Last year, the interventional neurosurgery team of Qilu Hospital of Shandong University completed the first case of Solitaire Y-shaped stent-assisted spring-ring embolization of a wide carotid aneurysm at the bifurcation of the middle cerebral artery in our province. The patient, a 60-year-old female, had a sudden onset of headache and dizziness with nausea and vomiting, right limb convulsion and urinary incontinence after activity in the morning, and was admitted to the local hospital in an emergency for cranial CT examination: arachnoid cavity hemorrhage, and external cranial CTA and DSA showed multiple intracranial aneurysms (right internal carotid artery posterior communicating aneurysm and right middle cerebral artery aneurysm). After the patient was admitted to the hospital, the experts of the department discussed and formulated a “two-step” treatment plan for endovascular interventional embolization. After adequate preoperative preparation, Professor Yunyan Wang of the Department of Neurosurgery first performed spring coil embolization of the right internal carotid artery posterior communicating aneurysm. After the operation, the patient’s headache was relieved, and under the careful care of the neurosurgery staff, the patient recovered well in general. The other intracranial middle cerebral artery bifurcation aneurysm, with a larger aneurysm and wider neck, and involving both trunks of the M2 segment of the middle cerebral artery, was difficult and risky to operate. Traditional interventional treatment methods are often not easy to embolize completely and have a high recurrence rate of the aneurysm after surgery. Based on the patient’s condition, the interventional treatment team fully discussed and developed a detailed interventional treatment method, and proposed to perform the newly developed international “Y-shaped stent” assisted embolization treatment. Two weeks later, Associate Professor Yunyan Wang led the interventional team to perform Solitaire Y-shaped stent-assisted spring-ring embolization to treat a wide carotid aneurysm of the middle cerebral artery bifurcation: the ENVOY guiding catheter was placed into the distal internal carotid artery through the right femoral artery sheath, the microcatheter was placed into the lower and upper trunks of the right middle cerebral artery in turn, and the two Solitaire stents were made into a The two Solitaire stents were made into a “Y” shape (see the figure below), spanned the aneurysm neck and released, and then five microsprings were delivered into the aneurysm. The middle cerebral artery and branches were well visualized intraoperatively, and the patient was immediately cured by imaging. The patient’s postoperative headache was relieved, and after a week of postoperative recovery, the patient was discharged from the hospital cured. The endovascular treatment of wide carotid aneurysms has been a major technical challenge in the field of interventional therapy. Although the application of balloon-assisted spring coil embolization techniques, new three-dimensional spring coils, and differently coated spring coils have enabled better immediate results in the embolization of intracranial aneurysms, the high recurrence rate is an insurmountable obstacle. Because most aneurysms are hemodynamically relevant, a new approach to treating aneurysms is now being used internationally – Flow diverter, which focuses the endovascular treatment of aneurysms on the aneurysm-carrying artery and treats the aneurysm by altering the flow pattern. flow diverter technology can be implemented in two ways: 1) using a dedicated dense mesh stent; 2) using other stent combinations, overlapping stents, X- or Y-shaped stents in the bifurcation section, etc. The dense mesh stent is still in the experimental demonstration stage as it is not yet officially available in China. For wide-necked or large or giant aneurysms, the “Y” stent can prevent the spring ring from protruding into the aneurysm-carrying artery by mechanical blocking, and can reduce the possibility of aneurysm recurrence by redirecting blood flow and promoting endothelialization of the aneurysm neck, which is a great advantage that is difficult to replace at present. However, the “Y” stent is difficult and risky to perform, and requires a high level of skill, technique and experience, so it has not yet been performed in the province. The Solitaire stent is a new stent system just released by EV3, which has the advantages of high plasticity, good controllability, and repeatable intraoperative release and recovery. Prof. Yunyan Wang, for the first time, perfectly combined the Solitaire stent and the “Y” shaped stent shaping technology, and successfully completed the embolization of huge, complex and wide carotid middle cerebral artery aneurysm, which filled the gap in the province.