58; glossopharyngeal and vagus nerves&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ruben Rodr&#237;guez-Mena, Jos&#233; Piquer-Belloch, Jos&#233; Luis Ll&#225;cer-Ortega, Pedro Riesgo-Su&#225;rez, Vicente Rovira-Lillo"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Ruben"
              "apellidos" => "Rodr&#237;guez-Mena"
            ]
            1 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Piquer-Belloch"
            ]
            2 => array:2 [
              "nombre" => "Jos&#233; Luis"
              "apellidos" => "Ll&#225;cer-Ortega"
            ]
            3 => array:2 [
              "nombre" => "Pedro"
              "apellidos" => "Riesgo-Su&#225;rez"
            ]
            4 => array:2 [
              "nombre" => "Vicente"
              "apellidos" => "Rovira-Lillo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S113014731830068X"
        "doi" => "10.1016/j.neucir.2018.06.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S113014731830068X?idApp=UINPBA00004B"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529849618300352?idApp=UINPBA00004B"
    "url" => "/25298496/0000002900000006/v1_201810280620/S2529849618300352/v1_201810280620/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Clinical Research</span>"
    "titulo" => "Clinical results and costs of endovascular treatment in comparison with surgery in non ruptured aneurysms"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "267"
        "paginaFinal" => "274"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Angel Horcajadas, Isabel Ortiz, Ana M&#46; Jorques, Majed J&#46; Katati"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "Angel"
            "apellidos" => "Horcajadas"
            "email" => array:1 [
              0 => "angel&#46;horcajadas&#64;gmail&#46;com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Isabel"
            "apellidos" => "Ortiz"
          ]
          2 => array:2 [
            "nombre" => "Ana M&#46;"
            "apellidos" => "Jorques"
          ]
          3 => array:2 [
            "nombre" => "Majed J&#46;"
            "apellidos" => "Katati"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Neurocirug&#237;a&#44; Hospital Virgen de las Nieves&#44; Granada&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Resultados cl&#237;nicos y de costes del tratamiento endovascular frente al quir&#250;rgico en aneurismas incidentales"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1425
            "Ancho" => 2138
            "Tamanyo" => 173313
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Mean costs&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Incidental aneurysms are relatively common and their incidence has increased due to the widespread use and improvement of imaging techniques&#46; The indication for treatment is based on the risk of the procedure versus the risk of bleeding&#46; Treatment may be endovascular or surgical&#46; The former has seen a significant increase over the past decade due to the publication of various works that found it to have lower morbidity and mortality rates&#46; However&#44; one disadvantage is that endovascular treatment is less stable and recanalisation and retreatment are common&#44; making long-term follow-up with invasive testing necessary on occasions&#46; The results of surgical treatment carried out by experts equate to those of endovascular treatment&#44; particularly in anterior circulation aneurysms&#44; though surgery is more invasive&#46; The cost of embolisation materials is high and the development of new devices such as stents and flow diverters has increased it further&#46; The cost of surgery&#44; on the other hand&#44; is moderate&#44; so the surgical treatment of aneurysms could be more worthwhile from a financial perspective&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The objective of this article is to compare two series of patients with incidental aneurysms treated endovascularly &#40;EV&#41; and surgically &#40;SC&#41; based on clinical&#44; angiographic and financial results&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">We reviewed patients treated EV and SC for incidental aneurysms and analysed demographic data &#40;age and gender&#41;&#44; the anatomical characteristics of the aneurysm &#40;location and size&#41; and the results &#40;Glasgow Outcome Score &#91;GOS&#93; after 6 months&#41; of both series&#46; The hospital stay &#40;Intensive Care Unit and ward&#41;&#44; costs related to treatment and retreatment &#40;number of coils&#44; stents&#44; guide catheters&#44; balloons&#44; craniotomy&#44; clips&#44; etc&#46;&#41; and costs related to the follow-up of these patients &#40;control angiography&#44; MR angiography&#41; were recorded&#46; Costs of stays&#44; procedures and materials were obtained from hospital sources &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; A descriptive study of both series was carried out and they were compared in terms of age&#44; gender and clinical and radiological characteristics&#46; To calculate the costs&#44; those where follow-up was not suitably performed were excluded&#46; The follow-up carried out on patients who underwent surgery differed from those who underwent embolisation&#46; The patients who received surgical treatment for their cerebral aneurysm underwent one control angiography&#44; generally during the first admission&#44; and did not require other standardised control imaging tests&#46; The embolised patients&#44; however&#44; underwent one angiography after six months and another after 12 months&#44; continuing with yearly MR angiographies thereafter for at least five years if the treatment was deemed stable&#46; In the event an increase in the permeable remnant was observed&#44; they were scheduled for retreatment&#44; reinitiating the cycle of angiographies and MR angiographies&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">To compare age between the groups&#44; the Student&#39;s <span class="elsevierStyleItalic">t</span>-test was used&#46; The Mann&#8211;Whitney test was employed for aneurysm size&#44; since this did not pass the normal hypothesis test&#44; and Pearson&#39;s chi-squared test was used for gender&#46; IBM SPSS Statistics 19 Program was used&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0025" class="elsevierStylePara elsevierViewall">89 incidental aneurysm patients were treated between January 2010 and December 2015&#44; 66 EV &#40;EV group 74&#37;&#41; and 23 SC &#40;SC group 26&#37;&#41;&#46; Two of the patients who underwent surgery had double aneurysms which were clipped during the procedure&#46; The mean follow-up for the series was 36&#46;1 months &#40;6&#8211;72&#41;&#44; which was slightly higher in the EV group &#40;37&#46;6 versus 32&#46;43 months&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The ages of the patients ranged from 22 to 75 years&#44; with a mean age of 53&#46;6 years&#44; which was slightly higher in the SC group &#40;54 versus 53&#46;4 years&#41;&#46; As regard gender&#44; female patients predominated&#44; constituting 59&#37; of the cases&#44; and was similar in both groups &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">In terms of the aneurysm characteristics&#44; they were mostly located in the anterior circulation &#40;88&#46;7&#37;&#41;&#46; The most common location in the series overall was the middle cerebral artery &#40;MCA&#41; &#40;30&#46;3&#37;&#41;&#46; The others were distributed across various locations &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; In the SC group&#44; there is a clear MCA predominance &#40;82&#46;6&#37;&#41;&#44; while in the EV group the locations are more diverse&#44; with the internal carotid artery &#40;33&#46;3&#37;&#41; and anterior communicating artery &#40;24&#46;2&#37;&#41; being most predominant&#46; As for size&#44; 23&#46;6&#37; of the aneurysms were smaller than 5<span class="elsevierStyleHsp" style=""></span>mm&#44; 58&#46;4&#37; measured 5&#8211;10<span class="elsevierStyleHsp" style=""></span>mm and 18&#37; were greater than 10<span class="elsevierStyleHsp" style=""></span>mm&#46; The embolised aneurysms were slightly larger than those treated surgically &#40;7&#46;8<span class="elsevierStyleHsp" style=""></span>mm versus 7<span class="elsevierStyleHsp" style=""></span>mm&#44; on average&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">There were no statistically significant differences between the series regarding age&#44; gender or aneurysm size&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The clinical and angiographic results are summarised in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#46; As regard the clinical results after six months&#44; measured in relation to the GOS&#44; 90&#37; of the patients had a GOS of 5&#44; 6&#37; had a GOS of 4 and 4&#37; had a GOS of 3&#46; The results were very similar in both groups&#46; There was no treatment-related mortality&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">As regard the angiographic results of the treatment&#44; a control angiography was conducted in 100&#37; of cases&#46; The complete closure of the aneurysm was achieved in the first treatment in 65&#37; of patients&#44; with the rest presenting neck remnants&#46; Complete occlusion was notably higher in the SC group &#40;96&#37; versus 55&#37;&#41;&#46; Of the cases treated EV&#44; 24&#37; required retreatment &#40;a quarter of these on two occasions&#41;&#46; The retreatment rates of anterior circulation aneurysms were also higher &#40;27&#37;&#41; than in posterior circulation aneurysms &#40;10&#37;&#41;&#46; 50&#37; of posterior communicating artery aneurysms&#44; 36&#46;5&#37; of MCA aneurysms and 25&#37; of anterior communicating artery aneurysms treated EV required retreatment&#46; The mean size of the retreated aneurysms was also greater than the mean &#40;9<span