endovascular embolotherapy of very small intracranial aneurysms

Objective The present study analyzes the clinical effect of and the operative techniques in endovascular embolotherapy for very small intracranial aneurysms.Methods Twenty-three patients(25 tumor bodies),composed of 15 males and 8 females,suffering from very small intracranial aneurysms were selected as subjects for the current study.They were admitted to the Neurosurgery Department of the General Hospital of Chinese PLA from May 2007 to June 2010.The patients’ ages ranged from 23 years to 82 years,with an average of 48.2.They were all diagnosed using cerebral angiography and given endovascular treatment.The 20 aneurysms were embolized,whereas the five wide-necked aneurysms were treated using the stent or balloon remodeling technique.Effects of the treatment were observed,and postoperative follow-up was conducted.Results Out the 25 tumor bodies,24 were embolized successfully,of which 9(37.5%) were embolized tightly in the first stage.Out of the 23 patients,14 had good postoperative recovery,6 were left with varying degrees of neurological deficits,2 died,and 1 went into a persistent vegetative state.No rebleeding occurred in the follow-up within three months to three years.Eighteen cases were followed up using angiography,of which one experienced recurrence and was treated through dense embolization.Aneurysm occlusion occurred in one case of stent coverage in the neck.Conclusion Endovascular treatment is a safe and effective treatment for very small aneurysms.The key factor in the treatment is the use of appropriate embolization technology rather than the deliberate pursuit of dense packing.