The Changing Landscape of Treatment for Intracranial Aneurysm

Abstract

ABSTRACT:There has been a significant transformation in the treatment of intracranial aneurysms (IAs) over the past century, with the most pivotal changes occurring in the past three decades. To characterize this evolution, we assessed the number of articles published on various procedures for the treatment of IA as a measure of their interest and usage over time. We separated our analysis into two main areas: surgical and endovascular approaches. We further subdivided these two main categories into clipping and bypass for surgery, and coiling, flow diversion, and liquid material embolization for endovascular approaches. We found 5956 publications on open surgical approaches in the 70-year period from 1947 to 2017, with papers on clipping (n = 4204), being the most common. We found 8602 endovascular publications beginning in 1964, with most of the activity taking place in the late 1990s and beyond. Coiling had the most publications of the endovascular approaches (n = 5436). In 1999, the number of annual publications on endovascular treatments surpassed those of open surgery, signaling a crossover point in the IA literature. The same trend continues to this date.

Clinical Usage of Different Doses of Cis-Atracurium in Intracranial Aneurysm Surgery and Its Effect on Motor-Evoked Potentials

“…Most scholars believe that intracranial aneurysms are caused by local congenital defects in the intracranial arterial wall and increased intraluminal pressure. Hypertension, cerebral arteriosclerosis, and vasculitis are associated with the occurrence and development of aneurysms [ 5 , 6 ]. Intracranial aneurysms are usually minor and cause no symptoms.…”

Pharmacological inhibition of STAT3 by BP‐1‐102 inhibits intracranial aneurysm formation and rupture in mice through modulating inflammatory response

“…Intracranial aneurysm is a disease that seriously threatens human life and health, with a high incidence rate second only to cerebral thrombosis and high‐pressure cerebral hemorrhage in cerebral tube disease, and its mortality rate is as high as 70% 21 . To date, the treatment methods of IA mainly include intravascular interventional therapy and surgical clamping, both of which inevitably also result in complications and mortality 27–29 . The disease is more common in middle‐aged people, which has no obvious symptoms in the early stage.…”

“…21 To date, the treatment methods of IA mainly include intravascular interventional therapy and surgical clamping, both of which inevitably also result in complications and mortality. [27][28][29] The disease is more common in middle-aged people, which has no obvious symptoms in the early stage. With the development of IA, once the tumor suddenly ruptures and bleeds, the patient condition will quickly deteriorate.…”

CircRNA DOCK1 Regulates miR-409-3p/MCL1 Axis to Modulate Proliferation and Apoptosis of Human Brain Vascular Smooth Muscle Cells

“…Intracranial aneurysm is an abnormal expansion in the intracranial arteries which could lead to aneurysm rupture ( Brinjikji et al, 2016 ). The therapeutic strategies against intracranial aneurysm mainly include surgical and endovascular approaches ( Lozano et al, 2019 ). However, the majority of cases with vascular remodeling undergo eventual rupture ( Frosen et al, 2004 ).…”