Department of Biomedical Engineering, College of Science and Engineering, University of Minnesota Minneapolis, MN, USA.
Front Neurol. 2011 Jul 8;2:45. doi: 10.3389/fneur.2011.00045. eCollection 2011.
Intracranial aneurysms are present in roughly 5% of the population, yet most are often asymptomatic and never detected. Development of an aneurysm typically occurs during adulthood, while formation and growth are associated with risk factors such as age, hypertension, pre-existing familial conditions, and smoking. Subarachnoid hemorrhage, the most common presentation due to aneurysm rupture, represents a serious medical condition often leading to severe neurological deficit or death. Recent technological advances in imaging modalities, along with increased understanding of natural history and prevalence of aneurysms, have increased detection of asymptomatic unruptured intracranial aneurysms (UIA). Studies reporting on the risk of rupture and outcomes have provided much insight, but the debate remains of how and when unruptured aneurysms should be managed. Treatment methods include two major intervention options: clipping of the aneurysm and endovascular methods such as coiling, stent-assisted coiling, and flow diversion stents. The studies reviewed here support the generalized notion that endovascular treatment of UIA provides a safe and effective alternative to surgical treatment. The risks associated with endovascular repair are lower and incur shorter hospital stays for appropriately selected patients. The endovascular treatment option should be considered based on factors such as aneurysm size, location, patient medical history, and operator experience.
颅内动脉瘤在人群中的发病率约为 5%，但大多数情况下是无症状的，从未被发现。动脉瘤的形成通常发生在成年期，而其形成和生长与年龄、高血压、先前存在的家族性疾病和吸烟等危险因素有关。蛛网膜下腔出血是最常见的动脉瘤破裂表现，是一种严重的医疗状况，常导致严重的神经功能缺损或死亡。成像方式的最新技术进步，以及对动脉瘤的自然史和流行率的认识增加，提高了对无症状未破裂颅内动脉瘤（UIA）的检测率。关于破裂风险和结果的研究提供了很多深入的见解，但关于如何以及何时处理未破裂动脉瘤的争论仍在继续。治疗方法包括两种主要的干预选择：夹闭动脉瘤和血管内方法，如线圈填塞、支架辅助线圈填塞和血流转向支架。这里回顾的研究支持这样一种普遍观点，即血管内治疗 UIA 为手术治疗提供了一种安全有效的替代方法。与血管内修复相关的风险较低，适当选择的患者住院时间更短。应根据动脉瘤大小、位置、患者病史和操作人员经验等因素考虑血管内治疗选择。
