Neurosurgical Procedures Versus Endovascular Treatment For Interventions Of Multiple Intracranial Aneurysms:an Analysis Of The Prognosis And The Related Factor To It

Objective:To analyse the prognosis and contributory factors of the microsurgery and the intravascular intervention of aneurysms.Materials and methods:We retrospectively analyzed the clinical materials of 211 MIA patients(with total 508 aneurysms)that accepted either intravascular intervention or microsurgery from the department of neurovascularsurgery of the first Bethune hospital of Jilin University ranging from Jan.2014 to Feb.2018.Among 113 patients choosing microsurgery,69 of them had all of their aneurysms clipped at one time while 44 patients' aneurysms were clipped in a few stage of operations.Furthermore,among 98 patients accepting intravascular intervention,40 of them had all of their aneurysms coiled at one time while 58 patients' aneurysms were coiled in a few stage of operations.We then analyzed the prognosis of these patients with different ways of operations after their discharge.We filed the age,history of hypertension,preoperative Hunt-Hess stage and Ct-Fisher stage,the number of aneurysms and their distributions,the numbers of operative stages and the timing of operations as the independent variables and the prognosis in short period as the dependent variable.All of these status was processed by software of SPSS23.0 and we used the Square test and Fisher exact test to analysis the influence of the single factor and then we used multiple logistic regression to analyze the variables with statistical difference,discussing how various independent variables affect the dependent variable--the prognosis of patients.Plus,we admitted the statistical difference when P value is less than 0.05.Result:1.The assessment of the two ways of operations and the prognosis of patients.According to GOS scoring of patients,about 90.82% of them in intravascular intervention group had good prognosis,which was statistically different from the microsurgery group(80.53%,P=0.035).The mortality of the intravascular intervention group was 3.54%,which was not different from the microsurgery group(2.04% P=0.688)2.The preoperative factors and the prognosis The single factor analysis shows that the age,gender,the number of aneurysms and their distributions,the numbers of operative stages and the timing of operations had no statistical relationship with the prognosis.However,the history of hypertension,preoperative Hunt-Hess stage and Ct-Fisher stage had statistical relationship with the prognosis of of the patients during the short period.3.The further multiple logistic regression showed that the history of hypertension,preoperative Hunt-Hess stage and Ct-Fisher stage were all the the history independent risk factor of the prognosis of the both groups.with the higher scoring of the preoperative Hunt-Hess stage and Ct-Fisher stage,the number of patients with worse prognosis increased in both groups.Moreover,without a history of hypertension was a protective factor for patients prognosis of both groups.Conclusion:1.The prognosis of short period of MIA patients accepting the intravascular intervention is better than the microsurgery.2.MIA patients with higher scoring of preoperative Hunt-Hess stage and Ct-Fisher stage have relatively bad prognosis no matter which kinds of operations they had.3.Without a history of hypertension is a protective factor for MIA patients prognosis of both operations.