1.Endovascular embolization for the treatment of posterior circulating aneurysms in 65 patients
Xiaohui LI ; Ge HUANG ; Zhengjian FENG ; Shengqiang JIANG ; Kang WANG ; Jinlang HE ; Zhibin LI ; Yi WU
International Journal of Cerebrovascular Diseases 2018;26(4):277-282
Objective To summarize the experience of endovascular embolization for the treatment of posterior circulation aneurysms. Methods The clinical and follow-up data of 65 patients with posterior circulation aneurysm treated with endovascular embolization in Jiangmen Central Hospital, Guangdong Province were analyzed retrospectively. Results A total of 65 patients with posterior circulation aneurysm received endovascular embolization in Jiangmen Central Hospital, including 30 females (46.2%) and 35 males (53.8%). Their age ranged from 37 to 76 years old(mean 57.3 ± 10.25).Ruptured aneurysms were found in 57 cases (87.7%) and unruptured aneurysms were found in 8 cases (12.3%). Parent arteries:22 (33.8%) in vertebral artery,23 (35.4%) in basilar artery,3 (9.2%) in posterior cerebral artery,2 (3.1%) in superior cerebellar artery, 2 (3.1%) in anterior inferior cerebellar artery, and 10 (15.4%) in posterior inferior cerebellar artery. Hunt-Hess grade:gradeⅠin 15 cases,gradeⅡin 29 cases,gradeⅢin 11 cases, grade Ⅳ in 6 cases, and grade Ⅴ in 4 cases. Twenty-one patients (32.3%) were treated with coil embolization alone,29 (44.6%) were treated with stent-assisted coil embolization, 6 (9.2%) were treated with stenting alone, and 9 (13.8%) were treated with parent artery embolization. Immediate angiography after surgery revealed that 54 patients (83.1%) were completely embolized, and 11 (16.9%) were not embolized completely. Three patients (4.6%) complicated with cerebral infarction, 2 (3.1%) had intraoperative rupture,2 had respiratory disturbance(3.1%),1 (1.5%) had hoarseness, and 1 had vitreous hemorrhage (1.5%).At discharge,the modified Glasgow outcome scale assessment showed that 53 patients (81.5%) had excellent outcome,5 (7.7%) had good outcome, and 7 (10.8%) had poor outcome. Of the patients with poor outcome, 2 (3.1%) died. Thirty-four patients (52.3%) were followed up by angiography, of whom 6 (17.6%) recurred, and 1 died of complicated cerebral infarction. Conclusion Although endovascular treatment of posterior circulation aneurysms is difficult, flexible selection of endovascular treatment may achieve good therapeutic effect.