Analysis On 50 Cases Of Interventional Therapy For Ruptured Tiny Intracranial Aneurysms

Objective: This study aims to summarize the influencing factors of the efficacy of interventional therapy by discussing the clinical data and treatment experience of 50 patients with intracranial rupture microaneurysm,and provide reference for improving the clinical treatment effect.Clinical data and methods: Retrospective analysis of general clinical data,surgical timing(onset to surgery time),Hunt-Hess classification,modified Fisher classification,and aneurysm in patients with intracranial ruptured microaneurysms admitted to our hospital from January 2015 to December 2018 Location,whether or not to combine high blood pressure.A total of 50 patients,including 16 male patients(32%),34 female patients(64%),age range 42~84 years,mean age 66.12 ± 10 years;history of hypertension 33 Case(66%);operation time ? 3 days 36 cases(72%),3~8 days 14 cases(28%),Hunt-Hess grade I~III level 43 cases(86%),IV~V level 7 cases(14%);improved Fisher classification 0~2 points in 42 cases(84%),3~4 points in 8 cases(16%);44 cases of anterior circulation aneurysm(including 28 cases of anterior communicating aneurysm,11 cases of internal carotid aneurysm,4 cases of middle cerebral aneurysm,1 cases of anterior cerebral aneurysm),6 cases Posterior circulation aneurysm(6 cases of basilar artery aneurysm).All patients admitted to the hospital had a CT scan of the subarachnoid hemorrhage,which ruled out the cause of trauma.In our hospital,CTA or DSA confirmed the existence of an aneurysm and was a SAH responsible aneurysm.All patients fully assessed the risk of surgery before surgery,improved preoperative preparation,and performed surgical treatment as soon as possible according to the actual condition and family wishes;postoperative imaging review and regular follow-up.Results: All patients underwent successful interventional therapy,35 cases(70%)with simple coil embolization,15 cases(30%)with stent-assisted coil embolization;42 cases(84%)with Raymond I grade immediately after angiography,including simple coil embolization 38 cases(76%),stent-assisted embolization in 4 cases(8%);Raymond II level in 8 cases(16%),including 4 cases(8%)with simple coil embolization and 4 cases(8%)with stent-assisted embolization.There was no recurrent rupture event during operation;2 cases(4%)had acute thrombotic events during operation,and the blood vessels were recanalized after mechanical thrombectomy,and the antithrombotic drugs were pumped through the guiding catheter;2 cases(4%).Six patients(12%)had serious complications after surgery,all of which were delayed cerebral ischemic injury.The discharge assessment GOS score 1-2 was divided into 10 patients with poor prognosis(20%),and 3-5 patients with good prognosis group(40%).Of the 31 patients who met the follow-up criteria,24 patients had simple coil embolization and 7 patients had stent-assisted coil embolization.Two cases of TIA recurrence were found,all of which were patients with simple coil embolization.They recovered well after stent-assisted embolization.Statistical analysis showed that univariate analysis showed that Hunt-Hess classification,modified Fisher classification,and timing of surgery were associated with TIA patients' interventional therapy;multivariate Logstic regression analysis showed lower modified Fisher classification and the timing of surgy between 3 to 8 days were TIA Independent risk factors for poor prognosis after interventional therapy.There was no statistically significant association between stent support and TIA recurrence.Conclusion: Interventional therapy for small aneurysms is a safe and effective treatment;The timing of surgery and improved Fisher score are independent risk factors for the clinical outcome of patients with TIA.It is helpful to identify high-risk patients for early operation and actively prevent and treat postoperative complications,so that patients can obtain better clinical results..