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Abstract：
Background: Very small intracranial aneurysms, generally considered to be those 3 mm in diameter or smaller, pose particular technical challenges for endovascular surgeons. For this reason, very small aneurysms have been excluded from many relevant studies. The aim of our research was to establish the risk factors for the occurrence of stroke complications after endovascular embolization of ruptured and unruptured small intracranial aneurysms. Methods: During the period of 2009-2023, our team performed endovascular embolizations of intracranial aneurysms in 1567 patients across four different centers within the territory of Serbia and Montenegro. Within the total number of patients mentioned, aneurysms of less than 4 mm were treated 185 times, with 119 ruptured and 66 unruptured. Results: In the group of 119 patients with ruptured small intracranial aneurysms, 19 (16%) patients had ischemia after the endovascular treatment, 6 (5%) patients had minor neurological deficits, while 13 (10.9%) patients had major neurological deficits, of which 6 (5%) patients died. In the group of 66 patients with unruptured small intracranial aneurysms, 7 (10.6%) patients had ischemia after the endovascular treatment, 5 (7.6%) patients had minor neurological deficits, and 2 (3.03%) had major neurological deficits. Multivariate binary logistic regression showed that the risk factors for the occurrence of ischemia were the patient\'s age, smoking and alcohol consumption. The type of endovascular treatment used also had a statistically significant effect on the development of ischemia. Conclusions: Understanding the influence of possible risk factors for the occurrence of ischemic insult after embolization of small intracranial aneurysms is of great importance. By recognizing them, periprocedural complications can be reduced to a minimum.
摘要：
背景：非常小的颅内动脉瘤，通常被认为是直径3毫米或更小的，对血管内外科医生构成特殊的技术挑战。出于这个原因,非常小的动脉瘤已被排除在许多相关研究之外.我们研究的目的是建立破裂和未破裂的颅内小动脉瘤血管内栓塞后卒中并发症发生的危险因素。方法：在2009-2023年期间，我们的团队在塞尔维亚和黑山境内的四个不同中心对1567例患者进行了颅内动脉瘤的血管内栓塞。在提到的患者总数中，小于4毫米的动脉瘤被治疗185次，119个破裂，66个未破裂。结果:119例颅内小动脉瘤破裂患者中,19例(16%)患者经血管内治疗后出现缺血,6例（5%）患者有轻微的神经功能缺损，13例（10.9%）患者有严重的神经功能缺损，其中6例（5%）患者死亡。在66例未破裂颅内小动脉瘤患者中，7例(10.6%)患者经血管内治疗后出现缺血,5例（7.6%）患者有轻微的神经功能缺损，2例（3.03%）有严重的神经功能缺损。多因素二元logistic回归分析显示,缺血发生的危险因素是患者的年龄,吸烟和饮酒。使用的血管内治疗的类型对缺血的发展也具有统计学上的显着影响。结论：了解颅内小动脉瘤栓塞后发生缺血性损伤的可能危险因素具有重要意义。通过识别它们，围手术期并发症可以减少到最低限度。
