At the LINNC China 2024 conference, doctors had a heated discussion on a case of anterior communicating artery aneurysm with ruptured daughter sac. Different doctors proposed different treatment plans. Let's take a look.

The films of anterior communicating artery aneurysm with ruptured daughter sac is shown below:

Professor Spelle from France:

We chose to implant WEB in the proximal aneurysm body for treatment. After WEB implantation, the aneurysm subsac was no longer visualized, and the aneurysm did not rupture and bleed again. However, this aneurysm recurred, probably due to the problem of the small size of the WEB.

Professor Zhu Liangfu from Henan, China:

I prefer stent-assisted embolization. One of the main advantages of WED in treating ruptured aneurysms is that it can avoid the use of antiplatelet drugs. The emergence of tirofiban has significantly reduced the incidence of complications from the use of stents in the acute phase.

Professor Li Qiang from Shanghai, China:

I think that intravenous tirofiban has not been able to significantly reduce thrombotic events caused by insufficient platelet preparation compared to classic oral dual-antibodies. In addition, some patients may need to receive ventricular drainage or even craniotomy for further treatment after embolization. In this case, the use of antiplatelet drugs will increase the corresponding bleeding risk. The emergence of tirofiban has indeed brought some convenience to acute stent-assisted embolization, but it is obviously better if the use of antiplatelet drugs can be avoided by using WEB.

Professor Moret from France:

I think that WEB implantation is safe and effective in treating such an aneurysm, and the aneurysm recurrence rate is low.