Treatment of intracranial microaneurysms

He Kejun; Qi Tiewei; Guo Shaolei; Liang Feng; Yang Yibing

doi:10.11850/j.issn.1009-122X.2014.06.005

Abstract：Objective To investigate the treatment strategies for intracranial microaneurysms. Methods Clinical data of 94 patients with 116 intracranial microaneurysms were analyzed retrospectively. Microsurgical treatment was performed in 30 patients with 37 microaneurysms (surgical group). Endovascular interventional treatment was performed in 29 patients with 36 microaneurysms (intervention group). Conservative treatment was performed in 35 patients with 43 microaneurysms. Results In surgical group, complete occlusion was achieved in 34 microaneurysms and subtotal occlusion in 3. In intervention group, complete occlusion was achieved in 16 microaneurysms, subtotal occlusion in 11 and part occlusion in 9. Postoperative complications in the surgical group and intervention group were hemorrhagic events in 1 and 5 patients, ischemic events in 4 and 0, respectively. During a mean follow-up period of 36 months (15 days to 5 years), the good outcomes (GOS≥4) were observed in 27 and 24 patients in the surgical group and intervention group respectively. The aneurysm relapse occurred in 3 patients in intervention group, including retreatment of 1 and routine observation of 2. No aneurysm ruptured during the follow-up period among the patients who received conservative treatment. Conclusions Both endovascular and microsurgical treatments are feasible for intracranial microaneurysms. Close follow-up observation is recommended to unruptured microaneurysms, and endovascular interventional treatment might be a preferred option if necessary.