What are the preparations before aneurysm embolization and what are the surgical steps?

What are the preparations before aneurysm embolization? What are the surgical steps?

What preparations are needed before aneurysm embolization?

1. After an aneurysm ruptures and bleeds, while waiting for surgery, the patient should take treatment measures such as lowering blood pressure, cooling, reducing intracranial pressure, cerebral vasospasm, fibrinolysis, and external cerebral drainage, actively create conditions, and strive to implement vascular embolization treatment.

2. Other patient preparation

① Understand the medical history in detail, conduct a comprehensive physical examination and systematic neurological examination.

② Patients with a history of epilepsy should be given anti-epileptic drugs before surgery.

③ Before surgery, CT plain scan, enhanced scan, MRI, and MRA examinations are performed according to the condition.

④ Preoperative examinations include routine blood and urine tests, bleeding and clotting time, liver and kidney function, chest X-ray, electrocardiogram, etc.

⑤Fasting before surgery, iodine allergy test, preparation of puncture sites such as perineal skin, and catheter placement.

⑥ Restrain the limbs with cloth straps.

What are the surgical steps?

1. Use Seldinger conventional femoral artery puncture cannula to insert 6F catheter sheath, 6F guide catheter or Tracker-38, Casasco in sequence. Under television monitoring, send the catheter to the affected carotid artery or vertebral artery to the level of the second cervical vertebra.

The end of the catheter is connected to the side arm of the Y-valve connector and the three-way soft connection tube, and then connected to the arterial pressure infusion. Open the pressure infusion bag, slowly drip in normal saline, and perform systemic heparinization on the patient. If whole-brain angiography is required, the location, size, and shape of the aneurysm must be understood first.

2. Choose the appropriate Excel-14 or Excelsior-1018 microcatheter and GDC platinum microcoil according to the shape and size of the aneurysm. The choice of microcoil depends on the ratio of the tumor cavity to the tumor neck. Generally, the ratio of the arterial tumor cavity to the tumor neck is 4:1, which is the most suitable for GDC embolization. If it is less than 4mm, it is not suitable for GDC embolization treatment.