Analysis On The Prognosis And Clinical Efficacy Of Interventional Therapy Of Ruptured Tiny Cerebral Aneurysms

Objective:To explore the key technique of interventional therapy of ruptured tiny cerebral aneurysms,and evaluate the clinical efficacy and prognosis.Materials and Methods:A retrospective analysis of clinical data of patients with subarachnoid hemorrhage was performed to rupture tiny cerebral aneurysm which was treated by endovascular embolization in the neurosurgery department of our hospital,and to evaluate the clinical efficacy.Modified Rankin Scale was adopted as the standard of prognostic evaluation in follow-up survey for the patients discharged from hospital for six months.Single-factor analysis was conducted on the basis of information of patients including Hunt-Hess grade at admission,Fisher grade at admission,age,whether to adopt anti-epileptic treatment,duration from admission to Fisher grade,whether there is severe complication,etc.Factors with statistical significance in single-factor analysis were included in multivariate logistic regression analysis.Results:A total of 52 patients were selected for strict screening.Among which,43 of them were only with coil and 9 were with stent-assisted embolization(2 with simple support,7 with stent-assisted embolization).There were complete embolization in 41 cases(79%),partial embolization in 11cases(21%),aneurysm neck residue in 8 cases,aneurysm tumor residue in 3cases(6%)and no bleeding recurred was found.Cerebral vasospasm occurred in 3 patients anacute thrombotic events occurred in 2 patients.Serious complications occurred in16 cases,including delayed CVS in 12 cases,severe intracranial infection in 3cases and severe pulmonary infection in 3 cases.Aneurysm were followed up for6-24 months.40(77%)patients had good prognosis,and 12(23%)patients had poor prognosis.The single-factor analysis result indicates that Hunt-Hess grade,Fisher grade,and obvious complications influence the prognosis(P<0.05)of patients.Multiple-factor analysis result indicates that Hunt-Hess grade,Fisher grade and obvious complications are the independent risk factors(P<0.05)correlated with the prognosis of ruptured tiny-aneurysm treated by interventional therapy.Conclusion:Interventional therapy for the treatment of ruptured tiny cerebral aneurysms is safe and effective.The long-term results were satisfied.Hunt-Hess grade,Fisher grade and obvious complications are the obvious factors associated with poor prognosis of ruptured tiny-aneurysm treated by interventional therapy,while the rate of embolism and surgical time are not related to the prognosis of ruptured tiny-aneurysm treated by interventional therapy.Doctors must attach importance to these factors to instruct the clinical therapy,make a judgment on the patients ' prognosis and improve the outcome of interventional therapy for ruptured tiny-aneurysm.