Summary
Recent advancement in microneurosurgery and interventional neuroradiology has brought us a new aspect in the treatment of cerebral aneurysms. There is now a choice of several therapeutic alternatives for the management of cerebral aneurysms. The selection of interventional neuroradiologic techniques with GDC therefore requires consideration of neurosurgical techniques, just as the selection of neurosurgical treatment requires an analysis of endovascular alternatives. The decision for treatment of an individual patient should be based on objective selection of the safest and the most effective treatment. It is self-evident that the primary consideration in the selection process must be the immediate and long-term welfare of the individual patient, rather than the physician’s preference for any specific treatment modality.
Although GDC embolization has been successful in preventing acute subsequent bleeding of aneurysms, incomplete endovascular occlusion of aneurysm leaves the patient at risk for future expansion and future subarachnoid hemorrhage. With this limitation in mind, patients need to be very carefully chosen for GDC embolization. Endovascular treatment of intracranial aneurysms with GDCs has thus been limited to adjuvant or palliative indications for many patients.
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References
Gruber A, Ungersböck K, Reinprecht A, Czech T, Gross C, Bednar M, Richling B (1988) Evaluation of cerebral vasospasm after early surgical and endovascular treatment of ruptured intracranial aneurysms. Neurosurgery 42: 258–268
Gruber DP, Zimmerman GA, Tomsick TA, van Loveren HR, Link M J, Tew Jr JM (1999) A comparison between endovascular and surgical management of basilar artery apex aneurysms. J Neurosurg 90: 868–874
Guglielmi G, Viñuela F, Dion J, Duckwiler GR (1991) Electro-thrombosis of saccular aneurysms via endovascular approach. Part 2: preliminary clinical experience. J Neurosurg 75: 8–14
Hayakawa M, Murayama Y, Duckwiler GR, Gobin YP, Guglielmi G, Viñuela F (2000) Natural history of the neck remnant of a cerebral aneurysm treated with the Guglielmi detachable coil system. J Neurosurg 93: 561–568
Hodgson TJ, Carroll T, Jellinek DA (1998) Subarachnoid hemorrhage due to late recurrence of a previously unruptured aneurysm after complete endovascular occlusion. AJNR 19: 1939–1941
Koivisto T, Vanninen R, Hurskainen H, Saari T, Hernesniemi J, Vapalahti M (2000) Outcomes of early endovascular versus surgical treatment of ruptured cerebral aneurysms. A prospective randomized study. Stroke 31: 2369–2377
Mericle RA, Wakhloo AK, Lopes DK, Lanzino G, Guterman LR, Hopkins LN (1998) Delayed aneurysm regrowth and re-canalization after Guglielmi detachable coil treatment. J Neurosurg 89: 142–145
Regli L, Uske A, Tribolet N (1999) Endovascular coil placement compared with surgical clipping for the treatment of unruptured middle cerebral artery aneurysms: a consecutive series. J Neurosurg 90: 1025–1030
Sethi H, Moore A, Dervin J, Clifton A, MacSweeney JE (2000) Hydrocephalus: comparison of clipping and embolization in aneurysm treatment. J Neurosurg 92: 991–994
Yalamanchili K, Rosenwasser RH, Thomas JE, Liebman K, McMorrow C, Cannon P (1998) Frequency of cerebral vasospasm in patients treated with endovascular occlusion of intracranial aneurysms. AJNR 19: 553–558
Zubillaga AF, Guglielmi G, Viñuela F, Duckwiler GR (1994) Endovascular occlusion of intracranial aneurysms with electrically detachable coils: correlation of aneurysm neck size and treatment results. AJNR 15: 815–820
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© 2002 Springer-Verlag
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Kaku, Y. (2002). Endovascular Aneurysm Treatment from the Neurosurgeon’s Point of View. In: Yonekawa, Y., Sakurai, Y., Keller, E., Tsukahara, T. (eds) New Trends in Cerebral Aneurysm Management. Acta Neurochirurgica Supplements, vol 82. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6736-6_18
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DOI: https://doi.org/10.1007/978-3-7091-6736-6_18
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