title: Is flow diversion the death of cerebral bypass and coiling/stent-assisted coiling for giant cavernous aneurysms? A critical review on comparative outcomes and ongoing clinical trials.
abstract: The classic surgical treatment for symptomatic giant aneurysms originating from the cavernous segment of the carotid artery has been either microsurgical direct clip-reconstruction or carotid occlusion followed by additional cerebral bypass for those patients who fail in a balloon test occlusion. Nevertheless the emergence of new endovascular techniques, especially flow-diverting devices, has promised to revolutionize the treatment of giant cavernous aneurysms, possibly avoiding major microsurgical operations. In this review the authors summarize the current "state-of-art" of treatment of giant cavernous aneurysms, comparing the overall outcomes, complications, morbidity and mortality rates of new flow-diverting devices in relation to traditional microsurgical series.
authors.affiliation: Department of Neurosurgery, University of Illinois College of Medicine at Peoria, 828 NE Glen Oak, #302, Peoria, IL, 61603, USA, tobias.a.mattei@osfhealthcare.org.
authors.forename: Tobias A
authors.initials: TA
authors.lastname: Mattei
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Ferrell
authors.forename: Gavin W
authors.initials: GW
authors.lastname: Britz
mesh_terms: D002548:Cerebral Revascularization / Q000379:methods*; D002986:Clinical Trials as Topic; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D002532:Intracranial Aneurysm / Q000401:mortality / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D015607:Stents; D016896:Treatment Outcome