A Comparison Study For Therapy Methods With Surgical Clipping And Intervertion Embolization For The Acute Stage Of Ruptured Posterior Communicating Artery Aneurysm

Objective: In this study,we compared the advantages and disadvantages between surgical clipping and coil embolization,and evaluated the efficacy of the two surgical methods in the treatment of ruptured internal carotid artery-posterior communicating artery aneurysm,which may provide evidence for patients and doctors to choose surgical treatment.Methods: We enrolled inpatient cases who diagnosed as a ruptured internal carotid artery-posterior communicating aneurysm and received treatment within 72 hours from January 2016 to October 2018 at the 81 st Group Army Hospital of the Army(formerly the 251 st Hospital of the Chinese People's Liberation Army).A total of 58 patients were divided into two groups(28 in the craniotomy group and 20 in the interventional embolization).Their gender,age,hospitalization number,examination results,preoperative Hunter-Hess classification,and operation date were recorded respectively.The surgical procedure,operative time,postoperative complications,postoperative residual,hospitalization time,hospitalization cost,discharge date,GOS score at discharge,MRS score at discharge were also documented and analyzed.Results: We used GOS to assess the outcome of discharge patients.The clipping group had 28 patients in total.There are 22 patients who had favorable outcome and 6 patients who had poor outcome.The interventional embolization group had 20 patients,which 3 patients had poor outcome.There was no statistic difference between the two groups.Comparing with the clipping group,the interventional embolization group had less surgical period(clipping versus interventional,191.5 min vs 243.1 min,P<0.05),length of stay(clipping versus interventional,.16.8d vs 33.9d,P<0.05),less cost(clipping versus interventional,.188010.3? vs 70547.9?,P<0.05).However,there had no statistic difference between the two groups in the complication rate(P=0.565)and also in the rate of residual aneurysm neck(P=0.294).Conclusion: Compared with the clipping group,the interventional embolization group had less length of stay and operation time but higher expenditure.Despite the expenses in clipping group was lower,it had the larger length of stay and surgical period.It showed no statistic significant in the residual aneurysm neck rate,the complication rate and the outcome of patients.