Clinical Study Of Stent-assisted Coil Embolization In The Treatment Of Ruptured Wide-necked Aneurysms In Acute Stage

Background:Stent-assisted coiling technique(SACT)in the treatment of ruptured wide-necked intracranial aneurysms in acute phase(?72h)remains controversial.AIMS:In this study,we report our experience of SACT of wide-necked RIAs and explore the safety and efficacy of stent-assisted coil embolization in the treatment of ruptured wide-necked aneurysms in the acute phase.Materials and methods:198 patients underwent SACT for ruptured,wide-necked saccular intracranial aneurysms at our center between 2012.01 and 2016.4.We analyzed perioperative complications(thromboembolism,intraoperative rupture of bleeding,cerebral vasospasm),can be developed,angiography and clinical follow-up and prognosis.Results:Operative-related complications occurred in 33 patients(16.6%,33/198),Thromboembolic complications in 26 cases(13.1%,26/198),Intraoperative thrombosis in 24 cases,There were 2 cases of postoperative cerebral infarction without thrombosis.Bleeding complications in 7 cases(3.5%,7/198),intraoperative aneurysm rupture in 3 cases,4 cases of rebleeding after surgery.Of the 33 patients who had complications,there were 5 patients(2.5%,5/198)with complications,but 20(10.1%,20/198)with no obvious symptoms,and 8 patients with neurological deficits(4%,8/198).A total of 218 aneurysms were treated in 198 patients.There were 19 aneurysms(8.7%,19/218)and 16 aneurysms(8.7%,21/218)Partial packing(tumordevelopment).At the time of discharge,GOS score of 4 ~ 5 points was 177(89.4%,177/1988),1 to 3 points in 19 cases(10.6%,11/1988),lethal(GOS score 1)in 7 cases,the mortality rate was 3.5%.A total of 110 patients were discharged at least after a cerebral angiography,the remaining patients did not review.There were 8 cases(7.3%,8/110)of tumor neck or tumor recurrence.Conclusions: 1.SACT is an effective treatment option for selected ruptured wide-necked aneurysms in the acute phase.Most patients have good prognosis,High Hun-t Hess score at admission is a risk factor for poor prognosis.2.The use SACT in the acute phase have acceptable complication ratio for ruptured wide necked aneurysms.The use of tirofiban on intraoperative embolization is effective 3.SACT in the treatment of ruptured wide-necked intracranial aneurysms in acute phase have a certain recurrence rate,the need for follow-up of cerebral angiography.