Middle cerebral artery aneurysm endovascular and surgical therapies: comprehensive literature review and local experience.

Zaidat, Osama O; Castonguay, Alicia C; Teleb, Mohamed S; Asif, Kaiz; Gheith, Ayman; Southwood, Chris; Pollock, Glen; Lynch, John R

The middle cerebral artery is a common location for cerebral aneurysms and is associated with a lower risk of rupture than aneurysms located in the anterior or posterior communicating arteries. No evidence supports the superiority of clipping over coiling to treat middle cerebral artery aneurysm (MCAA) or vice versa. The feasibility of treating the MCAA with endovascular therapy as the first choice of treatment in cohorts of nonselected aneurysms exceeds 90%. A randomized clinical trial comparing the 2 approaches in nonselected cases with long-term follow-up will shed light on which patients may benefit from one approach over another.