ABSTRACT
Intracranial aneurysms are an important and common clinical problem. Although the etiology of saccular aneurysms remains incompletely defined, the pathogenesis of aneurysm formation and rupture is likely multifactorial. Environmental factors, such as cigarette smoke, in combination with hemodynamic factors and genetic or developmental aberrations are likely contributory (1-12). With the nearly ubiquitous availability of noninvasive imaging studies, many endovascular therapists are witnessing an increase in referrals for patients with unruptured aneurysms (many of which are entirely asymptomatic). Additionally, with the published results of the International Subarachnoid Aneurysm Trial (ISAT) (13-15) demonstrating a significantly improved outcome with coiling compared to clipping in patients whose ruptured aneurysms were deemed suitable for either method, the proportion of patients harboring ruptured aneurysms treated with endovascular techniques has increased (16-19). The present chapter discusses pertinent issues associated with the endovascular management of intracranial aneurysms in this era where endovascular techniques have become adopted as an important therapeutic tool in the care of patients harboring these lesions.
