Comparison Of Craniotomy Clipping Versus Interventional Treatment Of Internal Carotid Artery-posterior Communicating Artery Aneurysm

Objective:To compare the advantages and disadvantages of the craniotomy clipping and interventional treatment of internal carotid artery - posterior communicating artery aneurysmMETHODS:Retrospective analysis of neurosurgical treatment of 42 cases of internal carotid artery - posterior communicating artery aneurysm between March,2005 and January,2009 in Neurosurgery of The First Affiliated Hospital of Guangxi Medical University,divided into two groups:17 cases of surgical group,25cases of intervention group,record the information as follow:age, gender,date of SAH attack,the bleeding frequency,date and results of DSA, preoperative Hunt - Hess grade,treatment date,At discharge,the patients clinical outcome was determined with the Glasgow outcome scale, hospitalization costs,operation time,whether postoperative residual aneurysm neck exists,whether postoperative complication appears,as well as postoperative follow-up results after 3～45 months.All statistical analyses were performed using t test,x2 test,fisher's exact test,rank sum test.Results:The surgical treatment group,17 people,nine cases had good recovery and were discharged(52.94%),two cases were dead(11.76%). Interventional treatment of embolization group,25 people,15cases(60%) had good recovery and were discharged,two cases were dead(8%).The results showed that the postoperative mortality of the two groups when they are discharged was no significant statistical difference(fisher's exact test,P＞0.1), the postoperative recovery extent of the two groups exists significant statistical difference(rank sum test,p＜0.05);two groups' in hospitalization costs, operation time and the number of days of postoperative hospital stay exist statistical significance(T test P＜0.05);the rate of postoperative residual aneurysm neck two groups exists statistical significance(fisher's exact test,P＜0.01);the incidence of postoperative complication two groups exists statistical significance(fisher's exact test,P＜0.01).Conclusion:the interventional treatment of the internal carotid artery posterior communicating artery aneurysm has short length of stay,quick postoperative recovery,good recovery extent discharge,short operation time, low postoperative complication incidence,but high cost of hospitalization, high rate of residual neck;while the craniotomy clipping treatment has low cost of hospitalization,low rate of residual neck,but longer length of stay in hospital, slow postoperative recovery,bad recovery extent discharge,long operation time, high postoperative complication incidence.