Evolution of intracranial aneurysm treatment: From Hunterian ligation to the flow diverter

Background:  Intracranial aneurysm rupture has the highest levels of mortality and morbidity among all stroke types. To answer the question of how and why different well‐established and novel treatment techniques were developed, it is crucial to understand the historic hurdles and breakthroughs in i...

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Bibliographic Details
Published in:Surgical practice 2011-02, Vol.15 (1), p.16-20
Main Authors: Wong, George K.C., Tan, Hai-Bin, Kwan, Marco C.L., Ng, Rebecca Y.T., Yu, Simon C.H., Zhu, Xian-Lun, Poon, Wai-Sang
Format: Article
Language:English
Subjects:
Aneurysm
Aneurysms
Angiography
Balloons
Cardiovascular system
clipping
Coiling
embolization
Evolution
flow diverter
History of medicine
Implants
intracranial aneurysm
Literature reviews
Medical treatment
Morbidity
Mortality
Occlusion
Stroke
subarachnoid haemorrhage
Surgical outcomes
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Summary:Background:  Intracranial aneurysm rupture has the highest levels of mortality and morbidity among all stroke types. To answer the question of how and why different well‐established and novel treatment techniques were developed, it is crucial to understand the historic hurdles and breakthroughs in intracranial aneurysm treatment over the years. Methods:  Literature review was carried out using PubMed and the electronic database of Surgical Practice. Relevant articles were retrieved for further appraisal. Results:  The neuro‐endovascular treatment field has evolved from the use of detachable balloons or coils to the use of bioactive coils, balloon test occlusion, the balloon‐ and stent‐assisted techniques, and the flow‐diverting stent. The application of intraoperative indocyanine green angiography has also improved microsurgical treatment in recent years. Conclusions:  Advances in endovascular technology have made coiling the cornerstone of intracranial aneurysm treatment. However, the roles played by different endovascular tools need to be better understood.
ISSN:1744-1625
1744-1633
DOI:10.1111/j.1744-1633.2010.00534.x