[Endovascular neurointervention for cerebral aneurysm].

Area of Science:

• Neurosurgery and Interventional Neurology
• Vascular Neurology
• Medical Devices and Technology

Background:

• Cerebral aneurysms pose significant risks, traditionally managed with open surgery (craniotomy).
• Endovascular techniques provide less invasive treatment options, avoiding the need for craniotomy.
• Key endovascular approaches include parent artery occlusion and intra-aneurysmal embolization.

Purpose of the Study:

• To review the advantages and techniques of endovascular embolization for cerebral aneurysms.
• To discuss the indications and considerations for parent artery occlusion versus intra-aneurysmal embolization.
• To highlight the impact of new technologies like Gugliemi's detachable coil (GDC) on treatment outcomes.

Main Methods:

• Classification of endovascular treatments into parent artery occlusion and intra-aneurysmal embolization.
• Consideration of proximal arterial occlusion for broad-necked aneurysms, guided by cerebral blood flow studies.
• Intra-aneurysmal embolization as an alternative for aneurysms with well-defined necks in non-craniotomy candidates.

Main Results:

• Parent artery occlusion remains a mandatory and effective clinical technique.
• Intra-aneurysmal embolization is recommended for specific patient and aneurysm anatomies.
• The advent of Gugliemi's detachable coils (GDC) has significantly advanced endovascular treatment potential.

Conclusions:

• Endovascular embolization offers a significant advantage by eliminating the need for craniotomy.
• Careful patient selection, procedural management, and use of advanced coils are crucial for successful outcomes.
• Preliminary results suggest endovascular treatment with GDC markedly improves cerebral aneurysm management.