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目的评价可脱卸球囊、可脱卸弹簧圈和颅内覆膜支架治疗颅内巨大动脉瘤的疗效。方法收集资料完整的经血管内治疗的颅内巨大动脉瘤20例,其中球囊/弹簧圈闭塞载瘤动脉9例,可脱卸弹簧圈动脉瘤腔填塞8例,覆膜支架治疗3例,另有2例为经弹簧圈瘤腔栓塞治疗后复发,行覆膜支架治疗。随访9～83个月,平均(41.1±25.3)个月。术后即刻血管造影结果评价标准为：动脉瘤完全闭塞(100%),大部闭塞(95%～99%)和部分闭塞(＜95%)。随访血管造影结果评价标准为：不变、血栓形成和再开放。结果所有动脉瘤血管内治疗均获得成功,无并发症。术后即刻血管造影显示动脉瘤完全闭塞11例,大部闭塞7例,部分闭塞2例,其中1例部分闭塞患者术后7 d再出血死亡。19例健在患者最终血管造影显示：动脉瘤完全闭塞15例,大部闭塞3例,部分闭塞1例。19例中,10例载瘤动脉保持通畅。长期临床随访结果显示11例患者的临床症状消失,8例改善。结论动脉瘤腔可脱卸弹簧圈栓塞治疗颅内动脉巨大动脉瘤的完全闭塞率低且再通率高；可脱卸球囊或弹簧圈闭塞载瘤动脉治疗动脉瘤完全闭塞率高但牺牲载瘤动脉,有潜在或短暂的脑缺血事件发生；覆膜支架治疗操作简单、安全,且可保持载瘤动脉通畅。
Objective To evaluate the efficacy of detachable balloon, detachable coil and intracranial stent in the treatment of giant intracranial aneurysms. Methods Totally 20 cases of intracranial giant aneurysms treated with endovascular therapy were collected. Among them, 9 were occluded with balloon / coil, 8 were filled with detachable coil aneurysm, 3 were covered with stent graft, There are two cases of recurrence after coil embolization of the coil, stent treatment. The follow-up ranged from 9 to 83 months, with an average of (41.1 ± 25.3) months. Immediate postoperative angiographic evaluation criteria were: complete aneurysm occlusion (100%), occlusion (95% -99%) and partial occlusion (<95%). Follow-up angiography evaluation criteria: unchanged, thrombosis and reopening. Results All aneurysms received endovascular treatment without complications. Immediate angiography showed complete aneurysm in 11 cases, occlusion in 7 cases and partial occlusion in 2 cases. One of the patients with partial occlusion died of hemorrhage 7 days after operation. The final angiographic findings of 19 healthy patients showed that aneurysm completely occluded in 15 cases, occluded in 3 cases and partially occluded in 1 case. Of the 19 patients, 10 had parental artery unobstructed. Long-term clinical follow-up results showed that the clinical symptoms of 11 patients disappeared and 8 patients improved. Conclusions The aneurysm embolization with detachable coils in the treatment of giant aneurysms of intracranial artery has a low rate of complete occlusion and a high recanalization rate. The detachable balloon or coil occludes the parent artery to treat aneurysms with high occlusion rate but sacrifices the parent artery , There is potential or short-term ischemic events; stent stenting is simple, safe, and can maintain the parent artery patency.