Long-Term Follow-up And Retrospective Analysis Of Micro Clipping And Endovascular Treatment Of Very Small Intracranial Aneurysms

Objective: Very small intracranial aneurysms are common intracranial vascular disease,which are mainly treated by micro clipping and endovascular intervention.By analyzing the clinical data of very small intracranial aneurysm patients treated in our hospital,we discussed whether there is any difference in the degree of effective treatment of very small intracranial aneurysm under different treatment modalities and compared the recurrence factors of microaneurysm,to provide some ideas for neuro-interventional doctors in the therapeutic intervention of very small intracranial aneurysms.Methods: The clinical treatment data of 76 patients with very small intracranial aneurysms in the Department of Neurosurgery of the Second Affiliated Hospital of Anhui Medical University were collected between January 2016 and December 2020,and the efficacy of the treatment modalities of interventional embolization and cranial clipping surgery on patients with very small intracranial aneurysm was compared by long-term follow-up and retrospective analysis,and the relevant factors affecting the recurrence of tiny intracranial aneurysms in the postoperative period and long-term follow-up of patients were analyzed.Results: 35 of patients with very small intracranial aneurysms were treated with micro clipping and 41 patients with endovascular embolization.14% of patients with very small intracranial aneurysms had intraoperative complications,and the most common complication was intraoperative rupture and bleeding.The clinical outcomes of the patients after surgery were satisfactory,and no deaths occurred.A small amount of visualization of the aneurysm neck was present in one patient after treatment with both procedures.During the three-year follow-up,one patient who underwent micro clipping had a recurrence,and five patients who underwent endovascular treatment had aneurysms’ neck or body shadowing.The results suggest that good outcomes can be obtained in either micro clipping or endovascular embolization of very small intracranial aneurysms,but there is a difference in the level of long-term recurrence between the two treatment modalities.Conclusion: Both micro clipping and endovascular interventional embolization are reasonable options for the treatment of tiny intracranial aneurysms,and there was no significant difference in the treatment outcome between the two groups in the postoperative period and long-term follow-up.In patients treated endovascularly,there was a possibility of recurrence in patients who showed contrast residuals in the neck or body of the aneurysm after treatment of intracranial microaneurysms in long-term follow-up.