Abstrait

Interventional Embolization of Subarachnoid Haemorrhage Caused by Cerebral Aneurysm and Review of Relevant Literature

Ri Le Wu1, Xiao Dong Wang2*

In recent years, the vast majority of cerebral aneurysm patients have been treated with one of two reconstructive methods: Craniotomy microsurgical occlusion of the tumour bearing artery for reconstruction, or intracapsular treatment, in which the detachable coil is placed into the aneurysm sac to generate thrombus, thereby excluding the aneurysm from the tumour bearing artery circulation. The Guglielmi Detachable Coil (GDC) was introduced in 1991 as the first product of the intracapsular spring coil platform and was approved by the Food and Drug Administration in 1995 for the treatment of aneurysms. However, this technique is not effective for wide-necked, dissected, or fusiform aneurysms. Advances in new technologies, such as three-dimensional spring rings, balloon assisted remodeling, polymer embolization, stents and flow-guiding devices, and Pipeline embolization devices, have allowed neurovascular surgeons to treat previously untreatable lesions. The International aneurysmal subarachnoid Haemorrhage compared the clipping of ruptured aneurysms with spring coil embolization, which proved the superiority of spring coil embolization and made spring coil treatment of ruptured and unruptured aneurysms more widely recognized. Moreover, the continuous innovation of spring coil design also increased the variety of geometric shapes and compliance. The bioactive coating helps to improve the filling effect and increase the cure rate. However, it should be noted that the object of International Subarachnoid Aneurysm Trial (ISAT) is aneurysms that can be clipped and coil embolized, but for some aneurysms that are not suitable for coil embolization, such as wide-neck aneurysms and very small aneurysms, clipping should be considered first. In addition, aneurysms with branches in the tumour body of the artery are partially embolized in order to preserve the branches, so they are not indications. For wide-necked aneurysms, consideration should be given to the need for stent-assisted treatment, which in turn requires long-term antiplatelet therapy.