The dissertation proposed a new science-based approach to solving problems of cerebral saccular arterial aneurysms (AA) endovascular treatment by the using of differentiated endovascular occlusion assisting techniques for AA. The results of a comprehensive survey and endovascular treatment of 1345 patients with cerebral saccular AA have been analyzed, 17,4% of these cases - complex AA, which were treated at the SI "Scientific-Practical Center of Endovascular Neuroradiology of NAMS of Ukraine" in 2002 - 2016. 214 clinical cases were selected based on inclusion criteria for the further clinical and instrumental dynamic observation and analysis. The age of patients ranged from 14 to 76 years, women - 117 (54,7%) cases, men - 97 (45,3%). All patients were operated by endovascular approach in before-hemorrhagic, acute or "cold" period of disease with symptomatic or asymptomatic intracranial saccular AA in both vascular pools with using the balloon-remodeling, stent-assisting or mono-spiral coiling techniques. Patients were divided into three groups depend on initial method of AA occlusion: I group - single-coiling -82 (38.3%) cases, II group - with balloon-remodeling technique using - 68 (31,8%) of cases, group III - with stent-assisting technique using - 64 (29,9%) cases. According to the international standards, the quality of life and social adaptation of patients before an extract from the hospital and at the control examinations in follow-up periods, were evaluated by the Glasgow Outcome Scale (GOS) and by a modified Rankine Scale (mRS). Radicalism of AA occlusion was assessed by modified Raymond - Roy Scale (mRRS) (Mascitelli JR, et al., 2015). "Effective" occlusion considered Raymond I and II by mRRS. On the basis of the results of angiographic studies and endovascular technical features of AA occlusion from the circulation, 9 criteria of cerebral saccular AA complexity inherent to endovascular surgery were developed. The conducted evaluation of the prognostic significance of cerebral AA complexity criteria to achieve the effective primary occlusion in different groups showed the high prognostic significance of 4 criteria in group I, 2 criteria - in group III and the leveling of their significance in group II. On the basis of defined criteria of cerebral AA complexity and the patient outcomes analysis, differentiated tactics of endovascular operations, which can help to reduce the incidence of AA recanalization, were developed.
