| Objedtives: Study the clinical characters of cerebral aneurysm. Discuss the technical main points of endovascular embolization for cerebral aneurysm. Analyse and compare the different methods and similarities and differences of endovascular embolization for cerebral aneurysm by using GDC and MDS. Discuss the relationship of different embolic degrees and recurrence of aneurysm. Fingding the strongpoints and shortcoming of endovascular embolization for cerebral aneurysm by using GDC and MDS. Ascertain the reason, management of aneurysmal recurrence and the prevention and cure methods for complications. Summarize the best methods of aneurysm treatment. Study the clinical characters of cerebral arteriovenous malformation. Analyse the best accommodations and treatment principles of endovascular embolization for cerebral arteriovenous malformation. Discuss the technical main points of endovascular embolization for cerebral arteriovenous malformation and the technique of mixing biological glue and casting mould. Ascertain the reason of cerebralarteriovenous malformation recurrence after the endovascular embolization and the main points of preventing and curing the complications. Summarize the clinical experience for these diseases' diagnoses and treatments.Methods: Collect 362 cases of cerebral aneurysm, male 163 cases, female 199 cases, age from 19 to 73 years old, average 53.7; 236 of it were embolized by GDC, 85 by MDS, 41 with huge aneurysms. Preoperation's Hunt-Hess grade: 205 in I grade, 71 in II, 58 in III, 18 in IV , 10 in V . Collect 469 cases of cerebral arteriovenous malformation, male 296 cases, female 173 cases, age from 7 to 63 years old, average 33.1. Spetzler grade: 71 in I grade, 97 in II, 192 in III, 82 in IV, 47 in V.Using Seldinger techque, along femoral puncture and intubation, through microcatheter, to embolize the cerebral aneurysm by using GDC, MDS or detachable balloon. To embolize the cerebral arteriovenous malformation by using NBCA or liquid coils. Results: (1) 236 cases with 243 aneurysms were embolized through endovascular approach by using GDC, 235 patients were cured, 1 dead. 236 cases with 243 little cystiform aneurysms were embolized by microcoils. 26 of it were treated in acute period. 210 aneurysms were 100% embolized, 8 were 95-99%, 4 were 90-95%, 1 were 80%. Complications: 4 cases with aneurysm rupture during embolization, 4 with brain infarction, 3 of 4 were thrombosis, 1 was suddenness embolism by arterial sclerosis spot, 3 in cerebral vascular spasm. All patients were cured by active treatment. One patient with anterior communicating artery aneurysm was achieved 100% embolization. But she suffered conscious handicap 12 hours after operation. Cerebral angiography show occlusion of left PICA, brain stem infarction, breathand circulation failure. And the patient died finally for the reason of arterial sclerosis spot's brush off. (2) 85 cases with 90 aneurysms were embolized through endovascular approach by using MDS, 83 patients were cured, 2 dead. MDS were used from 1 to 11. 83 cases with 90 aneurysms were 100% embolized, 4 were 95%, 2 were 90%. One posterior communication artery aneurysm died for breath and circulation failure , who was in Hunt-Hess V grade and achieved 100% embolization by MDS. One posterior cerebral artery aneurysm died for brain infarction after embolization for stubborn cerebral vascular spasm, two posterior communication artery anerysm and one anterior communication artery anerysm suffered from aneurysm rupture during embolization, and they were all cured by active treatment and continue embolization. (3) In 41 huge aneurysm, 38 cases were treated by detachable balloon occlusion of carrying artery, 2 were treated by GDC occlusion of carrying artery, 1 were treated by MDS occlusion of carrying artery.Following result: 173 of 362 aneurysm patients were followed-up. The follow-up ratio was 47.8%. The clinical follow-up time were between 3 to 45 months, average 18 months. 84 (48.6%) were followed by DSA angiography, 89 (51.4%) were followed by...
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