Analysis Of Recurrent Factors After Stent-assisted Coil Endovascular Embolization Of Intracranial Aneurysms

Background:Intracranial aneurysms have now become one of the leading causes of sudden death in adults.They are often compared to intracranial “untime bombs”.Therapeutic methods include surgical clipping and endovascular embolization.The gradual maturation of endovascular therapy has prompted intravascular interventions to gradually replace the craniotomy and become the preferred treatment for intracranial aneurysms.However,compared with surgical clipping,the early recurrence rate of intravascular embolization for aneurysms is relatively high.With the continuous improvement of technology,in recent years,stent-assisted embolization of intracranial aneurysms has lower rebleeding rate and higher occlusion rate,butstentassisted interventional aneurysm does not completely avoid the recurrence of aneurysms.There is still a certain recurrence rate.Therefore,it is very important to investigate the factors of recurrence after stent-assisted embolization,which can provide necessary reference for the further improvement of intracranial aneurysms.Objective:To investigate and analyze the factors affecting the recurrence after stent-assisted coil embolization of intracranial aneurysm Methods:A retrospective analysis was performed on patients who underwent stent-assisted coil embolization in the Department of Neurointervention of the First Affiliated Hospital of Zhengzhou University from January 2010 to December 2016 and met the inclusion criteria.According to the recurrence of aneurysm,it was divided into recurrent group and non-recurrent group.The gender,age,aneurysm size,location,wide neck or not,rupture or not,hypertension or not,the angle of inflow tract of parent arteries and aneurysm,angle of outflow tract of parent arteries and aneurysm,immediate Raymond grading,follow-up time were compared between the two groups.Logistic multivariate regression analysis the risk factors of intracranial aneurysm after stent-assisted coil embolization.Results:The data of the recurrence group and non-relapse group in this study,there were statistically significant differences in gender(?2=7.124,P=0.008),aneurysm size(?2=33.754,P<0.01),angle inflow tract(?2=7.860,P=0.005),aneurysm direction(?2=8.793,P=0.012),Raymond grading of postoperative immediatly embolization(?2=8.456,P=0.015).The multivariate binary logistic regression analysis show that sex males(OR=9.988,95%CI: 2.568~11.33,P=0.001)and angle of incidence angle >90°C(0R=5.737,95% CI :1.816~18.124,P=0.033),5-10 mm aneurysms(OR=3.146,95%CI:1.541~6.423,P=0.005),10-25 mm aneurysms(OR=4.037,95%CI: 2.082~7.828)(P=0.003),postoperative Raymond grade II(OR=2.209,95%CI:1.072 to 4.549,P=0.040),postoperative Raymond grade III(OR=2.285,95%CI:1.328 to 6.126,P = 0.036)was the risk factor for recurrence after stent-assisted embolization.ConclusionsIntracranial aneurysm still has a certain recurrence rate after stent-assisted embolization.The patient's gender,moderate or large aneurysm(>5mm),inflow tract angle>90°C,and immediate Raymond grade II or III may be the risk factors for aneurysm recurrence after stent-assisted interventional embolization.