Clinical Efficacy And Prognostic Related Factors Of Endovascular Embolism In The Treatment Of Vertebral-basal Artery Dissection Aneurysms

Objective Through the study of the included subjects,the clinical efficacy of endovascular embolization in the treatment of vertebral-basilar artery dissecting aneurysms was analyzed,and the difference of curative effect and the related factors affecting prognosis as discussed.Methods A retrospective study of 38 patients included in our unit in2015.01-2019.12 in accordance with the study criteria.the data of age,sex,past history,location of lesions,embolization mode and degree,postoperative complications,prognosis m RS score were analyzed.Postoperative mean follow-up(13.9±6.3)months(2～24 months).Data and datum included in the application SPSS 21.0 software for statistical analysis.Results A total of 38 patients were included in the study,among them,23 patients developed dissecting aneurysm rupture.In 38 patients,24 patients underwent tumor-carrying artery reconstruction,of these,18 patients had complete embolization,the near total embolism and partial embolism were 3 cases.Discharge m RS score: of 24 patients,20 cases recovered better(0-2 points),4cases with poor prognosis(3-6 points),the average follow-up(13.9±6.3)months,m RS score showed a good prognosis in 21 patients,the prognosis was poor in 3cases.In addition,recurrence occurred in 3 cases,no secondary treatment was performed.Occlusion of dissection aneurysm and tumor-carrying artery in 14 cases,of these,11 had complete embolization,the near total embolism was 3 cases.Discharge m RS score: of 14 patients,12 cases recovered better(0-2 points),2cases with poor prognosis(3-6 points);the average follow-up(13.9±6.3)months,m RS scores showed good prognosis,no recurrence.The admission m RS and discharge m RS scores were performed in all patients,the good rates were 60.5%and 84.2%,respectively,statistically significant(P<0.05).it suggests that endovascular embolization is effective in treating vertebral-basilar artery dissection aneurysms.Reconstruction and occlusion are effective treatments for the disease,however,there was no significant difference in the degree of embolization and follow-up prognosis between the two methods(P>0.05).In addition,a correlation between postoperative recurrence and incomplete embolism and involvement of basilar artery in dissection aneurysms was found(P<0.05).Univariate analysis of poor prognosis found,grade Hunt-Hess3-5,grade FisherⅢ-Ⅳ,postoperative pulmonary infection,postoperative hydrocephalus were associated with poor prognosis(P<0.05).Conclusion 1.Endovascular embolization is effective in the treatment of vertebral-basal artery dissection aneurysm and has a good overall prognosis.2.Endovascular embolization for the poor prognosis of vertebral-basal artery dissection aneurysm may be associated with preoperative grade Hunt-Hess3-5,grade FisherⅢ-Ⅳ,postoperative pulmonary infection,and postoperative hydrocephalus(P<0.05).3.Intravascularization and occlusion are effective treatment for vertebral-basal artery dissection aneurysm based on the location,its proximity to important branches,and its rupture.4.Intrascularization for relatively high recurrence rates of vertebral-basilar dissection aneurysm and may be completely associated with aneurysm involvement with basal artery and aneurysm embolism(P<0.05).