At the LINNC China 2024 conference, many doctors passionately discussed medical cases of aneurysms and common problems in aneurysm medicine. Let's take a look.

I. What treatment should be chosen for a case of left cerebral thrombotic aneurysm? The medical image is as follows:

Professor Ye Ming from Xuanwu Hospital of Capital Medical University:

If the patient is relatively young, based on long-term prognosis considerations, craniotomy and clipping surgery will be preferred. If the patient is older, endovascular treatment may be considered, and embolization treatment will be performed mainly on some dangerous areas. Blood flow guidance device implantation will not be chosen as a treatment method, as there are certain risks in implanting a blood flow guidance device here, and the lesion is located on the left side. Once an ischemic event occurs, it may seriously affect the patient's quality of life.

Professor Moret from France:

Considering the long-term prognosis, craniotomy and clipping surgery can indeed be selected. However, based on a large number of current research results, the safety and effectiveness of implanting a blood flow guidance device to treat aneurysms at the bifurcation of the middle cerebral artery has been verified to a certain extent, and it is also one of the treatment options.

Professor Victor from St' Michael's Hospital:

Although the treatment method of blood flow guidance device implantation has the risk of ischemia, it is undeniable that the clipping surgery of this aneurysm is also full of difficulties and risks. I may be inclined to choose stent-assisted embolization for treatment.

II. For aneurysms that are still visible after WEB surgery, do they need treatment?

Professor Spelle from France:

It is recommended to complete Dyna CT first. If the imaged part of the aneurysm is located inside the aneurysm, the risk of aneurysm rupture and bleeding is low, and you can continue to wait for a while to observe the aneurysm occlusion. If the imaged part of the aneurysm is located outside the aneurysm, re-treatment may be necessary.

Professor Guan Sheng from the First Affiliated Hospital of Zhengzhou University:

It is necessary to pay attention to the use of antiplatelet drugs in patients. Some patients will take monoclonal antibodies after WEB surgery. If the reexamination during the period of continuous medication shows that the aneurysm is still visible, the antiplatelet drugs can be discontinued and observation can be continued for a period of time. For cases where some of the visible parts are located outside the WEB, occlusion may also occur after discontinuation of antiplatelet drugs.