Microsurgical Treatment of Cerebral Aneurysms

Authors

Caleb Rutledge, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Jacob F. Baranoski, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow
Joshua S. Catapano, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow
Michael T. Lawton, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Follow
Robert F. Spetzler, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA. Electronic address: Neuropub@barrowneuro.org.

Document Type

Article

Abstract

Despite advances in endovascular techniques, microsurgery continues to play an important role in the treatment of cerebral aneurysms. This article reviews the history of surgical treatment of intracranial aneurysms and the evolving role of microsurgery in the endovascular era. Although endovascular tools and techniques have changed significantly since the placement of the first Guglielmi coils in 1990, with the development of endoluminal flow-diverting stents and now endosaccular flow-diverting devices, microsurgical treatment of aneurysms has also continued to evolve. Since the first treatment with Hunterian ligation by Horsley in the 1800s, surgical treatment of intracranial aneurysms has advanced significantly beginning with the introduction of the microscope and microsurgical techniques in the 1950s. More recent advances in microsurgical treatment of aneurysms include microsurgical adjuncts, such as indocyanine green angiography, adenosine, and the exoscope, as well as tailored craniotomies, retractorless surgery, and novel bypass constructs for complex aneurysms. Microsurgery continues to play an important role in the endovascular era.

Medical Subject Headings

Embolization, Therapeutic; Endovascular Procedures; Humans; Intracranial Aneurysm (surgery); Microsurgery (methods); Neurosurgical Procedures (methods); Treatment Outcome

Publication Date

3-1-2022

Publication Title

World neurosurgery

E-ISSN

1878-8769

Volume

159

First Page

250

Last Page

258

PubMed ID

35255626

Digital Object Identifier (DOI)

10.1016/j.wneu.2021.12.079

Recommended Citation

Rutledge, Caleb; Baranoski, Jacob F.; Catapano, Joshua S.; Lawton, Michael T.; and Spetzler, Robert F., "Microsurgical Treatment of Cerebral Aneurysms" (2022). Neurosurgery. 1582.
https://scholar.barrowneuro.org/neurosurgery/1582