Endovascular Embolization Of Large And Giant Intracranial Aneurysms Of Long-Term Angiographic Follow-Up

Objective:To investigate the outcome of endovascular treatment of large or giant intracranial aneurysm and evaluate the long-term angiographic follow-up results. Methods:Clinical data of 72 patients with large or giant intracranial aneurysms were analyzed retrospectively,who were treated with endovascular treatment.The 30 aneurysms were treated with coil embolization alone,14 with stent-assisted coiling,15 with covered stent-deployment,and 13 with parent artery occlusion.Results:The 10 cases of pure coil embolization completely, stent assisted coil embolization in 7 cases, completely covered stent-deployment in 11 cases, 13 cases of parent artery occlusion, the postoperative immediate complete embolism rate reached 56.9%;Nearly completely pure coil embolization of 17 cases, 6 cases of stent nearly completely auxiliary coil embolization, covered stent-deloyment in 4 cases,parent artery occlusion 0 cases, total postoperative immediate nearly complete embolism rate 37.5%;Pure coil incomplete thrombosis 3 cases, and stent assisted coil incomplete embolization 1 case,covered stent-deloyment 0 cases, parent artery occlusion 0 cases, total immediate postoperative incomplete embolization rate was 5.6%.Were followed up for 6 to 72 months, with an average follow-up of 24.2 months, all patients had no bleeding.The total periprocedural complication rate was 9.7%, no death cases.Comparing different endovascular treatment of recurrence of aneurysm found that pure spring coil embolization treatment of relapse rates were higher in the patients with aneurysms than other treatments.The overall recurrence ratewas 23.6%.The 14 aneurysms were successfully retreated endovascularly.Conclusions:Endovascular embolization treatment of intracranial large or giant aneurysm is safe and effective, long-term recurrence rate is high, it needs strengthen the follow-up observation. According to the location of aneurysm and shape characteristics, reasonable adopt corresponding endovascular interventional therapy can help to improve clinical treatment effect, and reduce recurrence rate.