الفهرس | Only 14 pages are availabe for public view |
Abstract Saccular intracranial aneurysms are localized enlargement lesions of the vasculature, most commonly located at bifurcation points in the circle of Willis. Advances in imaging technologies have improved our abilities to depict the anatomical three dimensions (3D) orientation of cerebral aneurysms and thus positively influenced their therapeutic management Aneurysm-related risk factors include location, size, and morphological features such as the shape of the aneurysm, linking such new indices with relevant clinical events should bring new insights on the processes behind aneurysm genesis, growth and rupture which could potentially provide robust criteria to assess the risk of aneurysm rupture, and benefit planned aneurysm surgery by understanding of the process of aneurysm formation, progression, and rupture so sound judgment in balancing the risks and benefits of possible therapies can be exercised. The objective of this work is to evaluate the Influence of the study of the parent vessel and aneurysm geometry on anticipating and planning of different therapeutic modalities (surgical clipping or endovascular surgery) of cerebral aneurysms. Treatment of MCA aneurysms remains the domain of operative vascular neurosurgery. However, besides the presence of subarachnoid hemorrhage, the identification of significant morphological features of the aneurysm itself and of its direct anatomical environment is strongly influencing the surgical strategy. Endovascular treatment of aneurysm becoming a well established procedure in some centers and a promising one in more centers has a large contribution in aneurysm surgery in different situation providing the minimally invasive procedure with a large zone of safety and efficacy for aneurysm treatment. Our results show that the detailed angiographic evaluation preoperatively is mandatory as it provides valuable information about the complexity of the aneurysm and the difficulty level of the clipping or coiling procedure with the indications of adding more special and advanced techniques in the treatment according to planning and anticipation of surgical circumstances. The key features size, shape, and branching vessels should always be considered. |