The evolution of intracranial aneurysm treatment techniques and future directions.
Authors
Nguyen, Vincent
Han, Julian
Kirollos, Ramez
Publication Date
2022-02Journal Title
Neurosurg Rev
ISSN
0344-5607
Publisher
Springer Science and Business Media LLC
Volume
45
Issue
1
Pages
1-25
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
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
Abstract
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.
Keywords
Review, Subarachnoid hemorrhage, Aneurysms, Clipping, Endovascular embolization, Coiling, Stents, Flow diversion
Identifiers
s10143-021-01543-z, 1543
External DOI: https://doi.org/10.1007/s10143-021-01543-z
This record's URL: https://www.repository.cam.ac.uk/handle/1810/333807
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/
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