Intracranial aneurysm embolization
Intracranial aneurysm coiling
see Aneurysm coiling.
Intracranial Aneurysm Flow Diversion
Intracranial Aneurysm Flow Diversion.
Since the emergence of the Guglielmi detachable coil in the late 1980s and early 1990s, intracranial aneurysm treatment has entered an endovascular era which has served as a crucial adjunct to the gold standard of microsurgical clipping. The International Subarachnoid Aneurysm Trial (ISAT) and International Study of Unruptured Intracranial Aneurysms (ISUIA) have established the exponential increase in utility of endovascular procedures for aneurysms treatment. Results of the ISAT showed that 1-yr disability or death occurred in 30.9% of patients treated via clipping vs only in 23.5% of patients in the coiling group 1)
With the increasing use of endovascular techniques in the treatment of both ruptured intracranial aneurysm and unruptured intracranial aneurysms, the issue of obliteration efficacy has become increasingly important.
Endovascular therapy is for certain aneurysms the treatment of choice for intracranial aneurysms (IAs) for its efficacy and safety profile. Still, many aneurysms such as large, giant, wide necked aneurysm, and fusiform aneurysms are considered more challenging and less amenable to traditional endovascular coiling 2).
In addition to coiling, balloon remodeling technique and Stent-assisted coiling have been employed for the endovascular treatment of wide-necked or otherwise morphologically challenging intracranial aneurysms, and each technique confers unique advantages. Flow-diverting stents may also be used as a primary treatment modality for complex aneurysms and have a number of benefits and limitations 3).
see Flow diverter
Timing of endovascular treatment for aneurysmal subarachnoid hemorrhage
Results
see Obliteration