The Comparative Study Of Surgical Clipping And Endovascular Rreatment Of Intracramal Aneurysm

Objective:To compare surgical clipping and endovascular treatment of intracranial aneurysm and the related factors.Methods:collect63cases of patients with intracranial aneurysms treated in the Second Affiliated Hospital of Zhejiang University Department of Neurosurgery with complete clinical data from September2011to March2012, including35patients receiving surgical-clipping and28endovascular treatment.Retrospectively analyze the preoperative state, Hunt-Hess grading, head CT Fisher classification, history of hypertension, age, complications and post-discharge modified Rankin score level of the patients’data by the chi-square test, t test statistical methods.Results:30out of35patients in the surgical clipping group have good recovery after discharge (rate of85.7%),25out of28patients in the endovascular treatment group have good recovery after discharge(rate of89.3%). There is no significant difference of good outcome rate after discharge (chi-square test, p=0.297>0.05) between two groups of patients. The poor outcome rate of the patients in the same level of Hunt-Hess grade or Fisher grade patients has no statistically difference (p>0.05) between two groups. The poor outcome rate of the patients in the same age-group has no significant difference (p>0.05). A history of high blood pressure in patients with intracranial aneurysms has no statistical influence on the outcome of the patients. Two groups of patients are not statistically different (p>0.05) in the postoperative vasospasm rate, rebleeding of aneurysm rate, postoperative infection rate, postoperative hydrocephalus rate, postoperative lumbar puncture rate. The two groups are statistically different (p <0.05) in the operation duration, the average days of stay in hospital and treatment cost..Conclusion:The surgical clipping and endovascular interventional treatment can be effective in the treatment of intracranial aneurysms. Endovascular treated patients compared with patients in the surgical clipping group experience shorter operative duration, more rapid postoperative recovery and higher hospital costs. There is no significant difference in good outcome rate between two groups of patients after discharge. The poor outcome rate of the patients in the same level of Hunt-Hess grade or Fisher grade patients has no statistically difference between two groups.. Age and a history of high blood pressure in patients have nothing to do with good recovery rate. Two groups of patients are not different in the postoperative vasospasm rate, rebleeding of aneurysm rate, postoperative infection rate, postoperative hydrocephalus rate and postoperative lumbar puncture rate.