Zhao Junjie, Lin Hao, Summers Richard, Yang Mingmin, Cousins Brian G, Tsui Janice
1 Division of Surgery & Interventional Science, UCL Centre for Nanotechnology and Regenerative Medicine, University College London, London, United Kingdom.
Authors equally contributed to this manuscript.
Angiology. 2018 Jan;69(1):17-30. doi: 10.1177/0003319717700503. Epub 2017 Mar 30.
Intracranial aneurysm is a leading cause of stroke. Its treatment has evolved over the past 2 decades. This review summarizes the treatment strategies for intracranial aneurysms from 3 different perspectives: open surgery approach, transluminal treatment approach, and new technologies being used or trialed. We introduce most of the available treatment techniques in detail, including contralateral clipping, wrapping and clipping, double catheters assisting coiling and waffle-cone technique, and so on. Data from major trials such as Analysis of Treatment by Endovascular approach of Non-ruptured Aneurysms (ATENA), Internal Subarachnoid Trial (ISAT), Clinical and Anatomical Results in the Treatment of Ruptured Intracranial Aneurysms (CLARITY), and Barrow Ruptured Aneurysm Trial (BRAT) as well as information from other clinical reports and local experience are reviewed to suggest a clinical pathway for treating different types of intracranial aneurysms. It will be a valuable supplement to the current existing guidelines. We hope it could help assisting real-time decision-making in clinical practices and also encourage advancements in managing the disease.
颅内动脉瘤是中风的主要病因。在过去20年里，其治疗方法不断发展。本综述从3个不同角度总结了颅内动脉瘤的治疗策略：开放手术方法、腔内治疗方法以及正在使用或试验的新技术。我们详细介绍了大多数可用的治疗技术，包括对侧夹闭、包裹加夹闭、双导管辅助弹簧圈栓塞和华夫饼锥形技术等。回顾了来自主要试验的数据，如未破裂动脉瘤血管内治疗分析（ATENA）、蛛网膜下腔内部试验（ISAT）、颅内破裂动脉瘤治疗的临床和解剖学结果（CLARITY）以及巴罗破裂动脉瘤试验（BRAT），以及其他临床报告和当地经验信息，以提出治疗不同类型颅内动脉瘤的临床路径。这将是对现有指南的宝贵补充。我们希望它有助于临床实践中的实时决策，并促进该疾病管理方面的进展。
