–When I first met Xiao Shao, it was hard to imagine that he was the patient with chronic heart failure combined with intracranial hemorrhage, and I was even surprised by his youth. After reviewing the patient’s medical history, I learned about his misfortune and why he was so seriously ill at the age of 29 in his prime. He became a father more than a month ago, and fortunately he was taken care of by the elderly and did not feel any discomfort. 2 weeks ago his father died in a sudden car accident, and he had to take care of his father’s funeral and his newborn child, so he finally collapsed physically and mentally. The diagnosis: congenital heart disease + chronic heart failure combined with subacute endocarditis. While the cardiothoracic surgeon was actively treating the heart failure and infection in preparation for surgery, the patient had a sudden onset of epilepsy accompanied by decreased consciousness and hemiparesis of the left limb, and the cranial CT showed an intracerebral hematoma of about 20 ml in the right parietal brain. It was obvious that the patient’s epilepsy and other neurological dysfunction was caused by this hematoma, but what was the cause of the hemorrhage? By cerebral angiography, the diagnosis was clear that most of the aneurysm hemorrhages are common with subarachnoid hemorrhage. There is only one rare type of aneurysm, the infected aneurysm, which tends to occur in the peripheral vessels, combined with the patient’s history of precordial + chronic infection and the site of bleeding consistent with it. Once anticoagulated, the original intracranial time bomb is likely to cause trouble again; craniotomy to clip the aneurysm and remove the abnormal vessel before dealing with the heart problem is obviously not suitable for this patient, not to mention the 4 or 5 hours of anesthesia, the bleeding during surgery, postoperative edema and infection, etc. Any of these complications could have pushed this unfortunate patient into the abyss. The other way is to perform interventional embolization followed by cardiac surgery, which can be solved with a small 2 mm incision at the root of the thigh, but the aneurysm is located in a distant part of the intracranial vasculature and is somewhat difficult to put in place. To cure such a very complicated case, it must be combined with sister departments, every step and every link must be taken into consideration. on July 31 DSA room, neurosurgery cerebrovascular group, cardiothoracic surgery, anesthesiology, radiology standby and start our rescue operation. Lying on the operating bed, the patient began to cough incessantly, and the attentive ones immediately judged that this was a sign of congestive pulmonary edema, and the operation time had to be shortened as much as possible, or the patient would most likely have heart failure aggravated by pulmonary edema. The experienced anesthesiologists started anesthesia, while the cardiothoracic surgeon closely monitored the patient’s vital signs. The hair-thin micro-catheter and micro-guide wire carefully entered the internal carotid artery under the guidance of the ROAD MAP, and finally reached the aneurysm through one bifurcation after another. The first spring coil was released according to the data measured in advance, and the blood flow in the aneurysm was already significantly slow. In view of the special characteristics of infected aneurysms, we did not use conventional embolization materials (continuing to use spring coils until they were densely packed) but used an embolic agent called ONYX in order to embolize the aneurysm and all the adjacent abnormal vessels. However, the distance between normal vessels and pathological vessels can only be calculated in millimeters, and the cost of a slight inadvertence to the patient’s normal vessels is paralysis of one arm or leg or even coma. The embolic agent in the syringe started to be pushed slowly, 0.1ml, 0.2ml, 0.3ml…, not enough, 0.1ml more, stop! The aneurysm embolization was completed and the normal blood vessel was unharmed, the operation took 57 minutes. The next day when I came to the monitoring room again to see Xiao Shao, he was still half lying down, his face was rosy, and he was joking with us while dancing around and expressing his gratitude. With the improvement of people’s living standard, the interventional treatment of intracranial aneurysm has been more and more accepted by everyone, it is less traumatic, fast recovery, satisfactory treatment effect, especially for some patients with critical conditions, such as Xiao Shao’s patients can not tolerate the conventional craniotomy, but the intervention can complete the task brilliantly. Since the establishment of the Cerebrovascular Specialized Group in Renji Hospital, a series of treatment norms for cerebrovascular diseases have been developed, especially for subarachnoid hemorrhage, which has a strict process and guidelines from pre-hospital emergency to admission screening to how to treat the disease, and the death and disability rate of the disease has improved significantly compared to 5 years ago. Modern medicine has placed higher demands on physicians, and the days of the so-called big, all-inclusive, know-it-all approach no longer exist. Our neurosurgery department has completed the subspecialty division of vascular disease, allowing more specialized people to do more specialized things. We look forward to when unfortunately you are lucky enough to meet us.