Principles in Case-Based Aneurysm Treatment: Approaching Complex Lesions Excluded by International Subarachnoid Aneurysm Trial (ISAT) Criteria

Objective To review notable aneurysm cases that required complex decision making from a single institution and to examine available literature when relevant to highlight evidence-based paradigms for treatment of complex aneurysms. Methods Case illustrations were used to highlight topics in complex aneurysm treatments. Reviews of the literature were conducted to evaluate the evidence for available treatment models. Results Current modalities for treating complex aneurysms involve endovascular and microsurgical tools. Conclusions Innovations in both arms of the cerebrovascular field will continue to advance the field and provide novel approaches to these complex lesions.