32
Vol. 66, No. 3 2015
Northeast Florida Medicine
Endovascular Neurosurgery
and induce thrombosis of the aneurysm. Because the metallic mesh
of the device is contained inside the lesion, dual-antiplatelet therapy
after treatment isunnecessary.Thefirst experimental resultsusing this
technology have been recently published in Europe and have shown
promising results for wide-neck and bifurcation aneurysms.16 In
the U.S., intrasaccular devices have yet to be approved by the FDA
and data regarding their safety profile and indications is warranted
in clinical trials and institutional registries.
Conclusions
The treatment of intracranial aneurysms has reached a new era of
unique endovascular devices and techniques, which has led to un-
precedented levels of safety and aneurysm occlusion rates. In the near
future, multiple minimally invasive options will become available and
thefieldismovingtowardstailoreddevicesandtechniquesbasedonthe
characteristics of the lesion and needs of the patients. Still, enthusiasm
should be tempered and treatment recommendations based on judi-
cious unbiased assessment of the available data.Microsurgical clipping
should be regarded as a complimentary therapy and remains a viable
option in certain groups of lesions. Lastly, the treatment of intracranial
aneurysms should be carried out in centers offering multidisciplinary
expertise inmicrosurgery, endovascular, andneurocritical care inorder
to optimize management and results.
v
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