class="elsevierStyleHsp" style=""></span>mm versus 7&#46;6<span class="elsevierStyleHsp" style=""></span>mm&#41;&#44; and 38&#46;5&#37; of the aneurysms larger than 10<span class="elsevierStyleHsp" style=""></span>mm required retreatment&#46; The mean number of coils used per patient in the first treatment was five and in the retreatments six&#46; Similarly&#44; the use of stents and flow diverters was more common in the retreatments&#46; There were four complications related to EV treatment&#44; none of which had subsequent sequelae&#58; two angiographic vasospasms&#44; one internal carotid artery dissection and one anaphylactic reaction&#44; accounting for 6&#37;&#46; One year after a flow diverter was inserted in a complex internal carotid artery aneurysm&#44; one patient presented complete occlusion following a cholecystectomy that resulted in death&#46; Surgery-related complications included a wound infection &#40;4&#46;5&#37;&#41; and a pseudomeningocele &#40;4&#46;5&#37;&#41;&#44; both of which were resolved with medical treatment and no sequelae&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">As regard hospital stays&#44; the mean length of hospitalisation among the patients was 7&#46;7 days&#46; The embolised patients had a mean stay of six days&#44; while the surgical patients&#8217; stay was more than twice as long &#40;12&#46;7 days&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Given that both groups had a different follow-up protocol&#44; the patients treated with embolisation following a subarachnoid haemorrhage &#40;SAH&#41; had a mean of 2&#46;5 angiographies per patient versus one control angiography in the surgical patients&#46; The mean number of MR angiographies was 2&#46;1 per patient &#40;2&#46;5 in the EV group and 1 in the SC group&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The total cost generated by the patients was &#8364;1&#44;848&#44;300&#46;00&#44; with the EV group accounting for 83&#37; of this amount&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Meanwhile&#44; in the SC group&#44; 88&#37; of the cost was generated during the first admission&#59; in the EV group this figure was 62&#37;&#46; Retreatment constituted 18&#37; of the cost in the EV group&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Taking into account only the first admission&#44; and despite the fact that the hospitalisation cost was more than double in the SC group&#44; endovascular treatment is 14&#37; more expensive than surgical treatment upon discharge&#46; This is due to the price of the embolisation materials used&#44; which account for 60&#37; of the cost upon discharge&#46; Around half of the embolisation material costs can be attributed to coils&#44; with flow diverters also constituting a significant expense &#40;one quarter of the total&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The cost of the embolisation materials alone amounts to 46&#37; of the total cost in the EV group&#46; The difference in costs increases when follow-up and retreatment costs are included&#44; which make endovascular treatment 31&#37; and 61&#37; more expensive&#44; respectively&#44; than surgery&#44; ultimately amounting to &#8364;22&#44;908 per patient versus &#8364;14&#44;264 for surgical treatment &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0080" class="elsevierStylePara elsevierViewall">Incidental aneurysms may be discovered by chance during radiological examinations or in the context of a SAH&#44; accompanied by a ruptured aneurysm&#46; Their detection is relatively common and their incidence has increased in recent years due to the improvement and widespread use of imaging techniques&#46; They are more common among women and the over 30<span class="elsevierStyleHsp" style=""></span>s&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">1</span></a> and there are a series of risk factors that predispose patients to cerebral aneurysms&#44; some of which are non-modifiable &#40;genetic&#41; and others that are modifiable &#40;smoking&#44; hypertension and excessive alcohol consumption&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">2</span></a> Based on these data&#44; the incidence of incidental aneurysms in the over 50s with no risk factors is estimated at 3&#46;2&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">2</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Indication for treatment is based on the rupture risk&#44; as well as the patient&#39;s age and the characteristics of the aneurysm&#46; Some studies&#44; such as the International Study of Unruptured Intracranial Aneurysms &#40;ISUIA&#41;&#44; have highlighted a rupture risk of 0&#46;5&#37; per year&#44; with this risk being greater in large &#40;&#62;10<span class="elsevierStyleHsp" style=""></span>mm&#41; and posterior circulation aneurysms&#46; The Unruptured Cerebral Aneurysm Study &#40;UCAS&#41; on Japanese patients showed a slightly higher rupture risk &#40;0&#46;95&#37;&#41;&#44; also related to the size and location of the aneurysm&#44; as well as the presence of sac irregularities&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">3</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Since the International Subarachnoid Aneurysm Trial &#40;ISAT&#41;&#44; there has been a progressive increase in indications for endovascular treatment versus surgery&#46; As a result&#44; endovascular treatment has now overtaken surgery in the context of both ruptured and incidental aneurysms&#46; This widespread use of endovascular treatments has led to a significant increase in indications for treatment &#40;and the resulting costs&#41; in incidental aneurysms&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">4</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Each treatment has its own advantages and disadvantages&#46; One advantage of endovascular treatment would be its less aggressive nature&#44; while a disadvantage is that it is less stable than surgical treatment&#44; meaning that rates of incomplete occlusion&#44;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">5&#8211;7</span></a> recanalisation&#44; retreatment<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">8&#8211;10</span></a> and rebleeding<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">5&#44;8&#44;9&#44;11</span></a> are far greater than with surgery&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">If symptomatic and ruptured aneurysms are excluded&#44; both forms of treatment generally yield results with low morbidity and mortality &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46; In the studies published to date featuring larger populations&#44; the surgical mortality related to this procedure ranges from 0&#46;6&#37; to 2&#46;6&#37;&#44; with a morbidity of 4&#46;1&#37; to 10&#46;9&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">12&#8211;21</span></a> Morbidity and mortality have been on the decline thanks to improvements in the surgical technique and the introduction of aids such as indocyanine green &#40;ICG&#41;&#46; Moreover&#44; there are large series with morbidity and mortality rates of 0&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">22&#44;23</span></a> Nevertheless&#44; in general&#44; endovascular treatment has lower mortality &#40;between 0&#46;5&#37; and 1&#46;7&#37;&#41; and morbidity &#40;between 1&#37; and 7&#46;5&#37;&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">14&#8211;18&#44;24</span></a> The only prospective study on endovascular treatment outcomes in incidental aneurysms was published by Pierot et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">25</span></a> on 649 patients and 1100 aneurysms treated across 27 sites&#46; In this study&#44; there was 0&#46;9&#37; mortality and 15&#46;4&#37; treatment-related adverse events&#44; with a mortality of 1&#46;4&#37; and an overall morbidity of 1&#46;7&#37; one month after treatment&#46; There was a 5&#46;4&#37; rate of symptomatic cerebral embolisms&#44; 2&#46;6&#37; of which were permanent and 0&#46;9&#37; resulted in patient death&#46; Three of the deaths were due to an intraoperative aneurysm rupture&#44; a phenomenon that occurred in 16&#46;7&#37; of patients&#44; half of whom were asymptomatic&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">Endovascular treatment has a lower complete occlusion rate&#44; with some series&#44; such as that of Naggara et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a> recording 86&#37; &#40;in the series by Pierot et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">25</span></a> this figure is 59&#37; and in the meta-analysis by Ruan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">21</span></a> it is 82&#37;&#41;&#46; Complete occlusion rates in the series subjected to surgical treatment for incidental aneurysms&#44; on the other hand&#44; stand at over 90&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">13&#44;20&#44;21&#44;26</span></a> Although the likelihood of recanalisation is greater in ruptured than incidental aneurysms&#44;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">27</span></a> it remains high in the latter and retreatment is required in 10&#37; of patients&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">Certain factors influence the outcome of surgical treatment on incidental aneurysms&#58; location in the posterior circulation&#44; size greater than 12<span class="elsevierStyleHsp" style=""></span>mm and an age of over 50 years&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">15&#44;25</span></a> The fact that recanalisation occurs fairly regularly prompts some authors to opt for surgery in anterior circulation aneurysms&#44; particularly in patients who are under 40 years of age&#46;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">10&#44;28&#44;29</span></a> Another factor influencing the outcome is the number of aneurysms