Abstract

Aneurysms of the internal carotid artery (ICA) are common, and the modern neurosurgeon has a wide range of microsurgical and endovascular options to offer when treating these lesions. The decision to pursue either microsurgical or endovascular treatment is influenced by rupture status and the patient’s age and medical comorbidities or acute medical stability, as well aneurysm location and morphology. This chapter aims to systematically review and suggest treatment options, taking into account these factors, for many of the common aneurysms in this region: posterior communicating artery (PComA), anterior choroidal artery (AChA), ICA terminus, and ICA trunk blister aneurysms. With the ongoing advances in endovascular techniques, new devices have allowed for treatment of aneurysms with flow diversion, assisted coiling, or device occlusion, when previously only microsurgical techniques were considered effective. Despite these advances, there remain aneurysms better suited to microsurgical approaches, due to both improved early outcomes and long-term occlusion. In this chapter, we aim to evaluate the role for these various endovascular and microsurgical techniques, and review recent studies that describe the safety profiles and long-term outcomes given specific aneurysm characteristics.

Original languageEnglish
Title of host publicationYoumans and Winn Neurological Surgery
Subtitle of host publicationVolumes 1-4, 8th Edition
PublisherElsevier
Pages3548-3554.e2
ISBN (Electronic)9780323661928
ISBN (Print)9780323674997
DOIs
StatePublished - Jan 1 2023

Keywords

  • anterior choroidal artery aneurysm
  • blister aneurysm
  • ICA bifurcation aneurysm
  • internal carotid artery aneurysms
  • posterior communicating artery aneurysm

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