Middle cerebral artery aneurysm endovascular and surgical therapies: comprehensive literature review and local experience

Osama O Zaidat; Alicia C Castonguay; Mohamed S Teleb; Kaiz Asif; Ayman Gheith; Chris Southwood; Glen Pollock; John R Lynch

doi:10.1016/j.nec.2014.04.005

Middle cerebral artery aneurysm endovascular and surgical therapies: comprehensive literature review and local experience

Neurosurg Clin N Am. 2014 Jul;25(3):455-69. doi: 10.1016/j.nec.2014.04.005. Epub 2014 Jun 3.

Authors

Osama O Zaidat¹, Alicia C Castonguay², Mohamed S Teleb², Kaiz Asif², Ayman Gheith², Chris Southwood², Glen Pollock³, John R Lynch⁴

Affiliations

¹ Department of Neurology, SNN (Stroke, Neurocritical Care, and Neurointerventional) Research Center, Froedtert Hospital, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA; Department of Radiology, SNN (Stroke, Neurocritical Care, and Neurointerventional) Research Center, Froedtert Hospital, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA; Department of Neurosurgery, SNN (Stroke, Neurocritical Care, and Neurointerventional) Research Center, Froedtert Hospital, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA. Electronic address: [email protected].
² Department of Neurology, SNN (Stroke, Neurocritical Care, and Neurointerventional) Research Center, Froedtert Hospital, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
³ Department of Neurology, SNN (Stroke, Neurocritical Care, and Neurointerventional) Research Center, Froedtert Hospital, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA; Department of Neurosurgery, SNN (Stroke, Neurocritical Care, and Neurointerventional) Research Center, Froedtert Hospital, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
⁴ Department of Neurology, SNN (Stroke, Neurocritical Care, and Neurointerventional) Research Center, Froedtert Hospital, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA; Department of Radiology, SNN (Stroke, Neurocritical Care, and Neurointerventional) Research Center, Froedtert Hospital, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA; Department of Neurosurgery, SNN (Stroke, Neurocritical Care, and Neurointerventional) Research Center, Froedtert Hospital, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.

PMID: 24994084
DOI: 10.1016/j.nec.2014.04.005

Abstract

The middle cerebral artery is a common location for cerebral aneurysms and is associated with a lower risk of rupture than aneurysms located in the anterior or posterior communicating arteries. No evidence supports the superiority of clipping over coiling to treat middle cerebral artery aneurysm (MCAA) or vice versa. The feasibility of treating the MCAA with endovascular therapy as the first choice of treatment in cohorts of nonselected aneurysms exceeds 90%. A randomized clinical trial comparing the 2 approaches in nonselected cases with long-term follow-up will shed light on which patients may benefit from one approach over another.

Keywords: Aneurysm; Clipping; Coiling; Endovascular; Intracranial aneurysm; Middle cerebral artery.

Publication types

Review

MeSH terms

Endovascular Procedures*
Humans
Intracranial Aneurysm / diagnostic imaging
Intracranial Aneurysm / surgery*
Middle Cerebral Artery / diagnostic imaging
Radiography