What Are the Pros and Cons of Aneurysm Embolization?

Aneurysm interventional therapy refers to vascular interventional therapy, which is performed on the basis of diagnostic angiography using catheter technology for various treatments under X-ray surveillance.

Interventional aneurysm

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Aneurysm interventional therapy refers to vascular interventional therapy, which is performed on the basis of diagnostic angiography using catheter technology for various treatments under X-ray surveillance.

Interventional aneurysm

With the development of neuroradiography, especially after digital subtraction cerebral angiography is applied to the clinic, many patients such as arteriovenous malformations, intracranial aneurysms, carotid cavernous sinus fistulas, etc. have avoided complicated and dangerous surgical treatment. This therapy is less invasive and easily accepted by patients.

Aneurysm interventional treatment is suitable for:

1. Huge aneurysms (such as cavernous sinus segments, ocular arteries, aneurysms of the vertebral base system) that are difficult to remove or difficult to access during surgery

2. The elderly or other systemic diseases can not tolerate surgery.

3. Failure of surgical clamping.

4. Spindle-shaped wide neck or no carotid aneurysm or saccular aneurysm.

5. All aneurysms except contraindications can be treated with embolization first.

1. Very small aneurysms.

2. Small and wide neck aneurysms.

3. Aneurysm neck stenosis balloon is difficult to pass contraindication for detachable balloon embolization.

Patient preparation

(1) Explain the purpose of treatment and possible complications and accidents to patients and their families, and sign an agreement.

(2) Explain the treatment process and precautions to the patient to eliminate concerns and strive for intraoperative cooperation.

(3) Check heart, liver, and kidney functions, as well as blood routine and clotting time.

(4) Necessary imaging examinations, such as CT and MRI.

(5) The iodine and anesthetic should be processed according to the pharmacopoeia.

(6) No diet for 4 hours before surgery.

(7) Skin preparation is routinely performed at the puncture site. Children and uncooperatives are given sedatives or general anesthesia.

(8) Establish a venous channel to facilitate intraoperative medication and rescue.

2. Equipment preparation

3. Drug preparation includes preparation of various rescue drugs.

(1) Self-catheter infusion of drug therapy, such as local chemotherapy for tumors, injection of thrombolytic drugs such as urokinase into the site of vascular occlusion.

(2) Transcatheter embolization, injecting some special emboli into the blood vessels that support the lesion through the catheter in the artery, interrupting the blood flow and achieving the purpose of treatment.

(3) Percutaneous transluminal angioplasty, such as stenosis of the dilated vertebral artery, subclavian artery, and carotid artery.

(4) Transcatheter thrombectomy. The application of DSA ensures the accuracy of the treatment plan. Can determine the location, size, shape, number of aneurysms, the relationship between tumors and tumor-bearing arteries, the width of the neck of the aneurysm; can measure the size of deformed blood vessel clusters, and understand the conditions of the supplying arteries and drainage veins, and can clarify the disease and normal blood vessels The relationship between them, understanding the degree of vascular stenosis and occlusion, and the presence or absence of vasospasm can better explain clinical symptoms and judge the prognosis, and help to formulate surgical and interventional treatment plans.

The microcatheter is inserted into the aneurysm via a guide catheter, and embolic material is placed into the aneurysm cavity through the microcatheter until the entire aneurysm is completely blocked, while keeping the tumor-bearing artery as smooth as possible, and the tumor-bearing artery can be occluded according to the condition . There are two types of embolic materials: detachable balloons and detachable micro-spring coils. The latter are mainly two types: electrolytic hemocoagulable detachable platinum spring coils (GDC); mechanical detachable tungsten spring coils ( MDS).

Pay attention to prevention and treatment of complications: aneurysm rupture and bleeding; premature balloon detachment causes cerebral embolism; embolization material slides into the tumor-carrying artery and causes embolism.