醫學研究

Paradigm shift in endovascular interventional of unruptured cerebral aneurysms – from coiling to flow diverters.

Yu SCH.  The Hong Kong Medical Diary – Interventional Neuroradiology 2013 Apr: 18(4):14-16

The Background

Cerebral aneurysm is a potential health hazard that is estimated to occur in about 3% of the Hong Kong population. Aneurysm rupture is a cause of intracranial bleeding that may lead to severe disabilities and the death rate is as high as 45%. The risk of rupture of an aneurysm is about 1.3% per year. In the overall population, the incidence rate of aneurysm rupture is 10.5 per 100,000 people. The aetiology of cerebral aneurysm is thought to be associated with hypertension, atherosclerosis, and congenital factors leading to vessel wall weakening. Although endovascular coiling is a well established treatment for intracranial aneurysms, unfavourable aneurysm features such as wide neck, large size, and fusiform morphology, as well as post-treatment recanalisation, remain important challenges^1-6. Stent-assisted coiling has been developed to address these challenges, but it is associated with relatively high rates of aneurysm recurrence (15%) and procedure-induced mortality⁷. Such limitations of coiling have fuelled continual search for better endovascular options for treatment of intracranial aneurysms. Endovascular placement of flow diversion devices such as Pipeline Embolisation Device (PED, ev3 Neurovascular, Irvine, California) for endoluminal circumferential reconstruction of segmental vascular defects as a treatment for intracranial aneurysms is gaining widespread attention^8-11

Citation:

Yu SCH. Paradigm shift in endovascular interventional of unruptured cerebral aneurysms – from coiling to flow diverters. The Hong Kong Medical Diary – Interventional Neuroradiology 2013 Apr: 18(4):14-16.

http://www.fmshk.org/database/hkmd/hkmd201304.pdf