We conducted a systematic review of the literature to evaluate the efficacy of various treatment modalities for intracranial aneurysms (IA) in patients with moyamoya disease (MMD) based on anatomical location of IA. A comprehensive review of studies documenting single cases or series of MMD patients with concomitant IA was conducted. Aneurysms were classified into two primary anatomical categories: those of the Circle of Willis (CoW) and those of peripheral "moyamoya" collateral vessels. Conservative, endovascular, and open surgical treatment modalities and their outcomes between each anatomical subgroup were descriptively compared. A total of 124 studies consisting of 275 patients with 313 IA were included. Of all IA, 59.6% were located on CoW vessels, 33.7% on peripheral vessels, and 6.7% in "other" locations. Of all CoW IA, 87.2% treated with endovascular techniques had no or minimal deficit at follow-up as compared with 56.7% of those treated with open surgery. Ninety-five percent of patients with peripheral aneurysms treated with endovascular therapy had no or minimal deficit, in contrast to open surgery (69.6%). Of peripheral IA treated conservatively with or without revascularization, 65.7% had spontaneous resolution as compared with 12.0% IA of the CoW. Our results support the use of endovascular techniques for direct treatment of both CoW and peripheral IA. Aneurysms of peripheral vessels respond well to indirect treatment through surgical revascularization as opposed to CoW aneurysms. The quality of evidence is limited due to heterogeneity of included studies and IA management in MMD patients should be considered in a case-specific manne.

中文翻译：

---

烟雾病的颅内动脉瘤定位治疗：系统评价和描述性分析。

我们对文献进行了系统的综述，以根据IA的解剖位置评估颅内动脉瘤（IA）在烟雾病（MMD）患者中的各种治疗方式的疗效。进行了一项研究综述，该研究记录了单例或系列MMD伴有IA的患者。动脉瘤分为两个主要的解剖类别：威利斯环（CoW）的那些和外周“烟雾病”侧支血管的那些。描述性地比较了保守，血管内和开放手术治疗方式及其在每个解剖亚组之间的结果。包括124项研究，包括275例313 IA的患者。在所有IA中，有59.6％位于CoW船上，占33.7％在外围船上，还有6.7％在“其他”位置。在所有CoW IA中，血管内技术治疗的87.2％的患者在随访中没有或仅有最小的缺陷，相比之下，开放手术治疗的患者为56.7％。与开放手术相比（69.6％），百分之九十五的接受血管内治疗的周围动脉瘤患者没有或只有很少的缺陷。在有或没有血运重建情况下保守治疗的外周IA中，有65.7％的患者具有自发性分辨力，而CoW的IA为12.0％。我们的研究结果支持使用血管内技术直接治疗CoW和周围性IA。与CoW动脉瘤相反，外周血管动脉瘤通过外科血管重建对间接治疗反应良好。由于纳入研究的异质性，证据质量有限，MMD患者的IA管理应根据具体病例而考虑。接受血管内技术治疗的患者中，有2％的患者在随访时没有或仅有最小的赤字，相比之下，接受开放手术的患者中只有56.7％的患者。与开放手术相比（69.6％），百分之九十五的接受血管内治疗的周围动脉瘤患者没有或只有很少的缺陷。在有或没有血运重建情况下保守治疗的外周IA中，有65.7％具有自然分辨率，而CoW中IA为12.0％。我们的研究结果支持使用血管内技术直接治疗CoW和周围性IA。与CoW动脉瘤相反，通过血管再血管化术对间接治疗的外周动脉瘤反应良好。由于纳入研究的异质性，证据的质量有限，MMD患者的IA管理应在特定病例中考虑。接受血管内技术治疗的患者中，有2％的患者在随访时没有或仅有最小的赤字，相比之下，接受开放手术的患者中只有56.7％的患者。与开放手术相比（69.6％），百分之九十五的接受血管内治疗的周围动脉瘤患者没有或只有很少的缺陷。在有或没有血运重建的情况下，经保守治疗的外周IA，自律率为65.7％，而CoW为12.0％。我们的研究结果支持使用血管内技术直接治疗CoW和周围性IA。与CoW动脉瘤相反，外周血管动脉瘤通过外科血管重建对间接治疗反应良好。由于纳入研究的异质性，证据的质量有限，MMD患者的IA管理应在特定病例中考虑。