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The role of endovascular treatment for pediatric aneurysms
Ronit Agid1, Marlise P S Souza, Gail Reintamm
1Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, 3 Fell Pavilion Room 210, 399 Bathurst St., Toronto, Ontario M5T 2S8, Canada. ronitagid@hotmail.com
Insights
Pediatric intracranial aneurysms present unique features. Endovascular treatment shows better outcomes compared to surgery, making it the recommended approach when feasible.
Area of Science:
- Neurology
- Vascular Surgery
- Pediatric Medicine
Background:
- Pediatric intracranial aneurysms are rare and distinct from adult counterparts.
- Characterizing these aneurysms is crucial for effective management.
- A shift in treatment paradigms is observed over time.
Purpose of the Study:
- To review and characterize pediatric intracranial aneurysms.
- To compare the efficacy and outcomes of surgical versus endovascular treatments.
- To establish optimal treatment strategies for pediatric aneurysms.
Main Methods:
- Prospective data collection of pediatric intracranial aneurysms over 12 years.
- Review of cases managed by the institution's vascular malformation database.
- Comparative analysis of treatment approaches and patient outcomes.
Main Results:
- Pediatric aneurysms exhibit distinct characteristics compared to adult aneurysms.
- A trend towards endovascular treatment has emerged over traditional surgical methods.
- Patients undergoing endovascular treatment demonstrated superior outcomes.
Conclusions:
- Endovascular treatment is the preferred approach for pediatric aneurysms when anatomically feasible.
- This approach offers both constructive and deconstructive techniques for aneurysm management.
- Further research into the etiology of pediatric aneurysms is needed for enhanced treatment decisions.
Objectives:
To review all cases of pediatric aneurysms, we treated and evaluated their characteristics. The objective of the study is to compare between surgical and endovascular approaches regarding treatment and outcome.
Methods:
All cases of pediatric intracranial aneurysms diagnosed and managed by our team in the last 12 years were prospectively collected in our vascular malformation data base and reviewed.
Conclusion:
Pediatric aneurysms differ in their features when compared to adult aneurysms. Over the last years, there has been a gradual shift from traditional surgical approaches towards endovascular treatment of pediatric aneurysms. In our experience, patients treated by endovascular means had a better outcome than when treated by surgery. Whenever possible, endovascular treatment for pediatric aneurysms is the recommended approach. This offers both constructive and deconstructive techniques. Improved understanding with respect to the etiology of pediatric aneurysms will be the next step that will likely lead us to even better treatment decisions.
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