Comparative Study Of The Risk And Efficacy Of Craniotomy Clipping And Interventional Embolization In The Treatment Of Anterior Communicating Artery Aneurysms

Objective:To detect further the comparison of clinical effectiveness between craniotomy clipping and endovascular embolism of anterior communicating artery(AcoA)ruptured aneurysms.Method:retrospectively collected and analyzed clinical data of 95 patients with AcoA aneurysm who were admitted and divided into two groups in our hospital for treatment from Jan 2015 to Jan 2017.The comparison of scale of mini-mental status estimate(MMSE),Glasgow Outcome Scale,incidence of hydrocephalus,hyponatremia and cerebral infarction secondary to vasospasm,outcome of cases with intraoperative rupture of aneurysms were achieved by means of SPSS software to investigate effectiveness and security of two groups.Result:There was no significant difference between the ratio of complete-clipping and the one of complete-coiling of ACoA aneurysms(P>0.05).As to the patients of Hunt-Hess grade I or II,the cognitive score of cases in endovascular coilng group was higher than that in craniotomy clipping group(P<0.05).However,for the patient of Hunt-Hess grade III or IV,the result was oppositive(P<0.05).In addition,there was no remarkable difference for patients of Hunt-Hess grade I or II in the incidence of hydrocephalus,hyponatremia and cerebral infarction(P>0.05).Nevertheless,among Hunt-Hess grade III or IV the incidence of hydrocephalus,hyponatremia and cerebral infarction of cases in craniotomy clipping group was lower than those of patients in endovascular coiling group(P<0.05).As to patients experiencing intraoperative rupture,outcome of the cases in craniotomy clipping group was better than those of patients in endovascular coiling group(P<0.05).Conclusion:1.Both of craniotomy clipping and endovascular coiling are effective methods for complete management of ACoA aneurysms.2.For patients of Hunt-Hess grade I or II with ACoA aneurysm,endovascular coiling is a better choice in protection of cognitive ability of patients.3.As to patients of Hunt-Hess grade III or IV,craniotomy clipping is more effective in decreasing the occurrence of hydrocephalus,hyponatremia and cerebral infarction,so craniotomy clipping is recommended if patients could endure surgery.4.Craniotomy clipping has more advantages than endovascular coiling dose in controlling and dealing with the aneurysms rupture during surgery.