Abstract:
Wide-neck aneurysms (WNA) often require advanced open surgical and endovascular techniques to achieve adequate aneurysm occlusion. Microsurgical treatment often requires advanced clip configurations. Occasionally, more complex open surgical techniques are required. Advancements in endovascular therapies (EVT) and devices have expanded endovascular treatment options for WNAs and have improved aneurysm occlusion rates compared with primary coiling. Certain EVT require dual antiplatelet therapy, limiting their use in the ruptured setting. Evidence suggests that microsurgical treatment should remain a consideration for treatment of ruptured WNAs, but perhaps with novel endovascular techniques and devices, EVT should be first-line treatment in the unruptured setting.
摘要:
宽颈动脉瘤(WNA)通常需要先进的开放手术和血管内技术来实现足够的动脉瘤闭塞。显微外科治疗通常需要先进的夹子配置。偶尔,需要更复杂的开放式手术技术。血管内治疗(EVT)和装置的进步已经扩大了WNA的血管内治疗选择,并且与初级卷绕相比已经提高了动脉瘤闭塞率。某些EVT需要双重抗血小板治疗,限制它们在破裂的环境中的使用。有证据表明,显微外科治疗仍然应该考虑治疗破裂的WNA,但是也许有了新颖的血管内技术和设备,在未破裂的情况下,EVT应该是一线治疗。