Aneurysms

Parameters

• Aspect ratio = Height 3 / Neck 1

• dome-neck ratio = Width 2/Neck 1

• Neck dimension = Neck 1

Old criteria for "wide-neck" aneurysm

• dome-neck ratio <2.0;

• neck size >4.0.

new criteria for "wide-neck" aneurysms:

• wide neck

  • dome-to-neck ratio <1.6,

  • aspect ratio <1.6;

• very wide-neck

  • dome-to-neck <1.2,

  • aspect ratio <1.2.

Tx

• coiling aneurysms /wo adjunctive techniques (stent/balloon) for aneu. /w aspect ratio >/=1.6, dome-to-neck ratio >/=1.6, and neck size <4mm.

• Coiling /w adjunctive techniques for aneu. /w dome-to-neck ratios <1.2 and aspect ratios <1.2.

• For aneu. /w dome-to-neck ratios or aspect ratios between 1.2 -1.6, coiling can be done /w ± adjunctive techniques.