Cerebral Aneurysms

• Published in: The New England journal of medicine Vol. 355; no. 9; pp. 928 - 939
• Main Authors: Brisman, Jonathan L, Song, Joon K, Newell, David W
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 31.08.2006
• Subjects: Aneurysm, Ruptured - etiology; Biological and medical sciences; Cerebral Angiography; Embolization, Therapeutic; General aspects; Humans; Imaging, Three-Dimensional; Intracranial Aneurysm - diagnosis; Intracranial Aneurysm - epidemiology; Intracranial Aneurysm - physiopathology; Intracranial Aneurysm - therapy; Magnetic Resonance Angiography; Medical sciences; Neurology; Prevalence; Subarachnoid Hemorrhage - diagnosis; Subarachnoid Hemorrhage - etiology; United States - epidemiology; Vascular diseases and vascular malformations of the nervous system; United States; Vascular disease; Medicine; Nervous system diseases; intracranial aneurysm; Central nervous system disease; Cardiovascular disease; Cerebrovascular disease; Cerebral disorder
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMra052760

Saccular intracranial aneurysms cause substantial morbidity and mortality. Recently, major changes have occurred in the way we think about and treat this disease. This review discusses the percutaneous endovascular treatment of intracranial aneurysms as compared with surgical intervention. The technological advances and supporting research contributing to this important change in practice patterns are reviewed. This review discusses the percutaneous endovascular treatment of intracranial aneurysms as compared with surgical intervention. The technological advances and supporting research contributing to this important change in practice patterns are reviewed. Saccular intracranial aneurysms, abnormal focal outpouchings of cerebral arteries, cause substantial rates of morbidity and mortality. Recently, major changes have occurred in the way we think about and treat this disease. Previous concepts about the natural history, particularly the risk of rupture of certain aneurysms, have been challenged. 1 , 2 When this topic was the subject of a Medical Progress article in the Journal in 1997, minimally invasive percutaneous endovascular treatment of intracranial aneurysms (a technique known as coiling) had been introduced as an experimental procedure for patients who were not good candidates for surgery. 3 After almost a decade of increased . . .