Practical Pathways for Ruptured vs Unruptured Aneurysms: Guilherme Dabus, MD

WATCH TIME: 3 minutes

"For ruptured aneurysms, if a patient is a good candidate for endovascular therapy, that’s usually our first choice given lower morbidity and mortality—but anatomy still rules; some small, wide-neck MCA aneurysms are best clipped."

Intracranial aneurysm is a common and life-threatening serious neurological disease caused by abnormal swelling or dilation of the walls of intracranial arteries. With the increased development of medical imaging technology, more intracranial aneurysms have been found, and the incidence rate among the general population is more than 3%. While most aneurysms are small, the identification of these aneurysms with a high risk of rupture is pivotal to improve management strategies going forward.

Guilherme Dabus, MD, co-director of interventional neuroradiology at Baptist Health's Neuroscience Institute, recently sat down with NeurologyLive® to discuss the decision-making process for ruptured vs unruptured aneurysms, particularly as technology continues to evolve. In the interview, Dabus provided clinical insights on the how each case may differ, emphasizing the each individual should have treatment plans tailored to the aneurysm location, neck morphology, age/frailty, and the full endovascular armamentarium.

Throughout the conversation, Dabus touched on several different approaches, such as simple coiling, stent-assisted coiling, flow diversion, and intrasaccular flow disruptors. In ruptured aneurysms, he noted that time simple coiling, stent-assisted coiling, flow diversion, and intrasaccular flow disruptors. Furthermore, Dabus emphasized that robust data favors endovascular therapy for many ruptured cases due to lower morbidity/mortality, while acknowledging surgical clipping remains optimal in select scenarios.