The Curative Effect Evaluation Of Endovascular Treatment Of Ruptured Intracranial Aneurysm

Objective: To evaluate the clinical efficacy of endovascular embolization treatment of ruptured intracranial aneurysms, and analyze the complications and the factors affecting the prognosis.Methods: Ruptured aneurysm cases selected from January 2012 to January 2016 in Qinghai People’s Hospital Interventional Radiology treatment 79 cases, 11 cases of multiple aneurysms, a total of 91 aneurysms. Endovascular treatment of 80 aneurysms, 78 aneurysms only handle responsibility, and one patient treated two aneurysms. 49 narrow-necked aneurysms using coil embolization alone; 31 for the wide-necked aneurysms using stent assisted embolization. And preoperative GCS score, Hunt-Hess grade, CT-Fisher grade, surgical time, surgical procedures, embolization degree, surgical complications, GCS score(1 month after the first hemorrhage), mRS score after the(first hemorrhage 1 month), and other clinical follow-up data were analyzed statistically, when P<0.05, the difference was statistically significant.Results: The group of 79 patients had successful surgery, early surgery(≤ 3 days) in 13 cases, the mid-surgery(4-10 days) in 52 cases, late surgery(＞ 10 days) in 14 cases. Good prognosis(mRS 0-2 points) 66 cases, the prognosis is poor(mRS 3-5 points) in 8 cases, death(mRS 6 points) in 5 cases. In January there was a significant difference(P<0.05) and preoperative GCS score after the first SAH. This group of patients liability aneurysm 79, responsibility aneurysm site(P>0.05), size(P>0.05) and clinical outcome(mRS) no significant correlation. 80 interventional endovascular aneurysm, immediate postoperative angiography: 49 total occlusion, aneurysm neck residual 22, most embolism 9. Surgical complications occurred in 21 cases, intraoperative rupture in 5 patients(6.3%), intraoperative thrombosis in 4 cases(5.0%), after four cases of cerebral infarction(5.0%), after cerebral hemorrhage in 2 cases(2.5%) postoperative arterial nerve palsy in 1 case(1.3%), after the death of five cases(6.3%). Hypertension and clinical outcome(mRS) there was a significant difference(P<0.05). Preoperative Hunt-Hess grade, preoperative GCS score, CT-Fisher grading and clinical outcome(mRS) patients correlated(P<0.05).Conclusions: 1. Within Endovascular treatment of ruptured intracranial aneurysms, can significantly reduce the risk of rebleeding aneurysms, improve the survival rate and reduce mortality, is currently the preferred method of treatment. 2. Responsibility aneurysm location, size and efficacy and the prognosis was no significant correlation. 3. For a different type of aneurysm should choose different treatment methods for narrow-necked aneurysms suitable for simple coil embolization, wide-necked aneurysms suitable stent assisted coil embolization, the efficacy of narrow-necked aneurysms better than wide-necked aneurysms. 4. Before preoperative Hunt-Hess grade, preoperative GCS score, CT-Fisher grade is an important factor affecting the prognosis of ruptured intracranial aneurysm patients. 5. Hypertension is intracranial aneurysm formation and rupture of the independent risk factor, and aneurysm rupture again the high risk factors for rebleeding.