| Objective:Analyze the CTA reliability of the preoperative assessment of ruptural intracranial aneurysms;discusse the endovascular treatment of ruptural intracranial aneurysms surgical procedures, complications,follow-up experience.Methods:Retrospective analysis of 46 cases using a simple coil embolization operation, a simple stent isolation operation and a stent assisted coil embolization operation for the clinical features of ruptural intracranial aneurysms, compared CTA with DSA the measurement of ruptural intracranial aneurysm neck and ruptural intracranial aneurysm size, bleeding treatment time, treatment process, post-operative cerebral angiography results and clinical long-term follow-up. The measured data were analyzed using SPSS 17.0 software.Results:The group of 46 cases, the implementation of a simple coil embolization operation in 35 cases, the implementation of a simple stent isolation operation in 3 cases, the implementation of stent assisted coil embolization operation in 8 cases.The group of 46 cases, compared with 37 cases of ruptural intracranial aneurysm size of DSA and CTA measurements, by using paired T test, P= 0.06 by the calculation of both sides, ranging between 0.05 and 0.1, is statistically significant, indicating that DSA and CTA for measuring the size of ruptural intracranial aneurysms are different; the group of 32 cases,compared with 32 cases of ruptural intracranial aneurysm neck of DSA and CTA measurements, by chi square test, P=0.001<0.05 by calculating, is statistically significant, indicating that DSA and CTA for measuring the neck of ruptural intracranial aneurysms are different; the group of 46 patients angiography, intraoperative rupture of ruptural intracranial aneurysm again, angiography showed contrast extravasation in 1 case,1 case with a coil terminal residue of the parent artery (anterior cerebral artery), but angiography showed arterial smooth, and did not affect blood flowing,1 case come out intraoperatively new neurological signs, angiography see the parent artery distal with filling defect, considering as acute cerebral infarction, 12 cases found that preoperative imaging of the brain through arteries segmental intracranial arteries open and uneven, it is preoperative ruptured intracranial aneurysms that induced cerebral vasospasm,1 patient intraoperative angiography found the brain through arteries opening up and intracranial arteries segmental uneven, and come out the corresponding neurological symptoms, considering as the intraoperative cerebral vasospasm.The group of 46 patients after the angiography of the modified Rankin Scale (mRS) score:6 points accounted for 22 cases,5 points accounted for 10 points,4 points accounted for 6 cases,3 points accounted for 2 cases,2 points accounted for 2 cases,1 points accounted for 0 cases,0 points accounted for 2 cases, the good prognosis group of 40 cases, the bad prognosis group of 6 cases; within 6 months after the follow-up of DSA or CTA, follow-up results showed a stable of 30 cases, further thrombosis of 10 cases, recurrences of 4 cases, deaths of 2 cases.Conclusion:Simple coil embolization or stent assisted coil or stent alone in the treatment of ruptural intracranial aneurysms are a minimally invasive, safe and effective treatment methods, this method is used to treat all terms of ruptural intracranial aneurysm with a high security, can reduce the mortality of ruptural intracranial aneurysms; the morphology more performance of ruptured intracranial aneurysm with the two-leaf, multi-section leaf, gourd-shaped, dumbbell-shaped, long strip, a single irregular leaf or ascus distinct between non-ruptured intracranial aneurysm and ruptured intracranial aneurysms in the applications, which should pay a attention;CTA and DSA measurements for ruptural intracranial aneurysm neck and size is different. DSA is still the gold standard for diagnosis of ruptural intracranial aneurysms;first coil embolization play base and global roles in the ruptural intracranial Intracranial aneurysm treatment, which should be given particular attention.dense embolization ruptural intracranial aneurysm is to prevent aneurysm ruptured and the recurrence of first principles,but dense Embolism may lead excessively to intra-operative ruptural intracranial aneurysm ruptural;in the posterior communicating ruptural intracranial aneurysm patients, it should be noted that the coil embolization of mass effect caused oculomotors nerve palsy's prevention caused by and basic diseases caused oculomotors nerve palsy's medicine treatment;ruptural intracranial aneurysms were followed up for the assessment of MRA or CTA in average, but DSA remains the gold standard for imaging follow-up.
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