ENDOVASCULAR TREATMENT OF SMALL RUPTURED INTRACRANIAL ANEURYSM AT ANTERIOR CEREBRAL CIRCULATION

Abstract

SUMMARY I nterest in endovascular techniques for treatment of intracranial aneurysms has exploded in the past decade. Not too long ago, endovascular aneurysm occlusion was considered a second-line treatment, but it has rapidly become the primary therapeutic option. The “minimally invasive” nature of this approach allows treatment of an intracranial aneurysm through a small groin incision. This approach is understandably more appealing to patients than open surgery involving craniotomy, brain retraction, and dissection. Other factors favoring the rapid spread of this technology include the ease of endovascular access to surgically difficult and demanding areas, such as basilar trunk or bifurcation, and the ability to visualize angiographically the patency of adjacent vessels during procedure. Endovascular therapy of intracranial aneurysms generally aims at occlusion or thrombosis of the aneurysm sac. The approaches can be classified into two broad categories. Deconstructive approaches involve occlusion of the parent vessel with resultant stasis of the blood inside the aneurysm. Reconstructive approaches involve selective occlusion of the aneurysm lumen sparing of the parent artery. The method of aneurysm obliteration depends primarily on the site, size, and morphologic features of the aneurysm.