Clinical Study Of Complications During Coil Embolization Of Ruptured Intracranial Aneurysms

Objective: This study was performed to identify the independent risk factors for complications during coil embolization and the best operation time of ruptured intracranial aneurysms.Methods : We retrospectively evaluated the clinical data of 236 patients with ruptured intracranial aneurysm treated with endovascular treatment and admitted to the Department of Neurosurgery,the Affiliated Hospital of Southwest Medical University from January 2014 to December 2017.Grouping according to whether intraoperative rupture occurs or not and whether thromboembolic events occurs during operation or not.Univariate and multivariate analyses were performed to analyze the risk factors for complications during coil embolization and the best operation time.The data were analyzed statistically with spss 24.0.Results: Intraprocedural rupture(IPR)occurred in 22 aneurysms(9.3%)and Thromboembolic events(TE)occurred in 9 aneurysms(3.8%).Univariate analyses showed that the rate of IPR was significantly higher in aneurysms ≤ 4.0mm,intraprocedural cerebral vasospasm,and poor prognosis.Univariate analyses showed that the rate of TE was significantly higher in older patients,intraprocedural cerebral vasospasm,and late coiling.There was no significant difference between ultra-early stage emergency surgery and intraoperative rupture or thromboembolism events.Multivariate analysis showed that aneurysms ≤ 4.0mm(OR:0.287,95%CI:0.111~0.739,P=0.010)and intraprocedural cerebral vasospasm(OR:2.011,95%CI:1.205~3.356,P=0.007)were independently associated with intraprocedural rupture.Multivariate analysis showed that older patients was independently associated with thromboembolic events(OR:1.127,95%CI:1.013~1.254,P=0.028).Conclusions: Intraoperative rupture and thromboembolic events are common and serious complications during interventional embolization of ruptured intracranial aneurysms.Independent risk factors for IPR during endovascular treatment of ruptured intracranial aneurysm were small aneurysm and intraprocedural cerebral vasospasm.Independent risk factors for IE during endovascular treatment of ruptured intracranial aneurysm was older patients.Endovascular embolization for ruptured aneurysms in the ultra-early stage emergency surgery does not increase the incidence of intraoperative complications.It is safe,feasible and beneficial to reduce the risk of rebleeding and minimize the complications and sequelae of the patients.