Therapeutic Effect Of Blood Flow Guiding Device Pipeline And Combined Coils Embolization Complex Intracranial Aneurysms

Objective:To evaluate the safety and efficacy of Pipeline and combined coil embolization complex intracranial aneurysmsMethods:A retrospective analysis of 23 cases of PED embolization complicated intracranial aneurysms performed at the Second Affiliated Hospital of Nanchang University from October 2016 to September 2018.All patients were treated with the seldinger technique and passed through the right femoral approach to the tumor-bearing artery.The position is juxtaposed into the blood flow guiding device PED or PED combined with the coil.Immediately after the end of the operation,DSA angiography is performed to check the relative position of the released PED device and the fit with the blood vessel wall,and the cranial CT scan is used to check whether the skull is cranial.Internal bleeding.Patients underwent routine CT examination on the second postoperative day and the prognosis was assessed by a modified Rankin Scale score(mRS).All patients were followed up for 6 months,and the prognosis was assessed by MRS score.Cerebral angiography was performed at 6 and 12 months postoperatively,and the degree of aneurysm embolization was assessed by OKM.Results:A total of 23 aneurysms in 23 patients were implanted with 23 PEDs and 11 coils.Immediately after surgery,DSA cerebral angiography showed that all PEDs accurately covered the neck and adhered well,but not in the intraoperative brain CT scan.Found intracranial hemorrhage.The perioperative complication rate was 13.0%(3/23).In all patients,intracranial hemorrhage,subarachnoid hemorrhage and acute cerebral infarction occurred in 1 or 4 days after surgery.Among the postoperative MRS scores,20 patients had 0 scores,1 patient had 1 score,and 1 patient had 4 scores.One patient was automatically discharged from hospital.Twenty-two patients were enrolled in our hospital for 6 months after surgery and obtained imaging data.The MRS score was 0 in 21 patients and 4 in 1 patient.In the OKM classification of aneurysms in 22 patients with angiography,there were 20 grades D,1 grade A,and 1 grade B;90.9%(20/22)of the aneurysms reached sub-total and above occlusion(OKM grade D,C).Conclusions:PED and combined coil embolization are safe and effective in the treatment of complex intracranial aneurysms,especially for large or large intracranial aneurysms combined with coil embolization.The cure rate and complication rate are low,and short-term follow-up is effective.However,long-term efficacy still requires more sample data evaluation,and attention should be paid to serious complications.