| Objective:Intracranial aneurysms occurred mainly in the cerebral arterial circle and its major branches,the incidence of the posterior circulation aneurysms is approximately 10% of intracranial aneurysms, because its special position is on the brain stem, near important nerves and blood vessels, craniotomy clipping is difficult, and its mortality and morbidity remained high. With the development of intervention materials science, intervention and technological progress, the popularization of interventional equipment, posterior circulation aneurysms intervention has made rapid development, recognition of the efficacy of intervention. This article aim is to explore aneurysms of treatment options and clinical efficacy,which are different forms and different parts of intracranial posterior circulation.Methods:First Affiliated Hospital of Dalian Medical University, Neurosurgery, from January 1,2005 to January 1,2010,20 patients of parallel intervention confirmed for the posterior circulation intracranial aneurysms by imaging were retrospectively analysis, including 12 females, 8 males; including 13 cases of basilar artery (BA) aneurysms,2 cases of vertebral artery (VA) aneurysms,3 cases of Posterior cerebral artery (PCA) aneurysms,1 case of anterior inferior cerebellar artery (AICA) aneurysm,1 case of posterior inferior cerebellar artery (PICA) aneurysm; including 3 cases of Hunt-Hess grade 0,4 cases of gradeâ… ,8 cases of gradeâ…¡,3 cases of gradeâ…¢,2 cases of gradeâ…£,0 cases of gradeâ…¤; including 5 cases of wide-necked aneurysms,13 cases of narrow-neck aneurysms, each one case of vertebral artery fusiform aneurysm and the basilar artery dissection aneurysm.13 cases of narrow-neck aneurysms and 2 cases of wide-necked aneurysms in all were treated by coil embolization,2 cases of wide-necked aneurysms and 1 case of vertebral artery fusiform aneurysm were treated by stent combining with coil embolization:Application of Neuroform self-expanding stent system,1 case of basal artery dissection aneurysm was treated, parent artery of 1 case of P3 aneurysm was occluded. Patients of complete embolization were recommended for DSA after 6 months postoperation, and ones of Subtotal Complete embolization and incomplete embolization were recommended after 3 months.Results:All patients were successfully conducted intervention.20 patients's DSA after embolization showed:Complete embolization in 12 cases,5 cases of Subtotal Complete embolization, Incomplete embolization in 3 cases.1 case of basilar artery aneurysms with preoperative Hunt-Hess gradingâ…£, intraoperative imaging showed extensive cerebral vasospasm, angiography after embolization showed Subtotal Complete embolization, after surgery by lumbar puncture,lumbar cistern drainage and fluid replacement, postoperative refractory cerebral vasospasm, concurrent brainstem infarction and ultimately died after 9 days.Other patients, the average follow-up period of 12 months, no further aneurysms ruptured, and arterial free Embolization treatment-related death,3 patients had DIND,1 patient had cerebellar ataxia.Conclusion:Intervention has become a preferred treatment of the posterior circulation intracranial aneurysms. In addition to primary disease of patients and the surgery's technical proficiency, the main impact factors in therapy involve aneurysm morphology, preoperative imaging datas of the patient combined with full of condition and developng individualized treatment programs; a simple coil embolization is an effective treatment for narrow-neck artery aneurysm; stent combining with coil embolization technique can achieve better results for wide-necked aneurysms, apply three-dimensional coils into a basket of technology on the part of wide-necked aneurysm embolization is effective; simple application of the aneurysm stent is effective and should be closely followed up; when the contralateral condition or collateral circulation condition of compensatory blood vessels is good, occlusion line of parent artery of vertebral artery and PICA distal posterior cerebral artery beyond the distal P2 huge and complex aneurysms is effective. Prevention and treatment of complications of intervention should be a priority.
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