title: Surgical strategies for aneurysms deemed unclippable and uncoilable.
abstract: Although most cerebral aneurysms can nowadays be successfully treated either by standard clipping or sole coiling, a subset of aneurysms may not be amenable to standard clipping or coiling and require alternative treatment options. Surgical options, other than clipping and/or endovascular options other than sole coiling, may be the optimal treatment plan for some complex aneurysms. Surgical strategies for such complex aneurysms include parent artery occlusion, revascularization procedures and flow redirection. In this article, we review which factors are predictive of failure of conventional aneurysm treatment options; summarize key information needed to orient treatment decision; and discuss surgical options for unclippable and uncoilable aneurysms.
authors.affiliation: Department of Neurosurgery, David-Geffen School of Medicine, Ronald-Reagan UCLA Medical Center, 757, Westwood Plaza, Suite 6236, Los Angeles, CA 90095-7436, USA.
authors.forename: N
authors.initials: N
authors.lastname: McLaughlin
authors.forename: N
authors.initials: N
authors.lastname: Gonzalez
authors.forename: N A
authors.initials: NA
authors.lastname: Martin
mesh_terms: D002548:Cerebral Revascularization; D004621:Embolization, Therapeutic; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery* / Q000628:therapy; D013345:Subarachnoid Hemorrhage / Q000601:surgery* / Q000628:therapy; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*