Clinical Analysis Of Stent-assisted Coil Interventional Embolization For Intracranial Ruptured Aneurysms

Objective: Interventional coil occlusion is the preferred procedure for the treatment of intracranial aneurysms,and clinicians can largely benefit from the use of stent-assisted techniques to treat wide-necked or relatively wide-necked intracranial aneurysms.The treatment of complex intracranial aneurysms allows the surgeon to easily occlude the intracranial aneurysm;at the same time,the coil does not easily dislodge into the aneurysm-carrying artery during treatment,while ensuring a smooth blood flow,and this procedure increases the likelihood of successful surgery and reduces the likelihood of recurrence of the intracranial aneurysm after surgery.However,its use in the treatment of acute ruptured aneurysms is controversial and the complication rate is high.With this in mind,we propose the idea of whether stent-assisted techniques can be used in the management of acute intracranial ruptured aneurysms.Clinical data from patients with ruptured intracranial aneurysms treated in the emergency department of our hospital were statistically analysed to investigate whether the use of stent-assisted surgery is safe and effective in the management of acute ruptured aneurysms.The prognosis of patients who underwent the stent-assisted procedure was compared with that of patients who underwent the tamponade procedure alone.This will help clinicians to choose a surgical option for the treatment of intracranial ruptured aneurysms.Methods: Retrospective analysis of 180 cases of acute ruptured intracranial aneurysms admitted to the Department of Neurosurgery of the Second Affiliated Hospital of Anhui Medical University from 01/01/2011 to 01/01/2020.All patients’ general material（patient’s hospital number,name,age,gender,patient’s state of consciousness on admission,Glasgow score,patient’s H-H classification on admission,modified CT Fisher rating,patient’s m RS score on admission,whether they had previous underlying conditions such as diabetes,hypertension,heart disease,etc.）,which surgical option was used,whether there were any complications during surgery,duration of surgery,aneurysm filling,patient’s recovery after surgery and patient’s prognosis at one year follow-up and whether there was recurrence of the aneurysm.complications,duration of surgery,aneurysm filling,patient recovery after surgery and patient prognosis after one year of follow-up and whether there was recurrence of the aneurysm.We used SPSS 23.0statistical software to process the patient data found to evaluate whether the stent-assisted technique was safe and effective,and we defined a p-value of less than 0.05 as a difference between the two surgical options.Results: A total of 180 patients with ruptured intracranial aneurysms in the acute phase treated with the stent-assisted spring-ring-filling procedure and the spring-ring-filling procedure alone from January 1,2011 to January 1,2020 were included in the Department of Neurosurgery,Second Affiliated Hospital of Anhui Medical University,of which 100 patients received the stent-assisted procedure and 80 patients received the spring-ringfilling procedure alone,all of whom had only a single intracranial aneurysm.There were107（59.4%）male patients and 73（40.6%）female patients;ages ranged from 27 to 86 years,with a mean age of（52.7±11.3）years for all patients included in the analysis.The GCS score was performed on 180 patients on admission,of whom 121（67.2%）had a GCS score of 15,35（19.5%）had a score of 13-14,15（8.3%）had a score of 8-12 and 9（5%）had a score of 3-7.As a result of immediate post-operative filling of the aneurysm,the stent-assisted spring coil filling（SAC）treatment group densely The results of immediate post-operative aneurysm occlusion were 91 cases,6 cases with residual aneurysm neck and 3 cases with partial occlusion;in the spring coil occlusion treatment group alone（CA）,62 cases were densely occluded;12 cases with residual aneurysm neck and 6 cases with partial occlusion,and the results of SAC treatment of aneurysms were better than those of the CA group（z=2.506,p=0.012,Table 9）.Intraoperative aneurysm rupture occurred in a total of 7 cases,including 1 case in the SAC group and 6 cases in the CA group,with a lower rupture rate in the SAC group compared to the CA group（P=0.046）.There were 4 cases of intraoperative spring coil,displacement,dislodgement and decompression,including 0 cases in the SAC group and 4 cases in the spring coilfilled group alone,with a lower rate of intraoperative spring coil,displacement,dislodgement and decompression in the SAC compared to the CA group（P=0.037）.No significant difference in short-term prognosis was seen between the SAC and CA groups when compared to the prognosis of the two procedures at discharge（P=0.91）.At one year follow-up,a total of 142 people were followed up,79 in the SAC group and 63 in the CA group,with one recurrence in the SAC group and seven in the CA group,with a lower recurrence rate in the SAC group（P=0.022）Conclusion: Stent-assisted coiling of burst intracranial aneurysms is safe and effective.