The evolution of intracranial aneurysm treatment techniques and future directions.
Springer Science and Business Media LLC
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Lee, K. S., Zhang, J. J., Nguyen, V., Han, J., Johnson, J. N., Kirollos, R., & Teo, M. (2022). The evolution of intracranial aneurysm treatment techniques and future directions.. Neurosurg Rev, 45 (1), 1-25. https://doi.org/10.1007/s10143-021-01543-z
Treatment techniques and management guidelines for intracranial aneurysms (IAs) have been continually developing and this rapid development has altered treatment decision-making for clinicians. IAs are treated in one of two ways: surgical treatments such as microsurgical clipping with or without bypass techniques, and endovascular methods such as coiling, balloon- or stent-assisted coiling, or intravascular flow diversion and intrasaccular flow disruption. In certain cases, a single approach may be inadequate in completely resolving the IA and successful treatment requires a combination of microsurgical and endovascular techniques, such as in complex aneurysms. The treatment option should be considered based on factors such as age; past medical history; comorbidities; patient preference; aneurysm characteristics such as location, morphology, and size; and finally the operator's experience. The purpose of this review is to provide practicing neurosurgeons with a summary of the techniques available, and to aid decision-making by highlighting ideal or less ideal cases for a given technique. Next, we illustrate the evolution of techniques to overcome the shortfalls of preceding techniques. At the outset, we emphasize that this decision-making process is dynamic and will be directed by current best scientific evidence, and future technological advances.
Review, Subarachnoid hemorrhage, Aneurysms, Clipping, Endovascular embolization, Coiling, Stents, Flow diversion
External DOI: https://doi.org/10.1007/s10143-021-01543-z
This record's URL: https://www.repository.cam.ac.uk/handle/1810/333807