Asymptomatic Unruptured Aneurysm; to Treat or not to Treat?
Yong Bae Kim, MD, PhD
Department of Neurosurgery, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
ABSTRACT
Although the unruptured aneurysms are increasingly discovered in recent years, the best policies for the treatment of asymptomatic unruptured aneurysms still remain unclear. Nevertheless, the preventive treatment is rationally desirable for the lesion at high risk of rupture because the aneurysmal rupture continues to have unacceptably high morbidity and mortality despite recent advancements in the neurovascular treatment. At the same time, to benefit from the preventive treatment, it is a fundamental requirement that the risks of each treatment modalities should outweigh the risks of natural course of untreated aneurysms. In this review, the author will focus on the current evidences in the literature regarding such various factors that may affect the decision making process for the management of incidental aneurysms including natural history of asymptomatic unruptured aneurysms, patient selections for each treatment options and the risks related to the treatment modality.