Intracranial arterial stenosis combined with intracranial aneurysms: risk factors for aneurysmal rupture and postoperative complications
10.3760/cma.j.cn115354-20240313-00159
- VernacularTitle:颅内动脉狭窄合并颅内动脉瘤时动脉瘤破裂及术后并发症的危险因素分析
- Author:
Xiao LIU
1
;
Zhenjun LI
;
Wangqing HE
;
Lei WU
;
Xin ZHANG
;
Xifeng LI
;
Chuanzhi DUAN
;
Xuying HE
Author Information
1. 南方医科大学珠江医院神经外科中心脑血管病外科，国家临床重点专科，脑血管病诊断与治疗教育部工程研究中心，广东省普通高校脑功能修复与再生重点实验室，广东神经外科研究所，广州 510282
- Keywords:
Intracranial aneurysm;
Intracranial arterial stenosis;
Aneurysm rupture;
Interventional treatment;
Complication
- From:
Chinese Journal of Neuromedicine
2024;23(4):357-365
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors for aneurysm rupture and post-intervention complications in intracranial arterial stenosis patients with intracranial aneurysms.Methods:A retrospective analysis was performed; 238 intracranial arterial stenosis patients with intracranial aneurysms (306 intracranial aneurysms) admitted to Cerebrovascular Disease Department, Neurosurgery Center, Zhujiang Hospital, Southern Medical University from January 2018 to August 2022 were chosen. Ruptured group and unruptured group were divided according to the rupture of intracranial aneurysms. Additionally, 139 patients who underwent interventional therapy and had complete follow-up data were divided into 2 groups according to occurrence of post-intervention complications. Univariate and multivariate Logistic regression analyses were used to identify the risk factors for aneurysm rupture and post-intervention complications.Results:(1) Of 238 patients, 269 unruptured aneurysms and 37 ruptured aneurysms were noted. Univariate regression analysis showed that significant difference was noted between the ruptured group and unruptured group in female ratio, aneurysm distribution, proportion of irregular shaped aneurysms, percentages of patients with increased white blood cell count, neutrophil count, total cholesterol and D-2 polymer, and percentage of patients with decreased blood lymphocyte count ( P<0.05). Multivariate Logistic regression analysis showed that irregular shaped aneurysms ( OR=12.393, 95% CI: 4.114-37.332, P<0.001), elevated neutrophil count ( OR=18.753, 95% CI: 6.555-53.648, P<0.001), and increased D-2 polymer ( OR=4.410, 95% CI: 1.758-11.065, P=0.002) were independent risk factors for aneurysm rupture in intracranial arterial stenosis patients with intracranial aneurysms. (2) Of the 139 patients, 57 had complications and 82 had no complications. Univariate regression analysis showed that the proportion of patients with hypertension history, distribution of arterial stenosis, and proportion of patients with elevated blood D-2 polymer were significantly different between patients with and without complications ( P<0.05); while multivariate Logistic regression analysis did not identify these 3 indexes as independent risk factors for post-intervention complications ( P>0.05). Conclusion:Patients with irregular shaped aneurysms, elevated blood neutrophil count and D-2 polymer trend to have aneurysm rupture; hypertension history, arterial stenosis, and elevated D-2 polymer have impact on postoperative complications in intracranial arterial stenosis patients with intracranial aneurysms.
