Clinical Analysis Of 228 Cases Of Intracranial Aneurysm

Objective: intracranial aneurysm(Intracranial aneurysm,IA)is the main cause of subarachnoid hemorrhage(Subarachnoid hemorrhage,SAH),but most of IA is not ruptured,and there are usually no obvious specific symptoms before rupture,so the detection rate and awareness rate are not high.At present,endovascular interventional therapy is the first choice for most IA.In this study,the related factors of IA rupture and the perioperative complications of simple coil embolization were analyzed in order to provide some reference for clinical diagnosis and treatment.Methods: IA(including intracranial segment of internal carotid artery and middle cerebral artery)diagnosed by head and neck CT angiography(CTA)and craniocerebral magnetic resonance angiography(MRA)in the Department of Neurology,the first affiliated Hospital of Guangxi Medical University from June2012 to August 2018 were collected.,anterior cerebral artery,anterior communicating artery,posterior communicating artery,intracranial segment of vertebral artery and basilar aneurysm).There were 228 patients with intracranial aneurysm diagnosed by(DSA)before operation.There were 94 patients with unruptured intracranial aneurysm(Unruptured intracranial aneurysm,UIA)and134 patients with ruptured intracranial aneurysm(Ruptured intracranial aneurysm,RIA).The characteristics of general clinical data(including sex,age)were compared between the two groups.Hypertension,diabetes,hyperlipidemia,atherosclerosis,smoking,drinking history)and aneurysm imaging features(including aneurysm shape,size,location,incident angle),speculate the possible rupture related factors;The differences of perioperative complications between the two groups were compared and the common causes were analyzed.The data were analyzed and compared by SPSS22.0 statistical software.Results: 94 cases in UIA group included 98 aneurysms and 134 cases in RIA group.The results of univariate analysis showed that there was no significant difference in sex,hypertension,smoking and drinking history between the two groups(P > 0.05).There were significant differences in age,diabetes,hyperlipidemia,atherosclerosis,aneurysm size,location,shape and incident angle between the two groups(P < 0.05).The average age of RIA group was 55.37 ±10.97 years old,and most of them were less than 60 years old(66.42%),which was lower than that of UIA group(59.66 ±9.32 years old).The proportion of diabetes,hyperlipidemia and atherosclerosis in RIA group was lower than that in UIA group.(4.48%);14.89%),(23.13% to 51.06%),(41.04%to 72.34%).Among the aneurysm characteristics of the two groups,the intracranial segment of internal carotid artery(46.27%),anterior communicating artery(29.10%),especially anterior communicating artery,accounted for a large proportion in RIA group.The proportion was significantly higher than that in UIA group(15.31%).Most of the small and medium-sized aneurysms(diameter? 10mm)were found in both RIA group and UIA group.The proportion of small aneurysm with diameter ? 5mm in RIA group was the highest(52.99%),which was significantly higher than that in UIA group(40.82%).In terms of tumormorphology,the proportion of irregular aneurysm in RIA group(43.28%)was significantly higher than that in UIA group(25.51%).From the incident angle of tumor-bearing artery and aneurysm,there was significant difference between the two groups.The incidence angle of > 90 °in RIA group was 64.18%,which was significantly higher than that in UIA group(51.02%).Perioperative complications occurred in 23 cases(9.91%)in the two groups,including 15 cases in RIA group(4 cases of intraoperative rupture and bleeding,8 cases of postoperative ischemic events in),UIA group(2 cases of intraoperative rupture and bleeding,6 cases of postoperative ischemic events).There was no significant difference between the two groups.Conclusion: diabetes,hyperlipidemia and atherosclerosis may reduce the risk of IA rupture,and irregular tumor morphology is an independent risk factor for IA rupture.Age,size,location and incident angle of aneurysm may be related to the rupture of intracranial aneurysm,but it remains to be further studied.The safety of simple coil embolization was higher in the two groups,and there was no significant difference in the incidence of perioperative complications between the two groups.