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The aneurysmal wall. The key to a subclassification of intracranial arterial aneurysm vasculopathies?

T Krings1, P L Lasjaunias, S Geibprasert

  • 1From the Division of Neuroradiology, Department of Medical Imaging, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada - The Service de Neuroradiologie Diagnostique et Thérapeutique, Hôpital de Bicetre, Le Kremlin-Bicetre; Paris, France - The Departments of Neuroradiology and Neurosurgery, University Hospital Aachen; Germany - timo.krings@uhn.on.ca.

Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences
|June 19, 2010
PubMed

Insights

Understanding intracranial arterial aneurysms (AA) is crucial for treatment. This article explores abluminal factors in AA pathogenesis, suggesting new therapeutic strategies targeting the vessel wall.

Area of Science:

  • Vascular Biology
  • Neurology
  • Pathology

Background:

  • Intracranial arterial aneurysms (AA) are life-threatening vascular conditions with debated pathogenesis.
  • Existing classifications of AA do not fully encompass all types, including berry, infectious, dissecting, and giant aneurysms.

Purpose of the Study:

  • To discuss the etiological classification of aneurysmal vasculopathies based on vessel wall alterations.
  • To explore the hypothesis that abluminal factors contribute to the development of intracranial AA.
  • To consider how recognizing abluminal disease may influence therapeutic strategies.

Main Methods:

  • Literature review and discussion of existing hypotheses on AA pathogenesis.
  • Analysis of the role of luminal versus abluminal factors in vessel wall alterations.
  • Exploration of potential therapeutic implications of an abluminal disease perspective.

Main Results:

  • The pathogenesis of intracranial AA remains incompletely understood.
  • Abluminal factors are hypothesized to play a role in the development of certain types of intracranial AA.
  • Altering the vessel wall, whether from luminal or abluminal causes, is key to classifying aneurysmal vasculopathies.

Conclusions:

  • Classifying aneurysmal vasculopathies based on vessel wall alterations (luminal or abluminal) offers a new perspective.
  • Viewing certain AA as an abluminal disease may necessitate therapeutic strategies that target the vessel wall directly, beyond intraluminal repair.
Abstract

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