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目的:评估初次行单纯弹簧圈栓塞或开颅夹闭术治疗后复发的颅内分叉动脉瘤患者行支架辅助栓塞再治疗的安全性及有效性。方法:回顾性分析2009年3月至2019年11月复旦大学附属华山医院放射科介入组收治的初次行单纯弹簧圈栓塞或开颅夹闭术治疗后复发并接受支架辅助栓塞再治疗的20例颅内分叉动脉瘤患者的临床资料。男性9例，女性11例，中位年龄55.5岁（范围：33~71岁）；首次治疗行单纯弹簧圈栓塞17例、开颅夹闭术3例；复发后15例行单支架辅助栓塞治疗，5例行Y形双支架辅助栓塞治疗。观察患者围手术期及术后并发症情况和患者预后情况。采用Mann-Whitney n U检验对患者初次及再次治疗后的随访时间进行比较；采用n t检验对再次治疗术前、术后即刻及末次随访时近端载瘤动脉主干与支架侧分支的夹角大小进行比较。n 结果:20例患者中，18例（90%）患者术后即刻脑血管造影示致密栓塞（Raymond Ⅰ型），2例（10%）示瘤颈少许残余（Raymond Ⅱ型），术后随访8.5（16.3）个月n M（n Qn R），与初次治疗后随访时间15.5（27）个月的差异无统计学意义（n U=157.7，n P=0.25）。随访期间2例患者复发，均为术后即刻瘤颈少许残余病例，其中1例为Y形双支架辅助栓塞病例。围手术期发生症状性缺血事件6例，其中4例为Y形双支架辅助栓塞病例；无围手术期出血等并发症，无手术相关的永久性致残及死亡病例。术后即刻及末次随访时载瘤动脉主干与支架所在分支成角分别为（115.4±28.9）°、（132.6±26.8）°均较术前的（90.1±21.1）°明显增大，差异均有统计学意义（n t=5.14，n P<0.01；n t=7.78，n P<0.01）。n 结论:初次弹簧圈栓塞或开颅夹闭术后复发的颅内分叉部动脉瘤患者再次接受支架辅助栓塞初步观察安全可行，动脉瘤再复发率较低。“,”Objective:To evaluate the safety and efficacy of stent-assisted coil embolization in patients with recurrent intracranial bifurcation aneurysms,after initial simple coiling or microsurgical clipping.Methods:Clinical data of 20 patients with recurrent intracranial bifurcation aneurysms who initially underwent simple coiling or surgical clipping subsequently re-treated by stent-assisted coiling embolization at the Radiology Intervention Department of Huashan Hospital between March 2009 and November 2019 were collected and analyzed retrospectively.There were 9 males and 11 females,with a median age of 55.5 years (range:33-71 years),including 17 aneurysms initially treated with simple coiling and 3 surgical clipping cases.All cases were re-treated with stent-assisted coiling,15 using a single stent and 5 employing two stents in a Y-configuration.Peri-and post-operative complications and outcomes were evaluated.Mann-Whitney n U tests were performed to compare the follow-up duration between initial treatment and re-treatment.Student′s n t tests were used to compare the pretreatment,post-operative and follow-up parent artery angles.The parent artery angle was defined using the proximal main trunk and the stented branch.n Results:Immediate complete occlusion (Raymond Ⅰ) was achieved in 18 aneurysms (90%) while 2 aneurysms (10%) had a residual neck (Raymond Ⅱ).The median follow-up time was 8.5(16.3)months(n M(n Qn R)),which had no significantly different from the initial treatment follow-up duration (15.5(27.0)months)(n U=157.7,n P=0.25).Upon follow up,2 aneurysms (10%) with immediate post-operative residual necks had recanalized again,including 1 aneurysm which had been re-treated via Y-configuration stenting.Symptomatic thromboembolic complications occurred in 6 patients,including 4 treated with Y-configuration stenting.No peri-operative hemorrhagic complications occurred,along with no operation-related permanent morbidity or mortality.Angle between the parent artery trunk and stented branch increased significantly from pre-operative(90.1±21.1)°to Post-operative and the last follow-up ((115.4±28.9)°,(132.6±26.8)°);n t=5.14,n P<0.01;n t=7.78,n P<0.01).n Conclusions:For recurrent intracranial bifurcation aneurysms after initial surgical clipping or simple coiling,stent assisted coil embolization proved safe and decreased the recurrence rate.