120 Cases Of Intracranial Aneurysm Endovascular Interventional Treatment Of Clinical Research

Objective:The essay is to make a retrospective analysis of the clinical data of patients with intracranial aneurysms, clinical characteristics and treatment outcomes. Then it discusses about safety, availability, and the proportion of complications and radiographic recurrence of intracranial aneurysm endovascular treatment and related factors that influence post-recovery. Through the summary of clinical experiences, the references can be offered for the further clinical treatment.Method:A retrospective analysis is made by collecting clinical materials of 120 intracranial aneurysms endovascular patients who are in the First Hospital of Shanxi Medical University Neurosurgery from January 1, 2012 to June 30, 2014. The analysis includes the sex ratio, morbidity age, aneurysm growth area and Hunt-Hess shape, size and preoperative classification. Approach also surgery and embolization situation. There is also preoperative complications analysis, MRS assessment and clinical and radiologic follow-up conclusions. The SPSS13.0 software is used for statistical analysis and X2 test,Fisher exact test and Wileoxon rank sum test are used for statistical methods.Results1. The group of 120 cases of intracranial aneurysms clinical information on patients,male 45 cases, female 75 cases, male to female ratio of 1: 1.667, with an average age of53.22 years. A total of 132 120 cases of patients with aneurysms of anterior circulationaneurysms 116, 16 posterior circulation aneurysms, aneurysms 68 small, 61 medium-sized aneurysms, aneurysms two large and giant aneurysms an irregular 59 aneurysm, dissection or fusiform aneurysm 5, irregular aneurysm 59, cystic artery aneurysm 68, wide-necked aneurysms 98, 34 narrow-necked aneurysms.2. Surgical number of cases before the Hunt-Hess grade of 0-III grade 110 cases, IV-V grade 10 cases. Successful treatment of 127 aneurysms, 65 cases make use of simple coil embolization, 62 cases of the use of stents to assisted coil embolization. And in contrast immediately after surgery showed dense aneurysm embolization number is 86, the residual aneurysm neck 36, section 5embolism. Wide neck and narrow neck aneurysm embolization extent on instantly without the significant difference(P>0.05), stent assisted coil group aneurysm neck residual rate than a simple coil embolization was lower, dense embolization and partial embolization degree the difference was not statistically significant(P>0.05). Perioperative complications in 12 cases, the rate was 10%, including 5 cases of thrombosis surgery, intraoperative aneurysm rupture in 4 cases, 2 cases of severe cerebral vasospasm, one case of postoperative acute hydrocephalus, killing two people, fatality rate of 1.6%, maimed six people, five percent disability. The method involved and the width of the aneurysm neck intracranial aneurysms during thrombus was not an independent risk factor(P>0.05)occurred during embolization.3. discharged with good prognosis(MRS score 0-2 points)113 cases, the prognosis is poor(MRS score 3-6), 7 cases of disability(MRS score 3-5points) 5 cases, 4.2% morbidity, mortality(MRS score 6 points) two cases, death rate of1.7%. Before surgery Hunt-Hess grading for 0-III IV-V grade level and the patient was discharged when the MRS scores were compared, there exists a significant difference was statistically significant(P<0.01), Clinical follow-up 85 patients were followed up for 3-12 months, with an average 7.2 months, the prognosis is good(MRS score 0-2 points) in78 cases, poor prognosis(MRS score 3-6 points) seven cases, four cases of disability,disability rate of 4.7%, 2 patients died, the mortality rate was 2.4%. Before surgery Hunt-Hess grade specific grade 0-III the prognosis is good for 70, IV-V grade 12 cases in eight cases with good prognosis, two MRS prognostic score 73 the difference was statistically significant(P<0.01). Imaging follow-up 70 cases of 78 aneurysms were followed up for 3-10 months, an average of five months, 54 embolism in stable condition,nine improved recanalization 15, 7 line again embolization, all dense embolism, does not appear complications. Three partial recanalization rate compared to the highest rate of recanalization embolization group(P<0.01). Stand alone adjuvant therapy group with coil embolization group recanalization rate, the difference was not statistically significant aspects of the(P>0.05). Wide-necked aneurysms overall recanalization rate than can narrow neck of the aneurysm to be higher(P<0.05), the treatment of wide-necked aneurysms method used stent assisted coil spring ring than simple therapy can significantly reduce recanalization ratio(P<0.01).Conclusions1. Endovascular embolization therapy for the treatment of intracranial aneurysms is safe and effective. Aneurysm aneurysm neck size doesn’t affect first aneurysm embolization. Coil bracket to assist the implementation of embolization can reduce the residual rate for the first time embolization of aneurysm neck; There is no association between thrombosis with interventional and artery surgery presence of wide-necked aneurysms.2.Hunt-Hess classification level for 0-IIIpatients, the prognosis for survival than patients with grade IV-Vsignificantly better; and stand as a secondary High coil embolization group, which then pass rate than the simple coil embolization of the group, but there is no difference between the two sides and statistical aspects; Stent assisted coil therapy can significantly reduce the wide-necked aneurysm recanalization ratio; and wide neck aneurysms recanalization rate than the narrow neck of the aneurysmlarge; recanalization ratio aneurysm embolization obtained as the highest part;intravascular treatment because of its relatively high rate of recanalization, it requires long-term follow-up imaging studies; and recanalization of the aneurysm and then treated with the safety and necessity.