Objective To investigate the outcome of endovascular treatment of large or giant intracranial aneu?rysm by long-term angiographic follow-up. Methods Clinical data of 72 patients with large or giant intracranial aneu?rysms receiving endovascular treatment were analyzed retrospectively. Thirty aneurysms were treated with coil emboliza?tion alone, 14 with stent-assisted coiling, 15 with covered stent-deployment and 13 with parent artery occlusion. Results complete occlusion was achieved in 10 cases of pure coil embolization, 7 cases of stent assisted coil embolization,11 cas?es of completely covered stent-deployment and,13 cases of parent artery occlusion. The postoperative immediate com?plete embolism rate was 56.9%. Nearly completely occlusion was achieved in 17 cases of pure coil embolization, in 6 cas?es of stent auxiliary coil embolization, 4 cases of covered stent-deloyment and zero case of parent artery occlusion. The total postoperative immediate nearly completely embolism rate was 37.5%. Incomplete occlusion was achieved in 3 cases of pure coil thrombosis, 1 case of stent assisted coil, zero case of ,covered stent-deloyment and zero case of parent artery occlusion. The total immediate postoperative incomplete embolization rate was 5.6%. Patients were followed up for 6 to 72 months, with an average follow-up of 24.2 months . All patients had no bleeding. The total periprocedural complica?tion rate was 9.7%and there were no death cases. The recurrence of aneurysm in pure spring coil embolization treatment was higher compared with other treatments. The overall recurrence rate was 23.6%. The recurrent 14 aneurysms were suc?cessfully treated endovascularly. Conclusions Endovascular embolization treatment of intracranial large or giant aneu?rysm is safe and effective but its long-term recurrence rate is high. Thus a close follow-up is needed. Endovascular inter?ventional therapy based on the location of aneurysm and shape characteristics can improve treatment effectiveness and re?duce recurrence rate.

Objective:To investigate the correlation between serum cystatin C (CysC), blood lipids and the risk of intracranial aneurysm (IA) rupture.Methods:Patients with saccular IA admitted to the First Affiliated Hospital of Xinjiang Medical University from December 2017 to May 2019 were enrolled retrospectively. The patients were divided into the ruptured group and the unruptured group. The correlation between CysC, lipids and IA rupture was identified by univariate and multivariate logistic regression analyses. Results:A total of 392 patients were enrolled, including 143 (36.5%) males and 249 (63.5%) females. Two hundred and seventy-eight patients (70.9%) were ruptured IAs, 114 (29.1%) were unruptured IAs. Univariate analysis showed that triglyceride (1.26±0.94 mmol/L vs. 2.12±1.45 mmol/L; t=5.872, P<0.001), apolipoprotein A-Ⅰ (0.95±0.29 g/L vs. 1.08±0.34 g/L; t=3.744, P<0.001 ), CysC (0.63±0.20 mg/L vs. 0.80±0.48 mg/L; t=3.650, P<0.001) level, and the proportions of hypertension (46.8% vs. 61.4%; χ2=6.938, P=0.008), hyperlipidemia (19.4% vs. 48.2%; χ2=32.493, P<0.001) and aneurysm diameter >7 mm (24.4% vs. 41.2%; χ2=11.504, P<0.001) of the ruptured group were significantly lower than those of the unruptured group, while the level of apolipoprotein B was significantly higher than that of the unruptured group (1.07±0.29 g/L vs. 0.99±0.30 g/L; t=2.417, P=0.016). Multivariate logistic regression analysis showed that aneurysm diameter ≤7 mm (odds ratio [ OR] 2.281, 95% confidence interval [ CI] 1.342-3.876; P=0.002), and the serum levels of triacylglycerol ( OR 0.484, 95% CI 0.333-0.705; P<0.001), apolipoprotein A-Ⅰ ( OR 0.248, 95% CI 0.105-0.587; P=0.002) and CysC ( OR 0.130, 95% CI 0.038-0.444; P=0.001) were significantly independently correlated with the risk of IA rupture. Conclusions:CysC, apolipoprotein A-Ⅰ and triacylglycerol are protective markers for IA rupture, and aneurysm diameter ≤7 mmis associated with IA rupture.

Objective:To investigate the efficacy and safety of endovascular recanalization in the treatment of chronically occluded internal carotid artery (COICA).Methods:From January 2014 to January 2019, patients over 50 years of age with symptomatic COICA underwent endovascular recanalization in the Department of Neurosurgery of the First Affiliated Hospital of Xinjiang Medical University were enrolled retrospectively. The modified Rankin Scale (mRS) was used to evaluate the improvement of neurological function.Results:A total of 19 patients with symptomatic COICA were enrolled, of which 16 (84.21%) were successfully recanalized. None of the patients had severe neurological deficits during the periprocedural period and after procedure. The neurological function of patients with successful recanalization gradually improved over time. The neurological function improved in 4 patients (25.0%) at 24 h after endovascular treatment and 9 (56.3%) at 18 months postprocedural follow-up. The follow-up of CT angiography showed that the internal carotid artery in patients with successful recanalization was unobstructed, and there was no obvious in-stent stenosis.Conclusion:Endovascular recanalization is feasible, safe and effective in patients with symptomatic COICA.

Objective A preliminary study of the safety and efficacy of the Pipeline embolization device(PED)for the treatment of vertebral artery dissecting aneurysm(VADA).Methods Clinical data of 21 patients with VADA treated with PED in the Department of Neurosurgery of the First Affiliated Hospital of Xinjiang Medical University from January 2019 to June 2023 were retrospectively collected,and the surgical approach,perioperative complications,and imaging results were recorded and followed up.Patients'prognosis was assessed by modified Rankin Scale score(mRS),and Kamran grading was used for imaging follow-up.Results Of the 21 patients,17 had unruptured aneurysms and 4 had ruptured aneurysms.A total of 22 PEDs were placed,of which 13 patients underwent PED placement alone and 8 patients underwent PED combined with coil embolization,with a technical success rate of 100% .Three patients with ruptured aneurysms had combined stenosis proximal to the aneurysm,and 1 patient with>50% stenosis received an additional Solitaire stent for in-stent posterior dilatation.Immediate postoperative Kamran grading was grade 1 in 16 patients,grade 2 in 1 patient,and grade 3 in 4 patients.There were 2 perioperative complications,including postoperative aneurysm rupture in 1 patient and severe pulmonary infection in 1 patient who eventually died.At the time of discharge,15 patients had an mRS score of 1,2 patients had a score of 2,1 patient had a score of 3,1 patient had a score of 4,and 2 patient had a score of 6.Eighteen patients were followed up with a median follow-up time of 12.5(6-30)months,of which 13 patients had an mRS score of 0,4 patients had a score of 1,and 1 patient had a score of 2.There were 2 patients with a Kamran grade of 2,4 patients with a grade of 3,and 12 patients with a grade of 4.Conclusion The surgical success rate and safety of VADA treatment with PED is high,but perioperative complications and postoperative care should not be ignored either and a large number of samples are still needed for further study in the future.