Clinical Study Of Pipeline Embolization Device For Treating Small And Medium-sized Intracranial Aneurysms

Objective: To explore the early clinical efficacy and safety of Pipeline embolization device in the treatment of small and medium-sized intracranial aneurysms of minority nationalities in Guangxi Zhuang Autonomous Region,and exploring the related factors affecting the prognosis after endovascular intervention of small and medium-sized intracranial aneurysm.Methods: According to the inclusion criteria and exclusion criteria,we retrospective analysis of 55 minority patients with single small and medium-sized intracranial aneurysms(diameter≤10mm)treated in Department of cerebrovascular disease from July 2018 to July 2021.Baseline data were collected to observe their clinical outcome and follow-up,including gender,age,hypertension,diabetes,hyperlipidemia,whether aneurysm rupture,the situation of the hospital,aneurysm size,aneurysm neck diameter,aneurysm site,etc.The aneurysm complete occlusion rate and MRS score were calculated to evaluate the surgical efficacy.The safety of surgery was evaluated according to postoperative mortality,hemorrhagic stroke,ischemic stroke,and retreatment rates.Multivariate logistic regression analysis was used to determine the risk factors for poor prognosis after small and medium-sized aneurysm interventional surgery.Complications were defined as ischemic stroke and hemorrhagic stroke due to surgery and related reasons.Ischemic stroke was defined as new infarcts in the blood supply area of treated vessels detected by MRI.The complete occlusion was defined as Raymond Roy occlusion grade I.The traditional treatment was defined as single coiling or stent-assisted coiling and included in the traditional treatment group.result:Of the 55 minority patients with single small and medium-sized aneurysms,19(34.5%)patients were treated with Pipeline embolization device(PED)and 36(65.5%)were treated with traditional treatment methods,after 6months,the complete occlusion rate was 84.2%(16/19)and 88.9%(32/36),respectively.Of the 19 patients treated with PED,one(5.3%)patient had an ischemic stroke;hemorrhagic stroke occurred in 4(11.1%)of the 36 patients treated with traditional treatment methods,ischemic stroke occurred in 3(8.3%),and death occurred in 3(8.3%)of the 36 patients treated with traditional treatment methods at the 6-month follow-up;However,there are no significant statistical differences between the complete occlusion rates,good prognosis rates(MRS ≤ 2 points),complication rates,and mortality rates in the following6-month follow-up.Age,smoking,diabetes,hyperlipidemia,postoperative complications and prognosis are correlated in univariate analysis(P<0.05).Multivariate logistic regression analysis showed smoking(OR 10.21,95%CI 1.489-70.091;P = 0.018),diabetes(OR 6.23,95% CI 1.184-32.799;P =0.031),complications(OR 10.87,95%CI 1.345-87.864;P = 0.025)are associated with poor prognosis.Conclusions: Pipeline embolization device(PED)is equally safe and effective as traditional treatment methods in the treatment of small and medium-sized intracranial aneurysms.In the endovascular interventional treatment of intracranial small and medium-sized aneurysms,smoking,diabetes and complications may lead to worse clinical outcomes.