Prognostic effects of interventional embolization at different time points on patients with ruptured intracranial aneurysms of Hunt-Hess Ⅳ-Ⅴ level
10.3760/cma.j.issn.1005-1201.2014.06.013
- VernacularTitle:介入治疗时机对Hunt-Hess高分级颅内动脉瘤破裂治疗效果的影响
- Author:
Yan ZHANG
;
Xiaoming YANG
- Publication Type:Journal Article
- Keywords:
Intracranial aneurysm;
Embolization,therapeutic;
Postoperative complications;
Prognosis
- From:
Chinese Journal of Radiology
2014;(6):492-495
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate prognostic effects and complications of interventional embolization at different time points on patients with ruptured intracranial aneurysms of Hunt -Hess Ⅳ-Ⅴlevels.Methods Through a retrospective analysis from 2008.1 to 2012.12, we collected 162 from 200 patients who underwent interventional embolization due to ruptured intracranial aneurysms according to the criteria.Patients with serious neurological disorders , coma, and end-stage diseases were excluded.Brain CT scan was performed to identify the spontaneous subarachnoid hemorrhage of the patients , followed by CTA or digital subtraction angiography ( DSA) to ensure the accurate diagnosis of intracranial aneurysms.All of the patients at Hunt-HessⅣ-Ⅴlevels were treated with interventional embolization , and were divided into two study groups:early stage therapy group of 79 patients ( embolization at the time <72 hours after the onset) and late stage therapy group of 83 patients ( embolization at the time ≥72 hours after the onset ).Factors including pre-and post-interventional Glasgow coma score ( GCS ) and Glasgow outcome score , ( GOS) as well as barthel index ( BI ) were statistically compared between the study groups.T-test was performed to compare the data between the two study groups.Chi-square test was taken to evaluate the enumeration data.And the correlation of therapeutic time and prognosis of patients was demonstrated by binary regression analysis.Results In the patients with ruptured intracranial aneurysms at Hunt-Hess Ⅳ-Ⅴlevels, early stage intervention (63.5 ±13.5) resulted in significantly better BI after three months , and demonstrated better recovery in comparison to the late stage intervention group (34.8 ±12.7) ( t=6.127, P<0.05).But no statistical significance of post-operative GCS (6.6 ±1.6 in early therapy group;6.1 ± 1.4 in late therapy group ) and discharging GOS ( 3.0 ±0.7 in early therapy group; 2.9 ±0.7 in late therapy group) was found between the two groups (t=1.822, 0.631 respectively; P>0.05).The early therapy group also presented a significant decrease of complications , such as hydrocephalus (χ2 =6.369, P<0.05 ) and venous thrombosis (χ2 =5.158, P <0.05 ), compared to the late therapy group.Furthermore, Statistical analysis revealed that therapeutic time closely correlated with the prognosis of patients with ruptured intracranial aneurysms at Hunt-Hess Ⅳ-Ⅴ levels ( P =0.009, OR =3.897).Conclusion The early stage therapy can improve the prognosis and decrease incidence of complications , which should benefit the efficient management of the patients with interventional embolization of ruptured intracranial aneurysms.