treated by the site<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">30</span></a> and surgeon&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">31</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Several studies comparing the outcomes of endovascular and surgical treatment from a financial perspective<a class="elsevierStyleCrossRefs" href="#bib0360"><span class="elsevierStyleSup">32&#8211;39</span></a> have been published &#40;<a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a>&#41;&#46; The majority do not include follow-up or retreatment costs&#44; so endovascular treatment costs are in fact underestimated&#46; In almost all of the studies&#44; endovascular treatment proves more expensive than surgery&#46; Although the mean hospital stay is generally longer in patients who undergo surgery&#44; the costs generated by embolisation materials exceed the money saved by a shorter initial admission for endovascular treatment&#46; This factor is most evident in the research carried out by Familiarli et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">32</span></a> based on giant aneurysms&#44; where the use of a stent or flow diverter is often required&#44; making endovascular treatment 153&#37; more expensive than surgery&#46; It is interesting to point out that both techniques involved similar mean stays&#44; despite the fact that 94&#37; of the patients who underwent surgery required complex revascularisation techniques&#46; This fact indicates that this type of surgery should only be performed at sites with vast experience and a high number of cases&#46; Similar conclusions can be drawn from the work of Zweifel&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a> where a proper surgical technique resulted in a mean hospital stay that was only one day longer in the surgical group&#44; as well as better clinical and angiographic outcomes &#40;67&#37; occlusion in the EV group versus 97&#37; in the SC group&#41;&#46; In this series&#44; the costs of the endovascular group were more than twice those of the surgery group&#44; excluding follow-up and retreatments&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">The only study to include follow-up and retreatments<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">34</span></a> reveals that the costs of the first admission are very similar in both types of treatment&#44; but that endovascular follow-up and retreatments &#40;which in this study was 16&#46;7&#37;&#41; drove up the final cost&#44; with endovascular treatment proving 8&#37; more expensive than surgery&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The study by Duan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">39</span></a> also shows endovascular treatment to be 28&#37; more expensive than surgery&#44; excluding follow-up and retreatments&#44; particularly among patients under 60 years of age and in anterior circulation aneurysms and aneurysms larger than 7<span class="elsevierStyleHsp" style=""></span>mm&#46; If&#44; alongside the financial saving&#44; we note that the clinical outcomes of treating aneurysms in this population subgroup are generally better&#44; there would be solid criteria for indicating surgery over endovascular treatment&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The following conclusions can be reached from the current series&#58; &#40;1&#41; the clinical results of both techniques are comparable&#59; &#40;2&#41; the angiographic results are superior with the surgical clipping technique&#59; &#40;3&#41; treatment stability is greater in clipped aneurysms&#59; &#40;4&#41; retreatments are more common in anterior circulation and large aneurysms&#59; &#40;5&#41; hospital stays are longer with surgical treatment but the costs generated by embolisation offset the hospitalisation saving&#59; and &#40;6&#41; the cost of the endovascular procedure is more expensive than surgery upon discharge &#40;14&#37; higher due to the price of embolisation materials&#41;&#44; and even more so over time due to the costs derived from follow-up and the retreatments it usually requires &#40;61&#37; more expensive in the end&#41;&#46; These results are corroborated by most of the published studies&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">In large incidental anterior circulation aneurysms in young patients requiring treatment&#44; surgery should be the first line therapy due to the positive clinical and angiographic outcomes that are usually yielded&#44; as well as the savings obtained&#46; However&#44; it should be noted that this treatment should always be carried out by experienced neurosurgeons at sites with a high volume of patients&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The series presented has limitations&#46; The first is that it is a small series&#46; The second is that it is a retrospective study and the cost estimates have been calculated based on a number of sources and&#44; on occasions&#44; using indirect methods&#46; The third limitation is that it does not evaluate potential differences between the treatments as regard return-to-work rates or so-called lost profits&#44; which could have an impact on the savings generated by one technique or the other&#44; and which according to one study would make endovascular treatment favourable&#46;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">40</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusions</span><p id="par0145" class="elsevierStylePara elsevierViewall">In the series presented&#44; the results obtained regarding morbidity and mortality for surgery and embolisation are similar&#46; Moreover&#44; the angiographic and stability outcomes pertaining to surgery are superior to those for endovascular treatment&#44; with higher complete occlusion rates and fewer retreatments required&#46; Although endovascular treatment requires a shorter hospital stay than surgery&#44; the total mean cost is considerably higher&#44; largely due to the price of embolisation materials&#44; the retreatment rate and the follow-up required&#46; The careful selection of patients who are candidates for endovascular or surgical treatment might improve the angiographic outcomes and retreatment rate and lower costs without affecting morbidity and mortality&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicts of interest</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres1100244"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objective"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Material and methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1041355"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1100245"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Objetivo"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Material y m&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1041354"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Material and methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conclusions"
        ]
        9 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Conflicts of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2018-04-11"
    "fechaAceptado" => "2018-07-03"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1041355"
          "palabras" => array:4 [
            0 => "Subarachnoid hemorrhage"
            1 => "Cost effectiveness"
            2 => "Coil"
            3 => "Brain aneurysm"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1041354"
          "palabras" => array:4 [
            0 => "Hemorragia subaracnoidea"
            1 => "Efectividad-coste"
            2 => "Coil"
            3 => "Aneurisma cerebral"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To evaluate the results and costs of surgical treatment against endovascular in non-ruptured aneurysms&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective study of consecutive series non-ruptured aneurysms from a single-centre treated endovascularly &#40;EV&#41; and surgically &#40;SC&#41;&#46; A descriptive study of demographic &#40;age&#44; sex&#41;&#44; characteristics of the patients and the radiological aspects of the aneurysms have been carried out&#46; Clinical results &#40;GOS at 6 months&#41;&#44; angiographic data &#40;occlusion classification&#41; and economic costs have been evaluated in both globally&#44; and in each of the groups&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">89 patients treated between 2010 and 2015 were reviewed&#46; Most of them were treated endovascularly &#40;74&#37;&#41;&#46; There were no statistically significant differences between EV and SC groups&#46; 89&#37; of the patients presented favourable GOS &#40;4&#8211;5&#41; at six months&#44; being this percentage similar in both groups&#46; Complete occlusion was much higher in SC group &#40;96&#37;&#41; than in EV &#40;55&#37;&#41;&#46; Retreatment rate was 24&#37; in EV group and 0&#37; in SC group&#46; The retreatments were more frequent in anterior circulation aneurysms and bigger aneurysms &#40;&#62;10<span class="elsevierStyleHsp" style=""></span>mm&#41;&#46; The expenses in the SC group come mainly from hospital stay&#44; meanwhile in the EV group is due to embolisation materials&#46; The average length of stay &#40;ALOS&#41; is higher in SC group but costs of first admission are higher in EV group &#40;14&#37; more&#41;&#46; When the costs of retreatments and follow up are included the costs of endovascular treatment is much higher than the surgical &#40;61&#37; more expensive&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">results of both types of treatment are comparable&#46; The grade of aneurysmal occlusion of the SC group was higher than the EV&#44; as well as the stability of the treatment&#44; requiring fewer retreatments&#46; Although the ALOS in SC group were longer&#44; the costs of the EV group were significantly higher than the SC group