Clinical Study Of Endovascular Treatment Of Paraclinoid Aneurysms

Objective: To analyze the clinical curative effects of endovascular treatment of paraclinoid aneurysms,and summarize the clinical experience to provide guidance for later work.Methods: We performed a retrospective review of 84 patients with paraclinoid aneurysms undergoing endovascular embolization from January 2013 to September 2015.Their clinical records,endovascular reports,Clinical and angiographic outcomes were analyzed.Results:The mean age of the 84 patients was 55.99±9.99 years,60 patients(71.43%)were female and 24 patients were male(28.57%).Of the 94 aneurysms,68(72.34%)had small,while 7(7.45%)had large fundus size,and 19(20.21%)had moderate fundus size.The dome–neck ratio was favorable in 18 aneurysms(19.15%%)and unfavorable in76(80.85%).24 aneurysms(25.53%)were managed with coil embolization and 67 aneurysms(71.27%)were treated with stent assistance,2 aneurysms adopted the single stenting implantation technique and 1 aneutysms were treated by parent artery occlusion(PAO).Two cases of peri-procedural mortality occurred,One patient died from aneurismal rupture during the operation and One patient died from vasospasm event.Immediate angiography demonstrated complete occlusion in 46(48.94%%),neck remnant occlusion in 26(27.66%),and residual aneurysm occlusion in 22(23.40%)aneurysms.Follow-up angiographic studies were performed on 64 aneurysms at a period of 10.19±7.88 months.Compared with immediate angiographic results,follow-up angiograms showed no change in 38 aneurysms,improvement in 14.The overall recurrence rate was 18.75%.Clinical follow-up was available for 75 patients with a follow-up time of 10.27±7.60 months,and the majority(93.33%)was good with a modified Rankin scale score of 0~2 and 5(6.67%)had a modified Rankin scale score of 3~6.One patient died from heart disease,and 2 patient was poor outcome related to the infarction.Conclusion: Out study suggests that properly selected patients with paraclinoid aneurysms can be successfully treated by endovascular treatment,but with a lower immediate complete occlusion;The stent assisted coiling technique are widely used,which was associated with a low recurrence rate,but increased stent thrombosis events,still need long-term observation.