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Related Concept Videos

Aneurysm I: Introduction01:30

Aneurysm I: Introduction

An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...

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Related Experiment Video

Updated: Jun 26, 2026

The Helsinki Rat Microsurgical Sidewall Aneurysm Model
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Complex intracranial aneurysms: a DELPHI study to define associated characteristics.

Francesco Diana1,2,3, Michele Romoli4, Eytan Raz5

  • 1Interventional Neuroradiology, University Hospital Vall d'Hebron, Barcelona, Spain.

Acta Neurochirurgica
|July 11, 2024
PubMed
Summary

Defining complex intracranial aneurysms (CIAs) is crucial for treatment selection. This study established consensus criteria for CIAs, highlighting differences between open surgery and endovascular approaches for better patient care.

Keywords:
Brain aneurysmClippingCoilingDELPHISAH

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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
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Microsurgical Creation of Giant Bifurcation Aneurysms in Rabbits for the Evaluation of Endovascular Devices

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Area of Science:

  • Neurosurgery
  • Interventional Neurology
  • Vascular Surgery

Background:

  • Intracranial aneurysms pose significant risks, with rupture leading to subarachnoid hemorrhage and high mortality.
  • Defining complex intracranial aneurysms (CIAs) is challenging due to differing criteria for surgical and endovascular treatments.
  • A lack of consensus on CIA definition impacts treatment planning and patient outcomes.

Purpose of the Study:

  • To achieve consensus on the variables that define complex intracranial aneurysms (CIAs).
  • To establish standardized criteria for identifying complex aneurysms across different treatment modalities.

Main Methods:

  • An international Delphi process involving 50 specialists across multiple disciplines.
  • Three rounds of surveys utilizing Likert scales and open-ended questions to gather expert opinions.
  • Statistical analysis to determine consensus and stability of defined CIA variables.

Main Results:

  • Open surgery CIAs criteria: fusiform/blister shape, dissecting etiology, giant size (≥25mm), broad/extensive neck, calcification, thrombus, collateral branches, specific locations, vasospasm, and need for bypass.
  • Endovascular CIAs criteria: giant size, very wide neck (dome/neck ratio ≤1:1), and collateral branches from the sac.
  • Significant differences identified in complexity definitions based on intended treatment modality.

Conclusions:

  • The definition of aneurysm complexity is treatment-dependent.
  • Divergent complexity factors for open surgery versus endovascular treatment necessitate distinct criteria.
  • Consensus criteria for CIAs can inform and guide the selection of the optimal treatment strategy.