Percutaneous Embolization of Intracranial Aneurysms

The endovascular therapy of intracranial aneurysms is in a state of rapid evolution because of new embolizing agents and delivery systems. Presently, embolization is considered in cases where neurosurgery can not be performed or carries unreasonable risk. Deconstructive procedures, which eliminate the aneurysm and the parent artery, are best performed with detachable balloons placed close to the entrance of the aneurysm in the parent vessel. This approach has been typically successful in the treatment of aneurysms of the cavernous internal carotid aneurysm. In contrast, reconstructive procedures eliminate the aneurysm and preserve the parent artery. Though a detachable balloon can occasionally accomplish this goal, metallic coils seem better suited for reconstructive procedures. No matter which method is used, percutaneous endovascular procedures have the advantage over surgery because of the ability to monitor the effects of embolization on the neurological status of the awake patient.ASembolizatio