Interventional cerebrovascular medicine is the study of the diagnosis and direct treatment of cerebrovascular diseases using intravascular interventional techniques under the monitoring and guidance of medical imaging. Transcatheter digital subtraction cerebral angiography, intravascular ultrasound imaging, optical laminography for the diagnosis of atherosclerosis and cerebrovascular stenosis, embolization of cerebral arteriovenous malformations, spring coil filling of cerebral aneurysms, embolization of severe rhinorrhea and blood-rich tumors of the head and face, ultra-early arterial selective thrombolysis in thrombotic cerebrovascular disease, thrombolysis of intracranial venous thrombosis, angioplasty and stenting, cerebral artery The repair of endothelial entrapment and intra-arterial chemotherapy for malignant glioma are all within the scope of this discipline, which covers most of the contents of vascular neurology. In the past 10 years, due to further research on cerebrovascular anatomy, the continuous development of electronic computer technology, imaging technology, angiography technology, catheters, embolic materials and non-ionic contrast agents, the scope of research has been broadened, the research methods have been changing day by day, and the therapeutic effects have been perfected. Interventional treatment methods for cerebrovascular disease mainly include: a. Head and neck, intracranial vascular lesion diagnosis “gold standard” Digital subtraction whole brain angiography (digitalsubtractangiography, DSA) is one of the most effective methods to examine cerebrovascular disease. It is performed by injecting an iodine-containing contrast agent into the internal carotid artery or vertebral artery to visualize the cerebral vessels to understand the morphology and lesions of the cerebral vessels themselves, as well as the nature and extent of the lesions. This test is of special value in the diagnosis of cerebrovascular disease. It is one of the most important tests for the diagnosis of cerebrovascular disease. It can visually determine the degree and extent of stenosis and observe the collateral circulation; the lesions shown are more intuitive, and it is better than other imaging tests in determining the source and number of diseased supply arteries, the direction of draining veins, and the degree of stenosis of diseased vessels. Endovascular arterial thrombolysis There are regional intra-arterial thrombolysis, early super-selective intra-arterial contact thrombolysis and venous sinus contact thrombolysis. Regional intra-arterial thrombolysis is performed by injecting thrombolytic agent into the large blood vessel where the lesion is located with a catheter. The dose of thrombolytic agent used is small, with few side effects, and the operation is simple and easy, and it is suitable for intracranial large vessel embolism and thrombosis, such as in the internal carotid artery and vertebrobasilar artery. Early super-selective intra-arterial contact thrombolysis means that after the site of vascular occlusion is clarified by routine DSA, a microcatheter with multiple lateral holes is used to selectively enter the arterial embolism and inject thrombolytic agent directly before and after the embolus and within the embolus, which is suitable for occlusion of all branches of large and small vessels above the internal carotid artery and occlusion of the vertebrobasilar system. Venous sinus contact thrombolysis is performed by puncturing the femoral artery using the Seldinger technique and performing cerebral angiography via the femoral artery to show the site and extent of venous sinus thrombosis. A catheter is delivered from the vein to the venous sinus for thrombolysis, which is suitable for venous sinus thrombosis. Cerebral artery aneurysm is called cerebral aneurysm clinically because the wall of cerebral artery gradually thins and expands abnormally due to local congenital defects of cerebral artery wall and increased pressure in the lumen, which is related to hypertension, cerebral arteriosclerosis, infection, trauma, etc. and has family genetic tendency. Because the thinning and bulging cerebral artery wall is prone to rupture and bleeding, which is a serious threat to life, people describe cerebral aneurysm as a “time bomb” that can explode at any time. Spontaneous subarachnoid hemorrhage belongs to the category of hemorrhagic cerebrovascular disease, and the main cause is the rupture of intracranial aneurysm, which accounts for more than 80% of cases. Unless the patient is in a dying state, early diagnosis and early treatment by cerebral angiography is preferred. Carotid artery stenting (CAS) is often associated with atherosclerosis and arterial stenosis in patients with long-term hypertension, diabetes mellitus and hyperlipidemia. Carotid artery stenosis is mostly caused by carotid atherosclerotic plaque and is commonly found in the bifurcation of the common carotid artery and the beginning segment of the internal carotid artery. Carotid stenting has a success rate of over 90% for carotid stenosis with few complications and is the main treatment for ischemic cerebrovascular disease.CAS is now increasingly used and comparative studies with endovascular debulking procedures are now being performed both nationally and internationally. A recently updated global registry survey showed >12,000 CAS cases with a technical success rate approaching 99% and an overall mortality and stroke incidence of <5%. Increasingly, the routine use of cerebral protection devices can reduce the complication rate to <2%. V. Interventional embolization of arteriovenous malformations (AVMs) AVMs are a mass of abnormally developed vessels containing arteries and veins and directly connected at multiple sites without intervening capillary intervals, and the masses vary in size. It can occur in all parts of the brain, most often at the junction of the cortex and white matter, and is mostly cone-shaped, with its broad base located in the cortex and its tip pointing to the white matter. AVM is characterized by low arterial pressure and high venous pressure due to direct arteriovenous communication. Low arterial pressure causes insufficient blood supply to the brain tissue in the blood supply area, and prolonged "blood theft" can cause atrophy of the surrounding brain tissue. Meanwhile, high venous pressure can cause poor reflux of brain tissues in the corresponding area, resulting in local bruising and cerebral edema, as well as disturbance of cerebrospinal fluid absorption and secretion, which can lead to symptoms of cranial hypertension, and at the same time, because the tissue structure of venous blood vessel wall is weaker and less elastic than that of arterial blood vessel wall, the increase of venous pressure can make it easier to rupture and bleed. In the past, the treatment of cerebral AVM mainly consisted of surgical resection and conservative medical treatment. In recent years, with the development of science and technology, minimally invasive treatment methods such as gamma knife and endovascular intervention have emerged, which enriches the treatment methods and represents a trend of minimally invasive treatment of the disease in international medical treatment. The advantages of interventional neuroradiotherapy for cerebral AVM are less trauma, less relative risk, fewer sequelae, faster postoperative recovery, etc. However, there are also disadvantages such as higher costs and more difficult to completely eradicate in patients with certain pathological conditions, and now it is often advocated to use multiple means of combined treatment. the interventional treatment of AVM mainly adopts the method of embolization of the malformed vascular mass. Although there are various ways of embolization, but the basic method is the same, they all adopt the built-in microcatheter of the guiding catheter and inject the embolization material into the malformation mass through the blood supply artery of AVM, only the embolization materials used are different, at present, the main ones used are NBCA biogel, ONXY biogel, spring ring and wire segment, etc., among which biogel embolization is the most effective and is also more commonly used internationally. It is also the most commonly used internationally. The operation is usually performed under general anesthesia, which can keep the patient in a quiet state and avoid accidents due to the increase of blood pressure caused by agitation, and the surgeon can also complete the operation in a stable state. During and after treatment, the patient should have blood pressure lowered to prevent the perfusion pressure from breaking through, and some anticoagulation should be given to prevent reverse thrombosis.