To compare the clinical effect of double microcatheter and stent-assisted techniques in the intravascular interventional treatment of unruptured intracranial wide neck lobulated aneurysm.

Ninety-five patients with unruptured wide-neck lobular aneurysms treated by neurosurgery department of Nanjing First Hospital from January 2012 to December 2022 were retrospectively included, including 34 patients treated with double microcatheter and 61 patients treated with stent-assisted technique. The therapeutic effects of the two methods were compared and analyzed from the indicators before and after the treatment.

Among the patients treated with dual microcatheter technique and the patients treated with stent-assisted technology, up to one year after the operation, there were 6 cases and 2 cases of recurrence. There was statistically significant differences in the recurrence rate between the two groups of patients (P < 0.05). There were 28 and 47 cases of Raymond Ⅰ-Ⅱ grade, respectively. There was a statistically significant difference in the degree of embolization between the two groups of patients (P < 0.1). There were 4 cases of thrombotic events, including 1 case with dual microcatheter technique and 3 cases with stent-assisted technique. There were 32 and 57 patients with mRS≤2, and 33 and 58 patients with GOS score of 5 in dual microcatheter and stent-assisted therapy, respectively. There were 1 and 2 cases of intraoperative aneurysm rupture in dual microcatheter and stent-assisted therapy, respectively.There were no statistically significant differences in the incidence of aneurysm rupture events, mRS and GOS scores after the operation (P > 0.1).

Double microcatheter and stent-assisted techniques can effectively treat unruptured wide-necked lobular aneurysms. Stent-assisted embolization has a higher embolic density, but a higher risk of bleeding. Double-microcatheter embolization is more economically safe and has a lower risk of bleeding but a higher recurrence rate.