探讨血管内治疗急性期破裂小脑上动脉动脉瘤的安全性和临床有效性。

回顾性分析哈尔滨医科大学附属第一医院神经外科自2011年10月至2024年10月行血管内治疗的34例破裂小脑上动脉动脉瘤患者的临床资料。观察患者住院期间并发症发生情况，采用改良兰金量表（MRS）评分评估患者的临床预后，采用Raymond-Roy分级评估动脉瘤闭塞情况。

本组患者中9例使用支架辅助栓塞，25例行单纯弹簧圈栓塞。11例（32.4%）患者出现住院期间并发症，其中出血性并发症4例（11.8%），有1例（2.9%）住院期间死亡；缺血性并发症5例（14.7%）；分流依赖性脑积水3例（8.8%），其中1例患者同时出现了分流依赖性脑积水和出血性并发症。34例患者完成临床随访，中位随访时间41.5（26.5，61.8）个月，有3例（8.8%）患者出现并发症，其中2例（5.9%）为随访期间首次出现并发症。随访期间，2例（5.9%）患者出现动脉瘤再次破裂出血，其中1例死亡，1例脑梗死。本组患者总死亡率为8.8%（3/34）。24例患者完成造影随访，中位随访时间9（6，12）个月，其中Raymond-Roy分级Ⅰ级20例（83.3%），Raymond-Roy分级Ⅱ级3例（12.5%），Raymond-Roy分级Ⅲ级1例（4.2%）。

血管内治疗急性期破裂小脑上动脉动脉瘤具有较好的可行性及临床有效性，但相关并发症仍需重点关注。

To evaluate the safety and clinical efficacy of endovascular treatment for acutely ruptured aneurysms located in the superior cerebellar artery.

A retrospective analysis was conducted on the clinical data of 34 patients with ruptured superior cerebellar artery aneurysms who underwent endovascular treatment at Neurosurgery Department of the First Affiliated Hospital of Harbin Medical University from October 2011 to October 2024. The incidence of in-hospital complications was evaluated. Clinical outcomes were assessed using the modified Rankin scale (MRS), and aneurysm occlusion status was evaluated according to the Raymond-Roy Occlusion Classification.

Among the 34 patients included in this study, 9 underwent stent-assisted coiling, whereas 25 were treated with simple coil embolization. In-hospital complications occurred in 11 patients (32.4%), including hemorrhagic complications in 4 patients (11.8%), with 1 in-hospital death (2.9%), ischemic complications in 5 patients (14.7%), and shunt-dependent hydrocephalus in 3 patients (8.8%). One patient developed both shunt-dependent hydrocephalus and a hemorrhagic complication. All 34 patients completed clinical follow-up, with a median follow-up duration of 41.5 (26.5-61.8) months. During follow-up, 3 patients (8.8%) experienced complications, including 2 patients (5.9%) who developed their first complication after discharge. Two patients (5.9%) suffered aneurysm rebleeding during follow-up, resulting in death in one patient and cerebral infarction in the other. The overall mortality rate in this cohort was 8.8% (3/34). Angiographic follow-up was available for 24 patients, with a median follow-up duration of 9 (6-12) months. According to the Raymond-Roy occlusion classification, complete occlusion (Grade Ⅰ) was achieved in 20 patients (83.3%), residual neck (Grade Ⅱ) was observed in 3 patients (12.5%), and residual aneurysm (Grade Ⅲ) was identified in 1 patient (4.2%).

Endovascular treatment for acutely ruptured superior cerebellar artery aneurysms is feasible and demonstrates favorable clinical efficacy. However, procedure-related and disease-related complications remain a significant concern and warrant close attention.