due to the costs of embolisation materials&#44; follow up that they need and the rate of retreatment&#46; Adequate selection of candidates for endovascular coiling could improve angiographic outcomes&#44; reduce retraction rates&#44; and save costs&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Evaluar los resultados cl&#237;nicos y angiogr&#225;ficos&#44; as&#237; como los costes del tratamiento quir&#250;rgico frente al endovascular&#44; en el tratamiento de los aneurismas incidentales&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo de una serie consecutiva de 89 pacientes de un solo centro tratados endovascularmente &#40;EV&#41; y quir&#250;rgicamente &#40;SC&#41;&#46; Se realiza estudio descriptivo de aspectos demogr&#225;ficos &#40;edad&#44; sexo&#41; y de las caracter&#237;sticas de los aneurismas as&#237; como se eval&#250;an resultados cl&#237;nicos &#40;GOS a 6 meses&#41;&#44; angiogr&#225;ficos &#40;grado de oclusi&#243;n&#41; y de costes econ&#243;micos tanto globalmente como de cada uno de los grupos&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Ochenta y nueve pacientes tratados entre 2010 y 2015&#46; Un 74&#37; de los pacientes recibieron tratamiento endovascular y un 26&#37; quir&#250;rgico&#46; No hubo diferencias significativas en cuanto a edad o sexo entre los grupos EV y SC&#46; Un 89&#37; de los pacientes presentaron GOS a los 6 meses favorable &#40;4-5&#41;&#44; sin diferencias entre ambos grupos&#46; La oclusi&#243;n completa del aneurisma fue mayor en el grupo SC &#40;96&#37; versus 55&#37;&#41;&#44; as&#237; como la estabilidad del tratamiento &#40;24&#37; de retratamientos en el grupo EV versus 0&#37; en el grupo SC&#41;&#46; Los retratamientos son m&#225;s frecuentes en aneurismas de circulaci&#243;n anterior &#40;27&#37;&#41; y de mayor tama&#241;o &#40;un 38&#44;5&#37; de los mayores de 10 mm&#41;&#46; El gasto en el grupo SC viene derivado fundamentalmente de la estancia hospitalaria en tanto que en grupo EV tiene m&#225;s importancia el coste de los materiales de embolizaci&#243;n&#46; Las estancias medias son notablemente superiores en el grupo SC pero el coste medio del primer ingreso es un 14&#37; superior en el grupo EV debido al precio de los materiales de embolizaci&#243;n&#46; El gasto total es notablemente superior en el grupo EV &#40;un 61&#37;&#41; debido a los gastos derivados del seguimiento y de los retratamientos&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los resultados cl&#237;nicos de ambos tipo de tratamiento son comparables&#46; El grado de oclusi&#243;n aneurism&#225;tica del grupo SC es superior al del EV&#44; as&#237; como la estabilidad del tratamiento&#44; precisando menos retratamientos&#46; A pesar de que el tratamiento quir&#250;rgico genera estancias m&#225;s largas&#44; los costes del grupo EV son notablemente superiores a los del grupo SC debido al precio de los materiales de embolizaci&#243;n&#44; el seguimiento que precisan y la tasa de retratamientos&#46; Una adecuada selecci&#243;n de los casos candidatos a coiling o pinzamiento podr&#237;a mejorar los resultados angiogr&#225;ficos&#44; reducir la tasa de retratamientos y ahorrar costes&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0006">Please cite this article as&#58; Horcajadas A&#44; Ortiz I&#44; Jorques AM&#46;&#44; Katati MJ&#46; Anatom&#237;a microquir&#250;rgica en 3 D del tracto corticoespinal y de la v&#237;a del lemnisco basada en microdisecci&#243;n de fibras y demostraci&#243;n a trav&#233;s de tractograf&#237;a&#46; Neurocirug&#237;a&#46; 2018&#59;29&#58;267&#8211;274&#46;</p>"
      ]
    ]
    "multimedia" => array:8 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1754
            "Ancho" => 1461
            "Tamanyo" => 75537
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribution of endovascular material costs&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1425
            "Ancho" => 2138
            "Tamanyo" => 173313
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Mean costs&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Item&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Price &#40;&#8364;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Day in ICU&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Day on ward&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">650&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Craniotomy<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Embolisation<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cerebral angiography&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">700&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">MR angiography&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Clip&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Coil&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">900&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Guide catheter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Balloon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Stent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Flow diverter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1881709.png"
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Craniotomy includes the costs of surgical time&#44; the materials &#40;excluding clips&#41; and human resources&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Embolisation includes the costs of angiography&#44; anaesthesia and human resources&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Cost guide&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">SC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&#46;5 &#40;22&#8211;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&#46;5 &#40;22&#8211;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54 &#40;34&#8211;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Gender &#40;F&#59; M&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#59; 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#59; 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#59; 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Follow-up &#40;months&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38 &#40;7&#8211;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">38 &#40;7&#8211;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;6&#8211;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Aneurysm location</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ant&#46; circ&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">85&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Post&#46; circ&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Size</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;5<span class="elsevierStyleHsp" style=""></span>mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5&#8211;10<span class="elsevierStyleHsp" style=""></span>mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;10<span class="elsevierStyleHsp" style=""></span>mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1881704.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Clinical and angiographic characteristics of the series&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">ACA&#58; anterior cerebral artery&#59; AChA&#58; anterior choroidal artery&#59; ACoA&#58; anterior communicating artery&#59; AICA&#58; anterior inferior cerebellar artery&#59; ICA&#58; internal carotid artery&#59; MCA&#58; middle cerebral artery&#59; PCA&#58; posterior cerebral artery&#59; PCoA&#58; posterior communicating artery&#59; PICA&#58; posterior inferior cerebellar artery&#59; SCA&#58; superior cerebellar artery&#59; VB&#58; vertebrobasilar artery&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">SC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Anterior circulation</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ICA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PCoA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ACoA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ACA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>AChA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>MCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Posterior circulation</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>VB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PICA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>SCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1881708.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Location of the aneurysms&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Tot&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">SC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Mean stay &#40;days&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">GOS at 6 months</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">90&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Angiography</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Complete occlusion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Neck remnant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Retreatment</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1881706.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Mean stay&#44; clinical and angiographic outcomes&#46;</p>"
        ]
      ]
      6 => array:8 [
        "identificador" => "tbl0025"
