Nonsaccular aneurysms: A wide comparison between the four main types

Surg Neurol Int. 2019 Mar 11:10:30. doi: 10.4103/sni.sni_138_18. eCollection 2019.

Abstract

Background: The present study aims to present the most important considerations when it comes to patients features, clinical presentation, localization, morphology, pathogenesis, and the best treatment for each type of the nonsaccular aneurysms.

Methods: We performed a literature review using PubMed. The search was limited to the studies published in English, from 2010 to 2017.

Results: Data about the clinical presentation; the aneurysm pathogenesis, morphology, and localization; the patient features; and about the surgical or endovascular approach were analyzed for the four types of nonsaccular aneurysms presented.

Conclusion: All types of nonsaccular aneurysms have a higher prevalence in young adults. Men are more affected by fusiform and mycotic aneurysms while women suffer more with blister-like aneurysms (BLAs). The mycotic and the BLAs affect more the anterior circulation while the fusiform affects more the posterior circulation. Mycotic and blister-like has as its major complication and clinical presentation the hemorrhage; however, the fusiform aneurysms usually present ischemia and/or mass effect. The reconstructive endovascular techniques for all types of nonsaccular aneurysms presented as the treatment with the best outcomes. Among this technique, the flow diversion presented good results in all types of aneurysms and it seems to promote the best outcomes.

Keywords: Aneurysm; blister-like; fusiform; intracranial; mycotic; nonsaccular.

Publication types

  • Review