The Meta-analysis Of Risk Factors For Rupture Of Intracranial Aneurysm During Embolization

Research purposes:The rupture of intracranial aneurysm embolization(intraoperative aneurysm rupture IAR)is the most serious complication of endovascular treatment in patients with aneurysm,and is also an important cause of poor prognosis and even death.In recent years,the study,cohort study,and case control study of IAR in China and abroad have been combined.we have raised the awareness of IAR risk factors,but the results are still more ambiguous or inconsistent,and the relevant data and results still need further research and discussion.In this paper,the risk factors of ruptured intracranial aneurysm embolization were analyzed by meta analysis to clarify its risk factors,so as to furnish a theoretical basis for the prevention and control of related measures,reduce the incidence of IAR,reduce the incidence of morbidity and mortality,and improve the clinical prognosis of patients.Research methods:Combining with "intracranial aneurysm embolism","intraoperative rupture","risk factors",these three key words,the author collects informationby means of the key words,keywords,titles and other methods from the computer to retrieve the October 1997 to October 2017 The Chinese biomedical literature database(CBMdisc)、China journal full-text database(CNKI)、Chinese science and technology periodical database(VIP)、a database of ten thousand,Google(Google)、take an examination of crane academic Library(the Cochrane Library)and The National Medical Library of the United States(MEDLINE)etc,and combines with manual search to select the relevant literature,according to the predetermined criteria for inclusion and exclusion of strict screening documents,then evaluating the quality of the screened literatures by the NOS scale,and extracting the relevant information from the high quality literature,the relevant data,and basic informationare also included,the research features and the results,etc,the system analysis and evaluation software(Review Manager 5.3)as for the research of Meta Analysis,it finallyset up the evaluation of risk factors for rupture of intracranial aneurysm during embolization: Ratio(OR)and 95% confidence interval(95% CI),and parallel mean difference test,the difference was statistically significant P < 0.05 in the study.Research results:There are 10 articles in this paper,of which 5 are in Chinese and 5 in English,IOR Group cases 176,control group(intracranial aneurysm patients received interventional embolization treatment,no rupture of the case)3798.Gender,age,past hypertension history,past smoking history,aneurysm size,aneurysm,aneurysm,carotid aneurysm,Hess classification and operative time(the first symptom was subarachnoid hemorrhage)were selected.which is also means that subarachnoid hemorrhage to the time of operation),cerebral vasospasm and the auxiliary techniques used in the Operation 12 risk factors are the risk factors in this study.The results showed that those aged less than 60 years old were 2.47 times as large as those over 60 years old,P = 0.002,and the difference was statistically significant.The incidence of IAR is 1.81 times times the incidence of IAR in the simple cystic group,P=0.002,and the difference was statistically significant.The incidence of IAR in Hunt Hess high grade group was 3.39 times,IAR Hunt Hess is in low grade group,P < 0.00001,the difference was statistically significant;while IAR in cerebral vasospasm group was 4.47 times,IAR in cerebral vasospasm group,P = 0.0007 which is a significant difference;the incidence of IAR in male group is similar with the female group,P = 0.29,the difference was not statistically significant.There was no statistically significant difference in the history of IAR and IAR in the previous hypertension history group.The incidence of IAR in the previous hypertensive history group was similar to that in the control group IAR,p=0.10,there was no significant difference between the two groups.The incidence of IAR in the ≤4mm group of aneurysm was similar to that of the >4mm group,P=0.85,the difference was not of great significance.The incidence of IAR in the anterior circulation aneurysms was similar to that of the posterior circulation IAR,p=0.47,and there existed no statistical significance.The incidence of IAR in narrow-necked aneurysms is 1.94 times times the incidence of IAR in wide-necked aneurysms,but p=0.39,andthere was no statistical significance in the difference.The rate of incidence of IAR over 3 days was less than the 3-day group or was 2.68 times lower than that in the 3-day group,so there existed no statistical significance between the two group.The IAR incidence rate of simple embolism group was similar to that of other technical groups,p=0.68,and there existed no statistical significance.Research conclusion:The age of patients with intracranial aneurysms was below 60 years old.The incidence of cerebral vascular spasm was a risk factor for IAR.The history of smoking,the size,location of aneurysms and tumor neckwere also the risk factors of Hess.The timing of operation and the auxiliary technique used in the operation can not be identified as a risk factor for IAR.In addition,all the risk factors of IAR were not included in the study and the results were relatively small,it still needs more evidence-based medical evidence to guide and confirm it.