ruptured_intracranial_aneurysm_treatment

Ruptured intracranial aneurysm treatment


It is a common standard to occlude the culprit aneurysm by surgical clipping or endovascular coiling within 24 to 48 hours after hemorrhage, with coiling being preferred if both methods are equally feasible 1)


Endovascular coil embolization and surgical clip occlusion are the currently accepted treatment options for patients with ruptured intracranial aneurysms. Since the publication of results from the International Subarachnoid Aneurysm Trial (ISAT) in 2002, endovascular treatment has become the mainstay in many centers, especially in Europe 2).

Surgical or endovascular treatment of ruptured cerebral aneurysms within the first 3 days of aneurysmal subarachnoid hemorrhage (aSAH) is associated with improved outcome.

Treatment has been a rapidly evolving field with numerous technical innovations, especially since 2000. Selecting the appropriate treatment can be a complex process that involves integration of information regarding the patient's clinical presentation, associated comorbidities, the aneurysm's morphological characteristics, safety and efficacy of the treatment options and skill and experience of available practitioners, amongst others 3).


1)
Molyneux A, Kerr R, Stratton I, et al; International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial.  Lancet. 2002;360(9342):1267-1274. doi:10.1016/S0140-6736(02)11314-6
2)
Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J, et al.: International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet 360:1267–1274, 2002
3)
Treatment of cerebral aneurysms-surgical clipping or endovascular coiling: the guiding principles. Semin Neurol. 2013 Nov;33(5):476-87. doi:10.1055/s-0033-1364217. Epub 2014 Feb 6. PubMed PMID: 24504611.
  • ruptured_intracranial_aneurysm_treatment.txt
  • Last modified: 2023/09/03 11:25
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