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目的:对比支架辅助弹簧圈栓塞与血流导向装置(FD)治疗大型和巨大型颅内动脉瘤的临床及影像学疗效。方法:回顾性分析2014年1月至2019年1月郑州大学第一附属医院神经介入科收治的64例大型和巨大型(直径≥20 mm)颅内动脉瘤患者的临床资料，其中应用支架辅助弹簧圈栓塞治疗23例(简称支架辅助栓塞组)，应用FD治疗41例(FD组)。比较两组患者术后即刻动脉瘤栓塞程度、并发症的发生情况、临床和影像学随访结果。结果:术后即刻疗效方面，支架辅助栓塞组中，Raymond分级Ⅰ、Ⅱ、Ⅲ级者分别占34.8%(8/23)、21.7%(5/23)、43.5%(10/23)；FD组中分别占19.5%(8/41)、17.1%(7/41)、63.4%(26/41)，两组的差异无统计学意义(n P>0.05)。支架辅助栓塞组与FD组术后总体不良事件发生率的差异有统计学意义[30.4%(7/23)对比7.3%(3/41)，n P0.05). Incidence of overall postoperative adverse events was 30.4% (7/23) in SAC group and 7.3% (3/41) in FD group, and there was significant inter-group difference (n P<0.05). The disability rate was 26.1% (6/23) in SAC group and 4.9% (2/41) in FD group (n P0.05). At 12 months post operation, DSA was performed in 16 cases in SAC group and 35 cases in FD group. The ratios of Raymond grade Ⅰ, Ⅱ, Ⅲ in SAC group were 4/16, 8/16, 4/16 respectively , while those in FD group were 71.4% (25/35), 22.9% (8/35), 5.7% (2/35) respectively (n P<0.05). The recurrence rate was 4/16 in SAC group and 0/35 in FD group, and there was significant difference between two groups (n P0.05).n Conclusion:Compared with SAC, FD is associated with better efficacy at follow-up and a lower rate of perioperative complications in the treatment of large and giant intracranial aneurysms.