Treatment of unruptured intracranial aneurysms: surgery, coiling, or nothing?
The decision of whether and how to treat an unruptured intracranial aneurysm (UIA) is complex. The goal in caring for patients with UIAs is to maximize their duration of high-quality life by optimally balancing the risks of aneurysm rupture--the "natural history" of the aneurysm--with those of treatment-related adverse outcomes. In this article, we review the literature concerning the natural history of UIAs and summarize the procedure-associated morbidity and mortality and efficacy of surgical clipping and endovascular coiling. Using this information, we make recommendations regarding the optimal management of patients with UIAs.
Burns
Joseph D
JD
Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Brown
Robert D
RD
D002560:Cerebrovascular Circulation; D017408:Guidelines as Topic; D006801:Humans; D002532:Intracranial Aneurysm / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D019635:Neurosurgical Procedures / Q000009:adverse effects; D012307:Risk Factors; D012422:Rupture, Spontaneous; D013525:Surgical Instruments; D016896:Treatment Outcome