Comparison Of Pipeline Embolization And Stent-assisted Coil Embolization For The Treatment Of Unruptured Intracranial Dissecting Aneurysms

Objective:To compare the safety and efficacy of pipeline embolizer and stent-assisted coil embolization(SAC)for the treatment of unruptured intracranial dissecting aneurysm(IDA),analyze the influencing factors of the prognosis of IDA;analyze the influencing factors of complete embolization of IDA.Methods:The clinical data of 167 patients with unruptured IDA treated with PED or SAC between January 2017 and June 2020 at the First Clinical Medical College of Shanxi Medical University and Neurointervention Center of Beijing Tiantan Hospital were retrospectively analyzed,and these 167 patients were followed up.Then the patient’s information such as gender,age average hospital stay,amount and cost,IDA location,hypertension,diabetes,smoking,drinking history and postoperative m RS,and the degree of complete embolization during postoperative DSA follow-up were statistically analyzed,and finally the advantages and disadvantages of pipeline embolization IDA compared with SAC embolization and the influencing factors of IDA prognosis and the influencing factors of complete embolization were summarized and summarized.Results:Of these 167 patients,they were divided into PED(79 cases)treatment group and SAC(88 cases)treatment group according to treatment methods,79 cases of unruptured IDA were treated with PED embolization,aged 52 years,60 males(75.9%),19 females(24.1%);88 cases of IDA were treated with SAC;aged 48 years,71 males(80.7%),17females(19.3%).In the two groups,76 patients(96.2%)had m RS(0-2 points)and 3patients(3.8%)had m RS(3-6 points)during follow-up after PED embolization,84 patients(95.5%)had m RS(0-2 points)and 4 patients(4.5%)had m RS(3-6 points)during follow-up after SAC embolization,P < 0.01.In the two groups of data,the cost of PED group was 215693.56 yuan,and the cost of SAC group was 146298.145 yuan,P <0.001.Of the 81 patients followed up by the final DSA,41(89.1%)had complete occlusion and 5(10.9%)had incomplete occlusion in the PED group;16(45.7%)had complete embolization and 19(54.3%)had incomplete occlusion in the SAC group,P value <0.001.In the complete occlusion group,15 patients(83.3%)had small aneurysms(< 10mm),36 patients(75.0%)had large aneurysms(10 – 25 mm),and 6 patients(40.0%)had giant aneurysms(> 25 mm),and in the incomplete occlusion group,3 patients(16.7%)had small aneurysms(< 10 mm),12 patients(25.0%)had large aneurysms(10 – 25 mm),and 9 patients(60.0%)had giant aneurysms(> 25 mm),with P values equal to 0.014.Conclusion:Both PED and SAC have high efficacy and safety in the treatment of unruptured IDA.PED was associated with a higher mean cost in the treatment of unruptured IDA than SAC,but a higher rate of complete embolization.The size of the aneurysm affected the degree of complete embolization of the unruptured IDA,and the lower the degree of complete embolization of the aneurysm.