Comparison Of Postoperative Recovery Of Oculomotor Nerve Palsy Secondary Internal Carotid-posterior Communicating Artery Aneurysm With Microsurgical Clipping And Endovascular Coiling

Objective:To investigated the outcomes of microsurgery clipping and endovascular coiling for oculomotor never palsy(ONP)secondary to internal carotid-posterior communicating artery aneurysms(IC-PcomA),and analyzed the factors affecting the recovery of ONP.Methods:A retrospective analysis of 50 patients with ONP secondary to posterior communicating artery aneurysms,37 cases of microsurgery clipping and 13 cases of endovascular coiling,compared the recovery time of ONP when 3 months and 6 months after different operations,Multivariate logistic regression analysis was used to demonstrate the relationship between age,gender,hypertension,diabetes,aneurysm rupture,treatment interval,paralysis,aneurysm diameter,Hunt-Hess classification,surgical procedure and postoperative ONP recovery.Result:At 3 months postoperatively,the complete recovery rate of the microsurgery clipping group(62.16%)was higher than that of the endovascular coiling group(38.46%).The partial recovery rate of the microsurgery clipping group(27.03%)was lower than that of the intervention group(46.15%).there was no significant difference between the two groups(P>0.05).The complete recovery rate of the clip group(75.68%)was higher than that of the endovascular coiling group(53.85%)after 6 months of operation.The partial recovery rate of the microsurgery clipping group(13.51%)was lower than that of the endovascular coiling group,there was no significant difference between the two groups(P>0.05)Univariate analysis of complete recovery patients with ONP whose treatment interval within two weeks(85.29%)was higher than after two weeks(46.15%)after surgery,statistically significant(P <0.05).and then logistic regression analysis of the treatment interval is an independent influencing factors(P<0.05),OR was 0.134(0.034,0.528),and the regression coefficient was-2.009.it can be seen that the treatment interval is negatively correlated with the treatment effect.The longer the treatment interval,the lower the probability of complete recovery,and the other factors have no statistically significant difference(P>0.05).Conclusion:Microsurgery clipping and endovascular coiling have an effect on therecovery of ONP,the recovery effect is not statistically different(P>0.05).Treatment interval is an independent influencing factor for the complete recovery of postoperative ONP.The earlier the treatment interval,the higher the complete recovery rate.