Clinical efficacy of stent semi-release assisted embolization in the treatment of ruptured tiny wide-necked intracranial aneurysms
Objective To investigate the safety and effectiveness of stent semi-release assisted embolization in the treatment of ruptured tiny wide-necked intracranial aneurysms.Methods A retrospective analysis was conducted on the clinical data of 102 patients with acute(time interval from aneurysm rupture to treatment≤7 days)ruptured tiny wide-necked intracranial aneurysms(maximum diameter of aneurysm ≤3 mm)admitted to the Department of Neurosurgery,Xingtai People's Hospital from February 2018 to February 2022.All aneurysms were embolized with stent-assisted semi-release embolization technique.The Raymond grading scale was used to evaluate the embolization effect of aneurysms(grade Ⅰas complete embolization,grade Ⅱ as near-complete embolization,and grade Ⅲ as partial embolization).The procedure-related complications were observed.The modified Rankin scale(mRS)was used to evaluate the clinical outcomes of patients(0-2 as good outcome and ≥ 3 as poor outcome).Results The preoperative mRS of 102 patients was 0 in 61 cases(59.8％),1 in 19 cases(18.6％),2 in 9 cases(8.8％),3 in 8 cases(7.8％),and 4 in 5 cases(4.9％).The operations of 102 patients were successfully performed.Immediate postoperative angiography showed Raymond grade Ⅰ embolization in 69 cases(67.7％),grade Ⅱ embolization in 30 cases(29.4％),and grade Ⅲ embolization in 3 cases(2.9％).Among them,4 cases(3.9％)had stent thrombosis,6 cases(5.9％)had local stenosis of parent artery,and no neurological deficit symptoms were left after operation.All patients were followed up for 3-12 months after discharge,and the follow-up time was 7.4±1.4 months.The mRS at the last follow-up was 0 in 84 cases(82.4％),1 in 6 cases(7.8％),2 in 6 cases(5.9％),and 3 in 4 cases(3.9％).Compared with the preoperative mRS,the difference was statistically significant(P＜0.01).The last DSA evaluation of patients showed Raymond grade Ⅰ embolization in 94 cases(92.2％),grade Ⅱ embolization in 8 cases(7.8％),and grade Ⅲ embolization in 0 cases,and the difference was statistically significant compared with the immediate postoperative grading(P＜0.01).Aneurysm recurrence occurred in 5 cases,and the recurrence rate was 4.9％.No aneurysm rebleeding or cerebral infarction occurred during the follow-up period.Conclusion Stent semi-release assisted embolization in the treatment of ruptured tiny wide-necked intracranial aneurysms has a low incidence of perioperative complications,a good short-term postoperative effect and a low recurrence rate.
NETL
NSTL
万方数据
