Clinical Study Of Stent Assisted With Coil Embolization Therapy In Wide-Necked Intracranial Aneurysms

Objective:Through a retrospective analysis using Solitaire AB stent assisted coiling technique in treating intracranial wide-necked aneurysms cases,summarize operative methods,operation points and perioperative management of this technique.Discuss the effect of stent assisted coil embolization in the treatment of intracranial wide necked aneurysm,and complications of surgery,the surgical complications,the degree of embolization,and the safety of the operation were analyzed.For the future clinical work,how to dense the aneurysm,reduce the recurrence and complications of the residual neck of the tumor.Therefore,the theoretical support is provided for the standardized treatment of patients with intracranial wide-necked aneurysms.Materials and methods:From January 2014 to October 2017 in our hospital department of neurosurgery with Solitaire AB stent assisted coiling technique for the treatment of 57 cases(A total of 62)patients with wide necked intracranial aneurysms,through the patient's age,gender,clinical symptoms,imaging findings,preoperative Hunt&Hess grade,and aneurysm size,location,complications,the degree of embolization are summarized.After 3-12 months of clinical and radiographic follow-up,understand the daily affairs and working conditions of patients,according to the MRS score to evaluate the therapeutic effect of patients.Results:The aneurysms were successfully embolized in 57 cases(62),and the Solitaire AB stent was successfully released and relieved successfully.The results of immediate cerebral angiography after operation: the aneurysm artery was unobstructed and no occlusion and stenosis were found at the distal part of the vessel.The 49 aneurysms were completely stuffed(79.03%),and 13 aneurysms were retained in a small amount(20.97%).Perioperative complications occurred in 7 cases(12.28%/7/57),including 3 cases of vasospasm,3 cases of intraoperative thrombosis,1 cases of aneurysm rupture again.After active treatment,no permanent neurological deficit and death occurred.A pseudoaneurysm was found in the femoral artery puncture site after operation in 1 case,which disappeared after multiple local compression by color Doppler ultrasound.The postoperative follow-up time was 3-12 months,with an average of 9 months.A total of 52 patients of 56 patients had been followed up for imaging follow-up and clinical follow-up,including 38 patients(41 total)with dense embolism and 14 patients of 15 patients with residual neck tumor.Among them,46 cases of 48 patients were examined by cranial CT and cerebral angiography after operation.There were 4 cases of 6 patients underwent CT/CTA examination,and 2 cases were given CT examination of the head only.There were 46 cases of cerebral angiography showed that 38 cases(a total of 40,35 of them had dense embolism,5 with residual tumor neck)had no significant change in aneurysms,and 7 patients had residual aneurysms.One patient with dense embolization was detected in the cervical part of the tumor.During the clinical follow-up,2 patients described a transient TIA attack.52 patients were followed up with a modified Rankin scale(Modified Rankin Scale)score standard,of which 0-3 scores were 52 cases.Conclusion:Solitaire AB stent assisted coil embolization for the treatment of Intracranial wide-necked aneurysms is simple and easy to be performed with strong controllability,and the recent effect is positive.However,its long-term clinical results and imaging results are expected to be further studied.