Safety and effectiveness of stent-assisted coil embolization in treatment of acute intracranial rupture wide-necked aneurysms
10.3760/cma.j.cn115354-20201011-00798
- VernacularTitle:支架辅助弹簧圈栓塞治疗急性期颅内破裂宽颈动脉瘤的安全性和有效性观察
- Author:
Hongliang MENG
1
;
Zhenjun LI
;
Heng ZENG
;
Chuanzhi DUAN
;
Xifeng LI
;
Xin ZHANG
;
Xuying HE
Author Information
1. 南方医科大学珠江医院神经外科，国家临床重点专科，教育部工程技术研究中心，广东神经外科研究所，广东省脑功能修复与再生重点实验室，广州 510282
- Keywords:
Intracranial aneurysm;
Rupture;
Wide neck;
Stent;
Coil embolization
- From:
Chinese Journal of Neuromedicine
2021;20(6):584-589
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and effectiveness of stent-assisted coil embolization in treatment of acute intracranial rupture wide-necked aneurysms.Methods:A total of 249 patients with acute intracranial wide-necked aneurysms (301 aneurysms) treated with stent-assisted coil embolization in our hospital from January 2014 to December 2018 were chosen in our study; these patients were divided into ruptured group ( n=114) and non-ruptured group ( n=135). The differences in the prognoses (modified Rankin scale [mRS] scores) and perioperative complications, mortality, and aneurysm recurrence rate were retrospectively analyzed. Univariate analysis and multivariate Logistic regression analysis were used to screen the risk factors for perioperative complications and recurrence of aneurysms in patients from the ruptured group. Results:The incidence of perioperative complications in the ruptured group (10.5%) was slightly higher than that in the un-ruptured group (6.6%), and the recurrence rate of aneurysms in the un-ruptured group (12.8%) was slightly higher than that in the ruptured group (9.6%), but the differences were not statistically significant ( P>0.05); except for 2 patients in the ruptured group who died of postoperative recurrent hemorrhage, the prognosis of the rest patients in the 2 groups was good (mRS scores≤3). Univariate analysis showed that there was significant difference in the age distribution between the complication group and the non-complication group in the ruptured patients ( P<0.05), and the sizes and degrees of embolization between the ruptured group and un-ruptured group showed significant differences ( P<0.05). Multivariate Logistic regression analysis showed that ages at 40-60 years was independent risk factor for perioperative complication ( OR=17.819, 95%CI: 2.356-137.719, P=0.005), and aneurysm diameter>10 mm and aneurysm Raymond grading 3 embolization were independent risk factors for aneurysm recurrence ( OR=36.823, 95%CI: 0.862-768.308, P=0.000; OR=52.813, 95%CI: 2.967-938.152, P=0.007). Conclusion:Stent-assisted coil embolization in the treatment of acute intracranial rupture wide-necked aneurysms is safe and effective, but patients aged 40-60 years should be wary of high incidence of perioperative complications, and patients with large aneurysms and incomplete embolization should be wary of their high risk of aneurysm recurrence.