        "etiqueta" => "Table 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at5"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Study&#44; year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col">No&#46; of cases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Mortality &#40;&#37;&#41;</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Morbidity &#40;&#37;&#41;</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">SC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">SC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">King<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">12</span></a>&#44; 1994<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">733&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Johnston<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">40</span></a>&#44; 1999&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2412&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Raymakers<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">13</span></a>&#44; 1998&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2460&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Barker<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">14</span></a>&#44; 2004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3929&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ISUIA<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">15</span></a>&#44; 2003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2368&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lanterna<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">24</span></a>&#44; 2004<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1379&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Higashida<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">16</span></a>&#44; 2007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2535&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pierot<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">25</span></a>&#44; 2008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Alskhlee<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">17</span></a>&#44; 2010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3738&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Brinjikii<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">18</span></a>&#44; 2011&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;940&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">McDonald<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">19</span></a>&#44; 2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4899&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kotowski<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">20</span></a>&#44; 2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9845&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Duan<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">39</span></a>&#44; 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">125&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;3<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ruan<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">21</span></a>&#44; 2015<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3135&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Zweifel<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a>&#44; 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">209&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Current study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1881707.png"
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Meta-analysis&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Morbidity at 2 months&#46; The initial morbidity was 18&#46;8&#37; in SC and 9&#46;8&#37; in EV&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Morbidity and mortality of incidental aneurysm treatment&#46;</p>"
        ]
      ]
      7 => array:8 [
        "identificador" => "tbl0030"
        "etiqueta" => "Table 6"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at6"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">EV&#58; endovascular&#59; FU&#58; follow-up&#59; incr&#58; increase&#59; R&#58; ruptured aneurysm&#59; Rett&#58; retreatment&#59; SC&#58; surgical&#59; UR&#58; unruptured aneurysm&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Author&#44; year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">No&#46; of cases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Aneurysm type&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">More expensive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">&#37; cost incr&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">FU included&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Rett&#46; included&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Halkes<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">33</span></a>&#44; 2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">R and UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hoh<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">34</span></a>&#44; 2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">565&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">R and UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#37;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hoh<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">35</span></a>&#44; 2010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9347&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">R and UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#37;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lad<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">38</span></a>&#44; 2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4504&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#37;<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Duan<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">39</span></a>&#44; 2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">125&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kim<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">36</span></a>&#44; 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">410&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Familiarli<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">32</span></a>&#44; 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">153&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Zweifel<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a>&#44; 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">209&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">114&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chang<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">37</span></a>&#44; 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&#44;422&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Current study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1881705.png"
              ]
            ]
          ]
          "notaPie" => array:4 [
            0 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Matched case series&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Percentage only for unruptured aneurysms&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0035"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Results after 5 years of follow-up&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0040"
              "etiqueta" => "d"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0040">Cases of giant aneurysms&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Summary of the studies published on the costs of incidental aneurysm treatment&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:40 [
            0 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of unruptured intracranial aneurysms&#44; with emphasis on sex&#44; age&#44; comorbidity&#44; country and time period&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;H&#46; Vlak"
                            1 => "A&#46; Algra"
                            2 => "R&#46; Brandenburg"
                            3 => "G&#46;J&#46; Rinkel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1474-4422(11)70109-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Neurol"
                        "fecha" => "2011"
                        "volumen" => "10"
                        "paginaInicial" => "626"
                        "paginaFinal" => "636"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21641282"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines for the management of patients with unruptured intracranial aneurysms&#58; a guidelines for healthcare professionals from the American Heart Association&#47;American Stroke Association"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:1 [
                            0 => "B&#46;G&#46; Thompson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STR.0000000000000070"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2015"
                        "volumen" => "46"
                        "paginaInicial" => "2368"
                        "paginaFinal" => "2400"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26089327"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The natural course of unruptured cerebral aneurysms in a Japanese cohort"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "The UCAS Japan Investigators"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1113260"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2012"
                        "volumen" => "366"
                        "paginaInicial" => "2474"
                        "paginaFinal" => "2482"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22738097"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recent trends in the treatment of cerebral aneurysms&#58; analysis of a nationwide inpatient database"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46; Andaluz"
                            1 => "M&#46; Zuccarello"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/JNS/2008/108/6/1163"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2008"
                        "volumen" => "108"
                        "paginaInicial" => "1163"
                        "paginaFinal" => "1169"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18518722"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictors of rehemorrhage after treatment of ruptured intracranial aneurysms&#58; the cerebral aneurysm rerupture after treatment &#40;CARAT&#41; study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;C&#46; Johnston"
