Türk Nöroşirürji Dergisi 2018 , Vol 28 , Num 1
The Endovascular Treatment of Cerebral Aneurysm: Use of Flow Diverter Stent, Coil
1Erciyes Üniversitesi, Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Kayseri, Türkiye The neurosurgical treatment of intracranial aneurysms dates back to 1937, when Dandy described microsurgical obliteration of a posterior communicating artery aneurysm by microsurgical clipping. For approximately six decades, this technique remained the gold standard and foremost modality for treatment of cerebral aneurysms. In 1974, Serbinenko developed a series of balloonmounted, flow-guided catheters and detachable balloons designed to occlude intracranial vascular lesions. Endovascular therapies emerged in the 1990s with the advent of the Guglielmi detachable coil system. This system established neurointervention as a new field, with multiple randomised clinical trials demonstrating the efficacy and safety of coil embolisation. The neuroendovascular space quickly experienced significant technological advancements aimed at improving the different properties of a coil, including coil lengths, shapes, softness and detachment zones. These developments have translated to improvements in clinical outcomes of cerebral aneurysms treated with coiling. Today, endovascular treatment has become the first choice in the treatment of aneurysms. New endovascular devices such has balloon, stent, flow diverter and WEB devices were developed for endovascular treatment. Despite these new technological advancements in endovascular treatment, aneurysms with large diameters, wide necks, a dome to neck ratio <2, and fusiform configurations have a poor outcome. Anahtar Kelimeler : Balloon, Coil, Endovascular treatment, Flow diverter, Stent