Unruptured intracranial aneurysms: management strategy and current endovascular treatment options

ABSTRACT

Introduction: Unruptured intracranial aneurysms (UIA) have a high prevalence (3.2%) and are increasingly diagnosed with modern imaging tools. The main risk of UIA is their rupture associated with intracranial bleeding with often severe clinical consequences.

Areas covered: This review discusses the management strategy of UIAs, based on the large series of the literature (ISUIA, ATENA, UCAS, …), knowing that no randomized controlled trial is available to compare different strategies. The different endovascular treatments are described.

Expert commentary: Due to the relatively scarce data regarding the risk of rupture of UIAs, the strategy of management is often difficult to define. It has to be multidisciplinary and has to take into account several factors related to the patient and the aneurysm. Beside the surgical approach, several endovascular tools are available to treat UIAs, that includes standard coiling, balloon-assisted coiling, stent-assisted coiling, flow diversion, and flow disruption.

KEYWORDS:

• Unruptured intracranial aneurysm
• endovascular treatment
• coiling
• balloon-assisted coiling
• stent-assisted coiling
• flow diversion
• flow disruption

Declaration of interest

L Pierot has consulted for Balt, MicroVention, Neuravi, Penumbra, and Sequent. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.