                            1 => "C&#46;F&#46; Dowd"
                            2 => "R&#46;T&#46; Higashida"
                            3 => "M&#46;T&#46; Lawton"
                            4 => "G&#46;R&#46; Duckwiler"
                            5 => "D&#46;R&#46; Gress"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STROKEAHA.107.495747"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2008"
                        "volumen" => "39"
                        "paginaInicial" => "120"
                        "paginaFinal" => "125"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18048860"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guglielmi detachable coil embolization of cerebral aneurysms&#58; 11 years&#8217; experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Murayama"
                            1 => "Y&#46;L&#46; Nien"
                            2 => "G&#46; Duckwiler"
                            3 => "Y&#46;P&#46; Gobin"
                            4 => "R&#46; Jahan"
                            5 => "J&#46; Frazee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.2003.98.5.0959"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2003"
                        "volumen" => "98"
                        "paginaInicial" => "959"
                        "paginaFinal" => "966"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12744354"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sixteen-year single-surgeon experience with coil embolization for ruptured intracranial aneurysms&#58; recurrence rates and incidence of late rebleeding&#46; Clinical article"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;S&#46; Plowman"
                            1 => "A&#46; Clarke"
                            2 => "M&#46; Clarke"
                            3 => "J&#46;V&#46; Byrne"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/2010.6.JNS091058"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2011"
                        "volumen" => "114"
                        "paginaInicial" => "863"
                        "paginaFinal" => "874"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20672900"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rates of delayed rebleeding from intracranial aneurysms are low after surgical and endovascular treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "CARAT Investigators"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.STR.0000221331.01830.ce"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2006"
                        "volumen" => "37"
                        "paginaInicial" => "1437"
                        "paginaFinal" => "1442"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16627789"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of recurrent subarachnoid haemorrhage&#44; death&#44; or dependence and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the international subarachnoid aneurysm trial &#40;ISAT&#41;&#58; long-term follow-up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;J&#46; Molyneux"
                            1 => "R&#46;S&#46; Kerr"
                            2 => "J&#46; Birks"
                            3 => "N&#46; Ramzi"
                            4 => "J&#46; Yarnold"
                            5 => "M&#46; Sneade"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1474-4422(09)70080-8"
                      "Revista" => array:7 [
                        "tituloSerie" => "Lancet Neurol"
                        "fecha" => "2009"
                        "volumen" => "8"
                        "paginaInicial" => "427"
                        "paginaFinal" => "433"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19329361"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1470204508701785"
                          "estado" => "S300"
                          "issn" => "14702045"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of recurrent subarachnoid haemorrhage&#44; death&#44; or dependence and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the international subarachnoid aneurysm trial &#40;ISAT&#41;&#58; long-term follow-up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;J&#46; Molyneux"
                            1 => "R&#46;S&#46; Kerr"
                            2 => "J&#46; Birks"
                            3 => "N&#46; Ramzi"
                            4 => "J&#46; Yarnold"
                            5 => "M&#46; Sneade"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1474-4422(09)70080-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Neurol"
                        "fecha" => "2009"
                        "volumen" => "8"
                        "paginaInicial" => "427"
                        "paginaFinal" => "433"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19329361"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Late rebleeding of ruptured intracranial aneurysms treated with detachable coils"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Sluzewski"
                            1 => "W&#46;J&#46; van Rooij"
                            2 => "G&#46;N&#46; Beute"
                            3 => "P&#46;C&#46; Nijssen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "AJNR Am J Neuroradiol"
                        "fecha" => "2005"
                        "volumen" => "26"
                        "paginaInicial" => "2542"
                        "paginaFinal" => "2549"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16286399"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Morbidity and mortality from elective surgery for asymptomatic&#44; unruptured&#44; intracranial aneurysms&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;T&#46; King Jr&#46;"
                            1 => "J&#46;A&#46; Berlin"
                            2 => "E&#46;S&#46; Flamm"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1994.81.6.0837"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1994"
                        "volumen" => "81"
                        "paginaInicial" => "837"
                        "paginaFinal" => "842"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7965113"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0735109715046215"
                          "estado" => "S300"
                          "issn" => "07351097"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mortality and morbidity of surgery for unruptured intracranial aneurysms&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46;W&#46; Raaymakers"
                            1 => "G&#46;J&#46; Rinkel"
                            2 => "M&#46; Limburg"
                            3 => "A&#46; Algra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "1998"
                        "volumen" => "29"
                        "paginaInicial" => "1531"
                        "paginaFinal" => "1538"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9707188"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Age-dependent differences in short term outcome after surgical or endovascular treatment of unruptured intracranial aneurysms in the United States&#44; 1996&#8211;2000"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;G&#46; Barker 2nd"
                            1 => "S&#46; Amin-Hanjani"
                            2 => "W&#46;E&#46; Butler"
                            3 => "B&#46;L&#46; Hoh"
                            4 => "J&#46;D&#46; Rabinov"
                            5 => "J&#46;C&#46; Pryor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2004"
                        "volumen" => "54"
                        "paginaInicial" => "18"
                        "paginaFinal" => "28"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14683537"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Unruptured intracranial aneurysms&#58; natural history&#44; clinical outcome&#44; and risks of surgical and endovascular treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;O&#46; Wiebers"
                            1 => "J&#46;P&#46; Whistnant"
                            2 => "J&#46; Huston"
                            3 => "I&#46; Meissner"
                            4 => "R&#46;D&#46; Brown"
                            5 => "D&#46;G&#46; Piepgras"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2003"
                        "volumen" => "362"
                        "paginaInicial" => "103"
                        "paginaFinal" => "110"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12867109"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of unruptured intracranial aneurysms&#58; a nationwide assessment of effectiveness"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46;T&#46; Higashida"
                            1 => "B&#46;J&#46; Lahue"
                            2 => "M&#46;T&#46; Torbey"
                            3 => "L&#46;N&#46; Hopkins"
                            4 => "E&#46; Leip"
                            5 => "D&#46;F&#46; Hanley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "AJNR"
                        "fecha" => "2007"
                        "volumen" => "28"
                        "paginaInicial" => "146"
                        "paginaFinal" => "215"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17213445"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hospital mortality and complications of electively clipped or coiled unruptured intracranial aneurysm"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Alshekhlee"
                            1 => "S&#46; Mehta"
                            2 => "R&#46;C&#46; Edgell"
                            3 => "N&#46; Vora"
                            4 => "E&#46; Feen"
