The Clinical Study Of Stent-assisted Coiling Of Ruptured Micro Intracranial Aneurysms

Objective:This clinical study was designed to investigate the clinical outcome and angiographic results of stent-assisted coiling of intracranial ruptured micro intracranial aneurysms,and to investigate the safety and efficacy of stent-assisted coiling for ruptured micro intracranial aneurysms.Methods: This article has analyzed the patients with stent-assisted coiling of intracranial ruptured micro intracranial aneurysms,who were once treated in neurosurgery department of the Affiliated Hospital of Southwest Medical University from January of 2010 to December of 2014.The article has also collected the basic information of these patients,as well as Hunt-Hess grade,morphological characteristics of aneurysm,postoperative immediate angiography and its following-ups,clinical follow-up results and complications associated with interventional embolism.Result:One hundred and ten patients(including 39 men patients and 71 women patients whose ages range form 39 to 73),all of whom(average age52.03±8.77)were with wide-necked ruptured micro intracranial aneurysms,were included in this article.The neurological conditions of our series were evaluated by Hunt-Hess,with a result that Hunt-Hess?in 28(25.45%)patients,Hunt-Hess?in 58(52.73%)patients,Hunt-Hess? 24(21.82%)patients.Of the 110 aneurysms,the mean ± standard diameter was 2.37 ± 0.52 mm,the mean ± standard neck size was 2.21±1.18 mm,mean ± standard DNR was 1.24±0.47.Of all the patients,108 patients were successfully cured.The risk of stent deployment failure was 1.82% and aneurysm rupture and hemorrhage was 3.70%.The initial angiographic results showed that complete occlusion in 64(59.26%)patients,near occlusion in 38(35.19%)patients and partial occlusion in 6(5.56%)patients.The gender and the size of the aneurysms were correlated with the initial angiographic results(p=0.043,p=0.037).The history of smoking,drinking,high blood pressure and diabetes had no correlation with the initial angiographic results.Of 110 patients,84 patients were followed with angiography for the first time.Complete occlusion was revealed in 54 patients(64.29%),near occlusion in 24patients(28.57%)and partial occlusion in 6 patients(7.14%).The difference between the initial and the first time angiographic follow-up outcome had no statistical significance.Of these 84 patients,64 patients were available for6-month or longer angiography follow-up.Complete occlusion was revealed in51 patients(79.69%),near occlusion in 10 patients(15.63%)and partial occlusion in 3 patients(4.69%).The difference between the initial and second time angiographic follow-up outcome had statistical significance(p<0.05).Clinical follow-up was obtained in 97 patients(89.81 %),of which74 patients(76.29%)had good clinical outcome(mRS 0-2)and 23patients(23.71%)had bad clinical outcome(mRS 0-2).Sixty-three patients were followed-up for over 2 years,of which 54 patients(85.71%)had good clinical outcome.The difference between the first and second time clinical follow-up outcome had no statistical significance(p=0.761).Conclusions: Stent-assisted coiling of relative wide-necked ruptured micro intracranial aneurysm is a safe and effective option due to the midterm follow-up.The long-term safety and efficacy should be further evaluated.