The Individual Choice Study Of Craniotomy Clipping Surgery And Interventional Embolization Operation In Surgical Treatment Of Middle Cerebral Artery Aneurysms

Purpose:To discuss the individual choice and complementary of craniotomy clippingsurgery and interventional embolization operation in surgical treatment of middlecerebral artery aneurysms(MCAA), and to analyze the clinical effect of two surgicalmethods.Method and material:To retrospectively analyze56MCAA patients in neurosurgery of the first affiliatehospital of Dalian Medical University from November2011to November2013, whichunderwent craniotomy clipping surgery or interventional embolization operation. Therecorded information of patents included age, gender, preoperative Hunt-Hessclassification, the conditions out of the hospital, tumor neck residue, postoperativecomplications and postoperative follow-up of6months. According to the size of tumorneck, all patients were divided into wide neck group and narrow neck group. Tocompare the difference of treatment effect between craniotomy clipping surgery groupand interventional embolization operation group in wide neck group and narrow neckgroup respectively. To compare the difference of mortality, morbidity, and tumor neckresidual rate between craniotomy clipping surgery group and interventionalembolization operation group in irregular MCAA group, and the difference of mortalityand morbidity between craniotomy clipping surgery group and interventionalembolization operation group in patients with hematoma. The statistical method waschi-square test. Results:In all patients, craniotomy clipping surgery group was33cases and interventionalembolization operation group was23cases, and the wide neck group was33cases andthe narrow neck group was23cases.The treatment effect of craniotomy clipping surgerywas better than interventional embolization operation in the wide neck group (p1=80%,p2=25%, p1＞p2, P=0.01, P＜0.05). While the treatment effect of interventionalembolization operation was better than craniotomy clipping surgery in narrow neckgroup (p1=37.50%, p2=86.67%, p1＜p2, P=0.03, P＜0.05). The tumor neck residual rateof craniotomy clipping surgery and interventional embolization operation in irregularMCAA group were10.00%and66.67%respective, and there was a statistical differencebetween two methods (P=0.04, P＜0.05), but no difference of mortality and morbiditybetween two methods (P＞0.05). And, there was also no difference of mortality andmorbidity between two methods in patients with hematoma (P＞0.05).Conclusion:Individual choice of craniotomy clipping surgery and interventional embolizationoperation in treating middle cerebral artery aneurysms can significantly reduce themortality and morbidity, and improve the treatment effect and prognosis.