目的　对 1985年以来经手术治疗的 18例前循环巨大动脉瘤作一回顾性分析。方法　行动脉瘤瘤颈夹闭术 11例 ,动脉瘤孤立或孤立后切除 4例 ,动脉瘤切除或孤立后载瘤动脉重建 2例 ,动脉瘤包裹 1例。结果　动脉瘤瘤颈夹闭术的 11例病人中 ,除 1例术前Hunt Hess分级IV级的病人术后重残外 ,均恢复良好。动脉瘤孤立或孤立后切除的 4例病人中 ,1例后交通动脉瘤 (PCoA)病人虽术前血管造影证实侧支循环充分 ,但术后出现暂时性对侧轻偏瘫。另 1例大脑中动脉 (MCA)动脉瘤病人术后第 6天因术野血肿再次进行手术 ,出院时能独立行走。行动脉瘤切除或孤立后载瘤动脉重建的 2例病人恢复良好。动脉瘤包裹术的 1例病人术后因再出血死亡。结论　为消除巨大动脉瘤的压迫症状和潜在的出血危险 ,对前循环巨大动脉瘤主张积极的手术治疗。动脉瘤瘤颈夹闭并保留载瘤动脉通畅是首选治疗 ,对必需行动脉瘤孤立且交叉循环不良的病例 ,应尽可能重建载瘤动脉 Objective To retrospectively analyze 18 cases of giant aortic aneurysms treated with surgery since 1985. Methods Eleven cases with aneurysm neck clipping were performed. Four cases were isolated or isolated after aneurysmectomy. Two cases were reconstructed with aneurysm resection or isolation. One case was covered with aneurysm. Results Among the 11 patients with aneurysm neck clipping, except one patient with a preoperative Hunt Hess grade IV grade, all recovered well. Of the 4 patients with isolated or isolated aneurysms, 1 patient with posterior communicating artery aneurysm (PCoA) demonstrated adequate collateral circulation with preoperative angiography, but temporary contralateral hemiplegia occurred after surgery. Another case of middle cerebral artery (MCA) aneurysm was reoperated on the sixth day after operation for intraoperative hematoma and was able to walk independently when discharged. Two patients who underwent aneurysm resection or reconstruction of parent artery after isolation recovered well. One patient with aneurysm surgery died of rebleeding after surgery. Conclusion In order to eliminate the compression symptoms and potential bleeding risk of giant aneurysms, aggressive surgery is advocated for giant anterior circulation tumors. Aneurysm neck clipping and retention of the parent artery is the preferred treatment. For cases in which the aneurysm must be isolated and the crossover cycle is poor, the parent artery should be reconstructed as far as possible.