Surgical treatment of aneurysms

Although an increasing number of aneurysms are treated with endovascular therapy, traditional surgical treatment continues to be an important therapeutic option for both ruptured and unruptured aneurysms. The goal of aneurysm treatment is to isolate the aneurysm from the circulation while ensuring patency of parent artery and/or perforator branches. With advanced neurosurgical approaches focused on minimizing brain manipulation, careful arachnoid dissection, adjunctive intraoperative monitoring, and imaging techniques, aneurysm surgery can reliably achieve definitive occlusion with low complication rates. In the last decade, the widespread utilization of noninvasive vascular imaging techniques has led to an increased number of unruptured aneurysms that are detected and treated. Noninvasive imaging studies such as MRA and CTA play an ever-increasing role not only for the preoperative assessment but also postoperative monitoring of patients with intracranial aneurysms.