الفهرس 
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Abstract
Saccular intracranial aneurysms are localized enlargement lesions of the
vasculature, most commonly located at bifurcation points in the circle of
Willis. Advances in imaging technologies have improved our abilities to
depict the anatomical three dimensions (3D) orientation of cerebral
aneurysms and thus positively influenced their therapeutic management
Aneurysm-related risk factors include location, size, and morphological
features such as the shape of the aneurysm, linking such new indices with
relevant clinical events should bring new insights on the processes behind
aneurysm genesis, growth and rupture which could potentially provide
robust criteria to assess the risk of aneurysm rupture, and benefit planned
aneurysm surgery by understanding of the process of aneurysm formation,
progression, and rupture so sound judgment in balancing the risks and
benefits of possible therapies can be exercised.
The objective of this work is to evaluate the Influence of the study of the
parent vessel and aneurysm geometry on anticipating and planning of
different therapeutic modalities (surgical clipping or endovascular surgery)
of cerebral aneurysms.
Treatment of MCA aneurysms remains the domain of operative vascular
neurosurgery. However, besides the presence of subarachnoid
hemorrhage, the identification of significant morphological features of the
aneurysm itself and of its direct anatomical environment is strongly
influencing the surgical strategy.
Endovascular treatment of aneurysm becoming a well established
procedure in some centers and a promising one in more centers has a
large contribution in aneurysm surgery in different situation providing the
minimally invasive procedure with a large zone of safety and efficacy for
aneurysm treatment.
Our results show that the detailed angiographic evaluation
preoperatively is mandatory as it provides valuable information about the
complexity of the aneurysm and the difficulty level of the clipping or coiling
procedure with the indications of adding more special and advanced
techniques in the treatment according to planning and anticipation of
surgical circumstances. The key features size, shape, and branching
vessels should always be considered.