Interventional Embolization And Surgical Clip Contrast Research For The Treatment Of Very Small Intracranial Aneurysm

Objective:To compare the efficacy of two surgical procedures,interventional embolization of intracranial aneurysms and intracranial aneurysm clamping,in the treatment of intracranial microaneurysms.Methods:A total of 195 patients with very small intracranial aneurysm admitted to the Second Affiliated Hospital of Nanchang University from January 2019 to June 2022 were screened according to the inclusion and exclusion criteria,of which 74 patients met the requirements.The 74 patients were divided into two groups: 30 patients(35aneurysms)treated by clamping and 44 patients(44 aneurysms)treated by interventional embolization,and the differences in age,gender,Hunt-Hess score,immediate postoperative occlusion rate and hospital discharge,the incidence of intraoperative and postoperative complications,and the total treatment time between the two groups were compared.The total cost of hospitalisation,duration of surgical operation,and 6-month follow-up results were compared between the two groups.Results:Among the 30 cases of very small intracranial aneurysms treated by craniotomy,25 cases had good prognosis(m RS≤2),accounting for 83.3%,and 5 cases had poor prognosis(m RS>2),accounting for 16.7%;among the 44 cases of very small intracranial aneurysms treated by endovascular intervention,23 cases were treated with stent-assisted embolization,4 cases were treated with flow-guiding device,and the remaining 17 cases were treated with simple spring coil embolization.The prognosis of 43 cases in the interventional group was good,accounting for 97.7%,and the prognosis of only 1 case was poor,accounting for 2.27%.The cardinality test was used to analyze the good and poor prognosis rates of the two groups,and it was found that the difference was not statistically significant at P > 0.05.Using the same statistical method,the rates of complete occlusion of postoperative aneurysms were compared between the two groups,and the results showed that the rate of complete occlusion was 97.1%(1/35)in the clamping group and 79.5%(35/44)in the interventional group,and the rates of complete occlusion in the two groups were analyzed using the continuity correction test,and the differences were statistically significant(p < 0.05),and the patients in the two groups were imaged after 6 months of Follow-up was performed after 6 months in both groups,in which 25 cases were followed up in the clamping group and 37 cases in the interventional group;one recurrence occurred in both groups,in which the recurrence rate was 4.8% in the clamping group and 10.8% in the interventional group,with no statistical difference between the two groups(p>0.05).A t-test was performed for the length of hospitalization,hospital costs and operative time in both groups,and the difference was statistically significant at P<0.05.A chi-square test was used to compare the perioperative complications between the two groups,and the difference was statistically significant at P<0.05.Conclusion:For patients with unruptured very small intracranial aneurysms without high-risk factors,regular imaging follow-up is recommended.Both procedures,cranial clamping and endovascular interventional embolization,are safe and effective in the treatment of microaneurysms.Open clamping has a higher rate of complete occlusion and a higher incidence of perioperative complications than endovascular interventional embolization,whereas interventional procedures are shorter,faster to recover,less invasive,and have a lower incidence of complications.