Effectiveness And Safety Of Interventional Embolization In The Treatment Of Intracranial Ruptured Small Aneurysms

Objective: Summarize the clinical experience of intravascular treatment of intracranial ruptured small aneurysms,discuss the relevant factors that affect the recurrence and progressive occlusion of invasive ruptured small aneurysms,and provide some reference for improving the clinical treatment effect;Methods : The data of 80 cases of micro-ruptured aneurysms treated by intravascular intervention in our center between November 2015 and January 2019 were retrospectively analyzed.Divided into 51 cases of simple coil embolization and 29 cases of stent-assisted coil embolization.The main difference between the two groups was recurrence,progressive occlusion,and surgery-related complications.Relapse is defined as a deterioration of more than 1 grade according to the Raymond-Roy grade or compared with immediate postoperative results.Progressive occlusion is defined as improvement of more than one level in the follow-up study,ie from the residual sac to the residual neck or complete occlusion,or from the residual neck To complete occlusion.Results: Fifteen(51.7%)of 29 patients in the stent-assisted group and 26(51%)of 51 patients in the coil-only embolization group achieved complete occlusion immediately after intravascular treatment.In the follow-up study,the recurrence rate of the stent-assisted group(1/29,1.2%)was lower than that of the simple coil embolization group(17/51,21.2%)(p = 0.002).Multivariate logistic regression model showed that the recurrence rate of the stent-assisted group was lower than that of the simple coil embolization group(odds ratio [OR = 0.048,95% CI =(0.005-0.489),P = 0.010].In addition,the stent-assisted group(13/29 Patients,16.2%)and the simple coil embolization group(10/51 patients,12.5%)also had a significant difference in the rate of progressive occlusion(p = 0.017).In the multivariate logistic regression model,the stent-assisted group The rate of progressive occlusion was also higher than that in the simple coil embolization group [OR = 4.767,95% CI =(1.312-17.321),P = 0.018].6 cases of acute thrombotic events occurred during the operation,and 5 cases in the stent-assisted embolization group,simple 1 case in the coil group;5 cases in the distal vasospasm,4 cases in the stent-assisted embolization group,1 case in the simple coil group;5 cases with postoperative cerebral infarction,3 cases in the stent-assisted group,and 2 cases in the simple coil group.Conclusions: ntravascular treatment of ruptured intracranial microaneurysms is relatively safe and effective.Compared with simple coil embolization,stent-assisted embolization can not only reduce the recurrence rate of aneurysm in patients with intracranial microaneurysms and can significantly increase the rate of progressive occlusion.Relatively high.Provide reference for the best treatment of patients with ruptured microaneurysm.