Efficacy of dual microcatheter vascular interventional therapy for intracranial aneurysms in elderly patients
10.3969/j.issn.1009-0126.2024.12.018
- VernacularTitle:双微导管血管介入术治疗老年颅内动脉瘤的疗效
- Author:
Chengchen REN
1
;
Tao LIU
1
;
Yunda WANG
1
Author Information
1. 250132 济南市第三人民医院神经外科
- Publication Type:Journal Article
- Keywords:
intracranial aneurysm;
double microcatheter vascular intervention;
brain injury mark-ers;
cerebral oxygen metabolism
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(12):1467-1471
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the therapeutic efficacy of double microcatheter vascular inter-vention on senile intracranial aneurysms by adjusting brain injury markers and cerebral oxygen metabolism.Methods A total of 240 elderly patients with intracranial aneurysms diagnosed and treated in our hospital from January 2018 to February 2024 were recruited,and according to their treatment methods,they were divided into double microcatheter endovascular embolization group(study group,120 cases)and self-expanding stents combined with spring coils group(control group,120 cases).Therapeutic efficacy,prognosis,recovery of mental state,changes in brain injury markers,cerebral oxygen metabolism,and adverse reactions were compared between the two groups.Results There were no significant differences between the two groups in terms of the ratios of total embolization,subtotal embolization and incomplete embolization(P＞0.05).The study group obtained significantly higher complete recovery rate than the control group(74.2％vs 55.0％,P=0.019).The scores of memory ability,recall function,computing ability,concentration ability of attention,orientation function and language function were obviously im-proved in both groups after treatment(P＜0.01),and above scores were statistically higher in the study group than the control group(P＜0.01).In 1 d after treatment,arterial blood oxygen pres-sure,arterial blood oxygen,oxygen differences of internal carotid arterial and venous bulb,and cerebral oxygen uptake rate were significantly decreased,while oxygen partial pressure of internal jugular vein and internal jugular venous oxygen were obviously increased in both groups(P＜0.01).What's more,arterial blood oxygen partial pressure,arterial blood oxygen,oxygen differ-ence of internal carotid arterial and venous bulb and cerebral oxygen uptake rate were significantly increased in the two groups at 6 months after treatment than 1 d after treatment(P＜0.01).The study group obtained significantly higher partial pressure of arterial blood oxygen,arterial blood oxygen,internal jugular vein oxygen,internal jugular venous oxygen difference and cerebral oxy-gen uptake rate,while lower partial pressure of internal jugular venous oxygen than the control group in 1 d after treatment,and had notably higher partial pressure of arterial blood oxygen,ar-terial blood oxygen,oxygen difference of internal carotid arterial and venous bulb and cerebral ox-ygen uptake rate,and decreased partial pressure of jugular vein oxygen and jugular venous oxygen than the control group in 6 months after treatment(P＜0.01).No statistical significances were observed in the proportions of cerebral infarction,vasospasm,vasorestenosis and transient cere-bral hemorrhage between the two groups(P＞0.05).Conclusion Double microcatheter vascular intervention can further improve the therapeutic efficacy of elderly intracranial aneurysms by ad-justing brain injury markers and brain oxygen metabolism indicators.
