Clinical Analysis Of Early Interventional Embolization In The Treatment Of Unruptured Small Necked Aneurysms

Objective: To analyze the effect of interventional embolization in the treatment of unruptured small necked aneurysms at early stage,so as to provide reference for early clinical treatment of unruptured small aneurysms.Methods: A retrospective analysis of our hospital nerve outside of a branch in January2014-2017 January 73 cases of unruptured intracranial aneurysms and patient medical records,according to cerebral angiography(DSA)examination of the measured unruptured intracranial aneurysm diameter,aneurysm neck length,aneurysm body length,and then select small aneurysms(diameter <0.5cm)(narrow necked aneurysms of the carotid body is less than or equal to 1/2)and divided into the intervention group and the conservative group.The interventional therapy group was treated with interventional embolization under general anesthesia.The patients were treated with dehydration,intracranial pressure reduction,cerebral vasospasm prevention,electrolyte balance adjustment and other symptomatic treatment.According to the degree of complete embolism,the aneurysms were divided into three grades: complete embolization(100%),sub total embolization(90% ~ 99%)and failed embolism(<90%),so as to be referenced in the follow-up observation.Referring to the patient's neurological function and rehabilitation,the score was scored according to the GOS prognostic score(Glasgow prognostic score).The death rate was 1 points,the survival rate of the plant was 2 points,the severe disability was 3 points,and the score was 4 or more.The patients in the two groups were followed up for 6 months by telephone and outpatient follow-up.The follow-up rate was 100%.The incidence of complications of statistics,summary of the relevant data,statistical analysis was performed using SPSS17 software,count data to proportion and percentage(%),2 groups were compared by comparison;measurement data to mean standard deviation were compared by t test,the test level is 0.05,p<0.05 there was statistically significant difference.Results: Among the 24 cases of interventional therapy group,22 cases(92%)reached complete embolization,and 2 cases(8%)reached secondary embolism,but no recurrence of embolism occurred after operation,the rate of change was 0%.The conservative observation of 49 cases of patients in the follow-up process of 2 patients underwent imaging examination showed that the aneurysm becomes larger,the change rate of 4%,but the difference was not statistically significant(P>0.05);the 24 cases of interventional embolization group in 2 cases with postoperative CT showed high signal,suggesting that cerebral hemorrhage,after treated in hospital after symptomatic postoperative 30 day prognosis of GOS scores more than 4 points;the conservative observation of 49 cases of patients in the follow-up process in 8 patients with aneurysm rupture caused by subarachnoid hemorrhage hospitalized,including 2 patients after admission treatment but due to severe illness caused by death.The statistical calculation of P <0.05,there were significant differences between the views of the changes in statistics;aneurysm,ruptured aneurysm of the conservative in the observation group were not included,two table,8% of the intervention group was significantly lower than that of the observation group of 20% conservative.Conclusion: Through the comparison of interventional therapy and conservative observation of unruptured aneurysms and the curative effect analysis for unruptured aneurysms,early embolization can to some extent reduce the risk of aneurysm rupture,reduce patients because of bleeding aneurysm rupture and lead to severe disability and even death risk;early aneurysm in patients with unruptured interventional embolization in the late follow-up process can be seen in the postoperative recurrence of aneurysm increased to significantly lower than conservative patients in the observation group,which also reduced aneurysm in the follow-up observation of the aneurysm increased due to changes in the process of aneurysm rupture risk rate.With the rapid development of neuroimaging,more unruptured aneurysms can be diagnosed,and the development of biology,new material science provides conditions for the treatment of small,new therapy,stent assisted balloon assisted operation and flow guiding device greatly reduces the risk of surgery and complication probability,so that more patients can be benefit.