Yeon Soo Kim, Sungbin Hwang, Mi Hyeon Kim, Boseong Kwon, Yunsun Song, Deok Hee Lee
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Time to Consider Pharmacologic Management of Unruptured Intracranial Aneurysms?
The increasing detection rate of unruptured intracranial aneurysms (UIAs) using advanced imaging underscores the need for alternative management strategies beyond surgical and endovascular interventions. Although these procedures have improved substantially, they still carry procedural risks, high costs, and psychological burdens related to continuous surveillance. This review aimed to suggest the potential role of pharmacological therapy in mitigating aneurysm progression and the risk of rupture. We first reviewed the key pathophysiological mechanisms-endothelial dysfunction, hemodynamic stress, inflammation, and thrombosis-contributing to UIA growth and instability. We then listed and examined a range of pharmacological agents, including antihypertensives, lipidlowering drugs, anti-inflammatory compounds, antioxidants, and novel candidates, summarizing both the preclinical and observational evidence supporting their use. While these findings are encouraging, current clinical data do not support broad, standardized treatment guidelines. Further prospective or randomized studies are required to clarify the safety, efficacy, and feasibility of using these agents in routine practice. By highlighting the rationale for pharmacological interventions and identifying key knowledge gaps, this review underscores the importance of an integrative management approach, encompassing medication, lifestyle modification, and vigilant monitoring, to better address patient needs and ultimately improve outcomes in UIA care.
Journal of StrokeCLINICAL NEUROLOGYPERIPHERAL VASCULAR DISE-PERIPHERAL VASCULAR DISEASE
CiteScore
11.00
自引率
3.70%
发文量
52
审稿时长
12 weeks
期刊介绍:
The Journal of Stroke (JoS) is a peer-reviewed publication that focuses on clinical and basic investigation of cerebral circulation and associated diseases in stroke-related fields. Its aim is to enhance patient management, education, clinical or experimental research, and professionalism. The journal covers various areas of stroke research, including pathophysiology, risk factors, symptomatology, imaging, treatment, and rehabilitation. Basic science research is included when it provides clinically relevant information. The JoS is particularly interested in studies that highlight characteristics of stroke in the Asian population, as they are underrepresented in the literature.
The JoS had an impact factor of 8.2 in 2022 and aims to provide high-quality research papers to readers while maintaining a strong reputation. It is published three times a year, on the last day of January, May, and September. The online version of the journal is considered the main version as it includes all available content. Supplementary issues are occasionally published.
The journal is indexed in various databases, including SCI(E), Pubmed, PubMed Central, Scopus, KoreaMed, Komci, Synapse, Science Central, Google Scholar, and DOI/Crossref. It is also the official journal of the Korean Stroke Society since 1999, with the abbreviated title J Stroke.