                            5 => "A&#46; Mohammadi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STROKEAHA.110.580647"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2010"
                        "volumen" => "41"
                        "paginaInicial" => "1471"
                        "paginaFinal" => "1476"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20522817"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of age on outcomes of treatment of unruptured cerebral aneurysms&#58; a study of the National Inpatient Sample 2001&#8211;2008"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "W&#46; Brinjikji"
                            1 => "A&#46;A&#46; Rabinstein"
                            2 => "G&#46; Lanzino"
                            3 => "D&#46;F&#46; Kallmes"
                            4 => "H&#46;J&#46; Cloft"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STROKEAHA.110.607986"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2011"
                        "volumen" => "42"
                        "paginaInicial" => "1320"
                        "paginaFinal" => "1324"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21441142"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative effectiveness of unruptured cerebral aneurysm therapies&#58; propensity score analysis of clipping versus coiling"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;S&#46; McDonald"
                            1 => "R&#46;J&#46; McDonald"
                            2 => "J&#46; Fan"
                            3 => "D&#46;F&#46; Kallmes"
                            4 => "G&#46; Lanzino"
                            5 => "H&#46;J&#46; Cloft"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STROKEAHA.111.000196"
                      "Revista" => array:7 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2013"
                        "volumen" => "44"
                        "paginaInicial" => "988"
                        "paginaFinal" => "994"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23449260"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1470204514704528"
                          "estado" => "S300"
                          "issn" => "14702045"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Safety and occlusion rates of surgical treatment of unruptured intracranial aneurysms&#58; a systematic review and meta-analysis of the literature from 1990 to 2011"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Kotowski"
                            1 => "O&#46; Naggara"
                            2 => "T&#46;E&#46; Darsaut"
                            3 => "S&#46; Nolet"
                            4 => "G&#46; Gevry"
                            5 => "E&#46; Kouznetsov"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/jnnp-2011-302068"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Neurol Neurosurg Psychiatry"
                        "fecha" => "2013"
                        "volumen" => "84"
                        "paginaInicial" => "42"
                        "paginaFinal" => "48"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23012447"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0190962212004525"
                          "estado" => "S300"
                          "issn" => "01909622"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endovascular coiling vs&#46; surgical clipping for unruptured intracranial aneurysm&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Ruan"
                            1 => "H&#46; Long"
                            2 => "H&#46; Sun"
                            3 => "M&#46; He"
                            4 => "K&#46; Yang"
                            5 => "H&#46; Zhang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3109/02688697.2015.1023771"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Neurosurg"
                        "fecha" => "2015"
                        "volumen" => "29"
                        "paginaInicial" => "485"
                        "paginaFinal" => "492"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26037936"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment-related morbidity of unruptured intracranial aneurysms&#58; results of a prospective single-centre series with an interdisciplinary approach over a 6-year period &#40;1999-2005&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Gerlach"
                            1 => "J&#46; Beck"
                            2 => "M&#46; Setzer"
                            3 => "H&#46; Vatter"
                            4 => "J&#46; Berkefeld"
                            5 => "R&#46; Du Mesnii de Rochemont"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/jnnp.2006.106823"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurol Neurosurg Psychiatry"
                        "fecha" => "2007"
                        "volumen" => "78"
                        "paginaInicial" => "864"
                        "paginaFinal" => "871"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17210624"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The interdisciplinary treatment of unruptured intracranial aneurysms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46; Seifert"
                            1 => "R&#46; Gerlach"
                            2 => "A&#46; Raabe"
                            3 => "E&#46; G&#252;resir"
                            4 => "J&#46; Beck"
                            5 => "A&#46; Szel&#233;nyi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3238/arztebl.2008.0449"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dtsch Arztebl Int"
                        "fecha" => "2008"
                        "volumen" => "105"
                        "paginaInicial" => "449"
                        "paginaFinal" => "456"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19626180"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of unruptured cerebral aneurysms by embolization withGu glielmi detachable coils&#58; case-fatality&#44; morbidity&#44; and effectiveness in preventing bleeding &#8211; a systematic review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;A&#46; Lanterna"
                            1 => "G&#46; Tredici"
                            2 => "B&#46;D&#46; Dimitrov"
                            3 => "F&#46; Biroli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2004"
                        "volumen" => "55"
                        "paginaInicial" => "767"
                        "paginaFinal" => "775"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15458585"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immediate clinical outcome of patients harboring unruptured intracranial aneurysms treated by endovascular approach&#58; results of the ATENA study"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "ATENA Investigators"
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Pierot"
                            1 => "L&#46; Spelle"
                            2 => "F&#46; Vitry"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STROKEAHA.107.512756"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2008"
                        "volumen" => "39"
                        "paginaInicial" => "2497"
                        "paginaFinal" => "2504"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18617659"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "26"
              "referencia" => array:2 [
                0 => null
                1 => null
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of ruptured vs unruptured aneurysms in recanalization after coil embolization"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46;N&#46; Nguyen"
                            1 => "B&#46;L&#46; Hoh"
                            2 => "S&#46; Amin-Hanjani"
                            3 => "J&#46;C&#46; Pryor"
                            4 => "C&#46;S&#46; Ogilvy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.surneu.2006.10.021"
                      "Revista" => array:6 [
                        "tituloSerie" => "Surg Neurol"
                        "fecha" => "2007"
                        "volumen" => "68"
                        "paginaInicial" => "19"
                        "paginaFinal" => "23"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17586214"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Could late rebleeding overturn the superiority of cranial aneurysm coil embolization over clip ligation seen in the international subarachnoid aneurysm trial&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46; Mitchell"
                            1 => "R&#46; Kerr"
                            2 => "A&#46;D&#46; Mendelow"
                            3 => "A&#46; Molyneux"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/JNS/2008/108/3/0437"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2008"
                        "volumen" => "108"
                        "paginaInicial" => "437"
                        "paginaFinal" => "442"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18312088"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "International subarachnoid aneurysm trial analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46;C&#46; Heros"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/JNS/2008/108/3/0433"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2008"
                        "volumen" => "108"
                        "paginaInicial" => "433"
                        "paginaFinal" => "435"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18312086"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "In-hospital mortality and morbidity alter surgical treatment of unruptured intracranial aneurysms in the United States&#44; 1996&#8211;2000&#58; the effect of hospital and surgeon volume"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "F&#46;G&#46; Barker 2nd"
