Crane Alex, Shanahan Regan M, Hudson Joseph S, Nowicki Kamil W, Gersey Zachary C, Agarwal Prateek, Jacobs Rachel C, Lang Michael J, Gross Bradley
Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Department of Neurosurgery, Yale School of Medicine, New Haven, CT 06510, USA.
J Clin Med. 2024 Jun 5;13(11):3324. doi: 10.3390/jcm13113324.
Management of intracranial aneurysms (IAs) is determined by patient age, risk of rupture, and comorbid conditions. While endovascular and microsurgical interventions offer solutions to mitigate the risk of rupture, pharmacological management strategies may complement these approaches or serve as alternatives in appropriate cases. The pathophysiology of IAs allows for the targeting of inflammation to prevent the development and rupture of IAs. The aim of this review is to provide an updated summary of different pharmaceutical management strategies for IAs. Acetylsalicylic acid and renin-angiotensin-aldosterone system (RAAS) inhibitor antihypertensives have some evidence supporting their protective effect. Studies of selective cyclooxygenase-2 (COX-2) inhibitors, statins, ADP inhibitors, and other metabolism-affecting drugs have demonstrated inconclusive findings regarding their association with aneurysm growth or rupture. In this manuscript, we highlight the evidence supporting each drug's effectiveness.
颅内动脉瘤（IA）的治疗取决于患者年龄、破裂风险和合并症。虽然血管内和显微外科干预提供了降低破裂风险的解决方案，但药物治疗策略可以补充这些方法，或在适当情况下作为替代方案。IA的病理生理学使得针对炎症进行治疗成为预防IA发生和破裂的靶点。本综述的目的是提供IA不同药物治疗策略的最新总结。乙酰水杨酸和肾素-血管紧张素-醛固酮系统（RAAS）抑制剂类降压药有一些证据支持它们的保护作用。选择性环氧化酶-2（COX-2）抑制剂、他汀类药物、ADP抑制剂和其他影响代谢的药物的研究，关于它们与动脉瘤生长或破裂的关联，结果尚无定论。在本手稿中，我们强调了支持每种药物有效性的证据。
