Comparative Study Of Different Number Or Type Of Stent-assisted Embolization Of Vertebrobasilar Dissection Aneurysm

Objective:This paper retrospectively analyzes the medical records of stent-assisted coil embolization in the treatment of vertebrobasilar dissection aneurysm in neurosurgery hospital affiliated to Southwest Medical University,discusses its safety and effectiveness,and compares the clinical effect of different number of stents or different types of stent therapy,with a view to better guiding clinical practice.Methods:To collect general clinical data(including sex,age,history of hypertension,history of diabetes,Hunt-Hess grade at admission),surgical complications,degree of aneurysm embolization and clinical and imaging follow-up of 42 patients with vertebrobasilar dissection aneurysm using stent-assisted embolization in the neurosurgical vascular group of our hospital from January 2013 to June 2019,according to the number of stent placement,it was divided into single stent treatment group(19 cases)and double stent treatment group(23 cases),and all patients were re-divided into LVIS/LVISJr stent treatment group(25 cases)and other stent treatment group(17 cases)according to the type of stent.All the patients’ treatment data were included in SPSS software for analysis and processing,and the quantitative data and qualitative data were used t test and chi-square test respectively.The results were statistically significant with P value <0.05 to evaluate the curative effect and prognosis of the patients.Results:In this study,42 patients successfully completed the surgical treatment,first of all,the general data of grouped cases(sex,age,history of hypertension,history of diabetes,clinical symptoms,and Hunt-Hess grade at admission)were statistically analyzed,and the grouped cases were comparable.1.Intraoperative complications(e.g.bleeding,thrombus,cerebral vasospasm,etc.)outcome analysis: single stent treatment group(3/19)and double stent treatment group(4/23),no statistical difference,LVIS/LVISJr stent treatment group(5/25)and other stent treatment group(2/17),no statistical difference;2.analysis of immediate postoperative findings: double stent treatment group(14/23)and single stent treatment group(9/19),no statistical difference,lvis/lvis jr stent treatment group(17/25)and other stent treatment group(6/17),The difference was statistically significant;3.For the results of discharge mRs score analysis: single stent treatment group(17/19)and double stent treatment group(20/23),the difference was not statistically significant;LVIS/LVIS Jr stent treatment group(22/25)and other stent treatment group(15/17),the difference was not statistically significant;4.For the effect of aneurysm embolization at mid-term follow-up: the double-stent treatment group(16/18)and the single-stent treatment group(7/13),the difference was statistically significant,and the difference was statistically significant between the LVIS/LVISJr stent treatment group(15/16)and other stent treatment groups(8/15);5,for the mid-term follow-up aneurysm recurrence rate: the double-stent treatment group(1/17)and the single-stent treatment group(2/11),the difference was not statistically significant,and the LVIS/LVISJr stent treatment group(1/15)and the other stent treatment group(2/13).Conclusion:1.Stent-assisted coil embolization of vertebrobasilar dissection aneurysm is a safe and effective treatment;2.LVIS/LVISJr stent can improve the immediate and mid-term complete embolization rate of vertebrobasilar dissection aneurysm after operation;3.Double-stent-assisted coil embolization of vertebrobasilar dissection aneurysm can improve the mid-term complete embolization rate;4.Standardize the use of platelet aggregation,anticoagulant drugs,appropriately increase the number of stents or use of high metal coverage stents without increasing bleeding and risk of thrombotic events.