                            1 => "S&#46; Amin-Hanjani"
                            2 => "W&#46;E&#46; Butler"
                            3 => "C&#46;S&#46; Ogylvy"
                            4 => "B&#46;S&#46; Carter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2003"
                        "volumen" => "52"
                        "paginaInicial" => "995"
                        "paginaFinal" => "1007"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12699540"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Functional outcome after repair of unruptured intracranial aneurysms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46; Chyatte"
                            1 => "R&#46; Porterfield"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.2001.94.3.0417"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "2001"
                        "volumen" => "94"
                        "paginaInicial" => "417"
                        "paginaFinal" => "421"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11235945"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cost comparison of surgical and endovascular treatment of unruptured giant intracranial aneurysms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Familiari"
                            1 => "N&#46; Maldaner"
                            2 => "A&#46; Kursumovic"
                            3 => "S&#46;A&#46; Rath"
                            4 => "P&#46; Vajkoczy"
                            5 => "A&#46; Raco"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1227/NEU.0000000000000917"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2015"
                        "volumen" => "77"
                        "paginaInicial" => "733"
                        "paginaFinal" => "741"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26225854"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Direct costs of surgical clipping and endovascular coiling of unruptured intracranial aneurysms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46;H&#46; Halkes"
                            1 => "M&#46;J&#46; Wermer"
                            2 => "G&#46;J&#46; Rinkel"
                            3 => "E&#46; Buskens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000092336"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cerebrovasc Dis"
                        "fecha" => "2006"
                        "volumen" => "22"
                        "paginaInicial" => "40"
                        "paginaFinal" => "45"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16567936"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Length of stay and total hospital charges of clipping versus coiling for ruptured and unruptured adult cerebral aneurysms in the Nationwide Inpatient Sample database 2002 to 2006"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46;L&#46; Hoh"
                            1 => "Y&#46;Y&#46; Chi"
                            2 => "M&#46;F&#46; Lawson"
                            3 => "J&#46; Mocco"
                            4 => "Barker F&#46;G&#46; 2nd"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/STROKEAHA.109.569269"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2010"
                        "volumen" => "41"
                        "paginaInicial" => "337"
                        "paginaFinal" => "342"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20044522"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of coiling versus clipping of ruptured and unruptured cerebral aneurysms on length of stay&#44; hospital cost&#44; hospital reimbursement&#44; and surgeon reimbursement at the University of Florida"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46;L&#46; Hoh"
                            1 => "Y&#46;Y&#46; Chi"
                            2 => "M&#46;A&#46; Dermott"
                            3 => "P&#46;J&#46; Lipori"
                            4 => "S&#46;B&#46; Lewis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1227/01.NEU.0000340784.75352.A4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2009"
                        "volumen" => "64"
                        "paginaInicial" => "614"
                        "paginaFinal" => "619"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19197221"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative cost analysis for surgical and endovascular treatment on unruptured intracranial aneurysms in South Korea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Kim"
                            1 => "J&#46; Park"
                            2 => "J&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3340/jkns.2015.57.6.455"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Korean Neurosurg Soc"
                        "fecha" => "2015"
                        "volumen" => "57"
                        "paginaInicial" => "455"
                        "paginaFinal" => "459"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26180615"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0385"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cost-effectiveness analysis of endovascular coiling versus neurosurgical clipping for intracranial aneurysms in Republic of Korea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46;W&#46; Chang"
                            1 => "S&#46;H&#46; Shin"
                            2 => "S&#46;H&#46; Suh"
                            3 => "B&#46;S&#46; Kim"
                            4 => "M&#46;H&#46; Rho"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5469/neuroint.2016.11.2.86"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurointervention"
                        "fecha" => "2016"
                        "volumen" => "11"
                        "paginaInicial" => "86"
                        "paginaFinal" => "91"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27621944"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0390"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term economic impact of coiling vs clipping for unruptured intracranial aneurysms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;P&#46; Lad"
                            1 => "R&#46; Babu"
                            2 => "M&#46;S&#46; Rhee"
                            3 => "R&#46;L&#46; Franklin"
                            4 => "B&#46; Ugiliweneza"
                            5 => "J&#46; Hodes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1227/01.neu.0000429284.91142.56"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2013"
                        "volumen" => "72"
                        "paginaInicial" => "1000"
                        "paginaFinal" => "1011"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23612602"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0395"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Analysis of short-term total hospital costs and current primary cost drivers of coiling versus clipping for unruptured intracranial aneurysms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Y&#46; Duan"
                            1 => "K&#46; Blackham"
                            2 => "J&#46; Nelson"
                            3 => "W&#46; Selman"
                            4 => "N&#46; Bambakidis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/neurintsurg-2014-011249"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurointerv Surg"
                        "fecha" => "2015"
                        "volumen" => "7"
                        "paginaInicial" => "614"
                        "paginaFinal" => "618"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24891453"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0400"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endovascular and surgical treatment of unruptured cerebral aneurysms&#58; comparison of risks"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;C&#46; Johnston"
                            1 => "C&#46;B&#46; Wilson"
                            2 => "V&#46;V&#46; Halbach"
                            3 => "R&#46;T&#46; Higashida"
                            4 => "C&#46;F&#46; Dowd"
                            5 => "M&#46;W&#46; McDermott"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Neurol"
                        "fecha" => "2000"
                        "volumen" => "48"
                        "paginaInicial" => "11"
                        "paginaFinal" => "19"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10894211"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/25298496/0000002900000006/v1_201810280620/S2529849618300364/v1_201810280620/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "65581"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Clinical research"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/25298496/0000002900000006/v1_201810280620/S2529849618300364/v1_201810280620/en/main.pdf?idApp=UINPBA00004B&text.app=https://revistaneurocirugia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529849618300364?idApp=UINPBA00004B"
]
Article information
ISSN: 25298496
Original language: English
DOI:10.1016/j.neucie.2018.09.002
The statistics are updated each day
Year/Month Html Pdf Total
2023 March 6 1 7
2021 March 1 2 3

Follow this link to access the full text of the article

Subscribe to our newsletter

Sociedad española de neurocirugía
Free access articles
Mortality risk factors for adult trauma patients treated...
10.1016/j.neucie.2024.09.003
Cauda equina malignant peripheral nerve sheath tumor...
10.1016/j.neucie.2024.10.001
Neurocirugía (English edition) is a member and subscribes the principles of, the Committee on Publication Ethics (COPE)
www.publicationethics.org.
Congresses
XXVII Congreso Nacional de la Sociedad Española de Neurocirugía
See more
Idiomas
Neurocirugía (English edition)
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?