Intracranial aneurysm endovascular treatment

• Flow diversion for treatment of acutely ruptured intracranial aneurysms: Comparison of complications and clinical outcomes with coil embolization
• Flow diverter with or without adjunctive coils in the treatment of large and giant intracranial aneurysms: a meta-analysis
• Endovascular treatment of posterior circulation aneurysms with flow diverters with hydrophilic polymer coating in patients receiving prasugrel single antiplatelet therapy: a multicenter case series presenting complication and occlusion rates
• Treatment outcomes of successful M1 versus M2 thrombectomy for low-ASPECTS stroke patients
• Association between body mass index and intracranial procedural complications in patients undergoing endovascular treatment for unruptured aneurysms
• Endovascular or microsurgical? Defining the best approach for blood blister aneurysms: A comparative meta-analysis
• Minimizing human-induced variability in quantitative angiography for a robust and explainable AI-based occlusion prediction in flow diverter-treated aneurysms
• Efficacy and performance of the new pipeline vantage flow diverter stent with shield technology: Short-term results of a single-center experience

Endovascular treatment is widely applied as the first-line treatment for intracranial aneurysms and includes simple intracranial aneurysm coiling (SC), intracranial aneurysm stent-assisted coiling (SAC), intracranial aneurysm flow diversion, and intracranial aneurysm flow disruption.

Intracranial aneurysm coiling.

Intracranial aneurysm stent-assisted coiling.

Intracranial aneurysm flow diversion.

Intracranial aneurysm flow disruption.

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 the 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

see Aneurysm Recanalization Stratification Scale.

Timing of endovascular treatment for aneurysmal subarachnoid hemorrhage.