A Retrospective Study Of Risk Assessment Of Intracranial Unruptured Aneurysm With PHASES Score

Objective By evaluating the risk of rupture of intracranial unruptured aneurysms,patients with a low risk of rupture were identified from the group of patients diagnosed with intracranial unruptured aneurysms,and the most appropriate treatment was chosen.Methods The patients with intracranial aneurysms treated in our hospital from 2012 to 2017 were divided into 4 groups(n = 528).(1)stable UIA(S);(2)growing UIA(G);(3)Immediate treatment of UIA(T);(4)aneurysmal subarachnoid hemorrhage(a SAH).All patients were pooled in the follow-up UIA group;the stable UIA(S group)and growing UIA(G group)were combined with follow up UIA group(F group),immediate treatment UIA(T group)and a SAH group were associated with high risk rupture group(H group).For patients who were enrolled in the study,basic demographic information,such as sex,age,risk factors,complications,SAH history,smoking history,hypertension history(systolic >140mm Hg),drug dependence,was recorded.Each patient was analyzed according to a PHASES score presented by Philippe Bijlenga.MD,Ph D on the assessment of the risk of intracranial unruptured aneurysms,and their scores were calculated,and the mean PHASES score of each group was obtained.Total statistical differences among all patient groups using Kruskal-Wallis rank sum test.P < 0.05 is considered statistically significant.The ability of unruptured aneurysms to rupture was evaluated by comparing their PHASES score and the ability to provide decision support for follow-up or immediate treatment of accidentally diagnosed UIA.Results Of the 528 patients,214 had unruptured aneurysms and 314 had ruptured aneurysms,with an average aneurysm size of 6.4mm.56% of aneurysms were less than 7 mm,28% were between 7 mm and 12 mm.The largest diameter of aneurysm > 13 mm accounted for 16% of the lesions.The most common sites of aneurysms are the internal carotid artery and the middle cerebral artery,followed by the anterior and anterior communicating part of the brain.The relative incidence of posterior circulation aneurysms appears to be low.The mean diameter of the aneurysm in group S was 2.5mm.The mean diameter of the aneurysm in the T group and Asah group was 3.9,7.1 and 8.2mm.Respectively.Among them,aneurysms located at the anterior and posterior communicating sites tended to be actively treated.Aneurysms situated in the internal carotid artery are more stable.The number of patients in group S was 98,and the average PHASES score was 1.33;The number of patients in group G was 46,and the average PHASES score was 2.71;The number of patients in group T was 70,and the average PHASES score was 6.68;The number of patients in a SAH group was 314 and the average PHASES score was 7.55;Most patients in group E scored between 1 and 4,while most patients in group F scored between 4 and 8.The total statistical differences among all patients with KruskalWallis rank sum test.P < 0.05 were examined statistically significant.The median score of each group was quite different(P < 0.001).The average score of the patients in the follow-up group(F)was less than 3 points;the average score of patients in the high-risk rupture group(H)was greater than 6;the PHASES scores of the patients with high-risk rupture group(H)were significantly higher than the average.Follow-up group(F group)patients with UIA.Conclusion Based on the analysis of intracranial unruptured aneurysm rupture factors,patients with a PHASES score of ?3 were more likely to observe the value and significance,and patients with a score of ?4 should be considered for intervention.