Comparison Of The Efficacy Of Microsurgery And Endovascular Embolization For The Treatment Of High Grade Aneurysms

Objective:To study the relatively high level aneurysm microsurgery and endovascular surgery effect.Methods:A retrospective analysis of January 2014-November 2016 at the Second Affiliated Hospital of Nanchang University neurosurgeon treated 54 cases of high-grade intracranial aneurysms(complete medical records).Clipping patients 30 patients,24 patients embolization.Comparative history of hypertension patients take two methods of operation,age,complications and improve Rankin score at discharge levels and other clinical data were analyzed using t test,chi-square test and other statistical methods.Results:In 30 cases of surgical clipping of the patients,26 patients discharged with good prognosis,accounting for 86.67%,4 cases with poor prognosis,accounting for 13.33%;24 cases of patients with intravascular embolization,22 cases were good prognosis,accounted for 91.67%,poor prognosis in 2 cases,accounting for 8.33%.There was no significant difference between the two groups in the prognosis of the hospital discharge and the rate of adverse events(chi square test,p>0.05).There was no significant difference in prognosis between the two groups in the same age group(P>0.05).The history of hypertension had no effect on the prognosis of the discharged patients.In two groups of patients with postoperative complications(aneurysm breaking,postoperative infection,hydrocephalus,cerebral vasospasm,lumbar puncture and mortality)were not statistically different between(P>0.05).There was a significant difference in mean operative time and average length of stay(P<0.05).Conclusions:In the treatment of patients with high levels of aneurysms,early surgical options craniotomy microsurgery and endovascular interventional procedures can be both surgical outcomes showed no significant difference.However,endovascular surgery is shorter than the clipping surgery,postoperative recovery faster,higher cost of hospitalization.But if when patients have a greater intracranial hematoma,craniotomy microsurgical clipping surgery should be preferred,because while clipping the removal of intracranial hematoma can be obtained prognosis than ideal.