Clinical Analysis Of Clipping And Endovascular Treatment For Wide-necked Intracranial Aneurysms

Objective:To discuss curative effect of wide-necked intracranial aneurysms which were treated with different methods.Methods:A series of149patients with wide-necked intracranial aneurysm which underwent surgical clipping and endovascular treatment were analyzed retrospectively, the modified Rankin Scale(mRS) was used to evaluate the outcome. mRS score=0-2was defined as good outcome and mRS score=3-6score was defined as poor outcome. Hunt-Hess grade、CT Fisher grade and location of aneurysms that might affect the mRS of Surgical clipping and Endovascular treatment were analyzed. The recurrence rate、complication and average length of stay of the two groups were all compared.Results:Hunt-Hess grade was positively related to mRS of the two treatment, patients with higher Hunt-Hess grade may had worse clinical effects (P<0.05); CT Fisher grade was positively related to mRS of the two treatment, patients with higher CT Fisher grade may had worse clinical effects (P<0.05). Modified Rankin Scale in the two groups,which were in the same grade of Hunt-Hess and CT fisher did not differ significantly (P>0.05). The recurrence rate and average length of stay of the two groups had significant difference (P<0.05)Conclusion:The clinical effects and outcomes of the wide-neckde intracranial aneurysms can be remarkably affected by Hunt-Hess grade of patients; The clinical effects and outcomes in the two groups,which were in the same grade of Hunt-Hess did not differ significantly (P>0.05); The clinical effects and outcomes of the surgical groups can be remarkably affected by CT fisher grade of patients; The clinical effects and outcomes in the two groups,which were in the same grade of CT fisher Ⅰ、Ⅱ and Ⅳ did not differ significantly (P>0.05).The patients of endovascular group had better outcomes than the patients of suigical group, which were in the same CT fisher Ⅲ grade. The clinical effects and outcomes in the anterior circulation,which were in the same aneurysm location did not differ significantly (P>0.05).The recurrence rate、complication and average length in the two groups had difference significant;The long term effection of surgical clipping and endovascular treatment need further investigation.