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Study on Endovascular Therapy of Intracranial Aneurysms and the Comparison with Microsurgical Clipping

Author: ZhuYuan
Tutor: ZouAnZuo
School: Nanchang University
Course: Surgery
Keywords: Intracranial aneurysms Embolism Detachable coil Endovascular treatment Surgical clipping
CLC: R651
Type: Master's thesis
Year: 2008
Downloads: 81
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Abstract


The first part of the endovascular treatment of intracranial aneurysms (66 cases) Purpose: To investigate the effect of embolization of intracranial aneurysms with detachable coils intravascular and technical points. Methods: 66 cases of intracranial aneurysms application of micro-catheter technology, digital subtraction angiography (DSA) monitoring downstream endovascular embolization. Results: 66 patients with 69 aneurysms, occlusion and 61 cases were cured, and 2 deaths. Satisfaction embolism 62 more satisfactory four embolism the less satisfied embolism 3. Secondary thrombosis in two cases, of which 1 died, 1 cases left over from hemiplegia. The embolization process aneurysm rupture after successful embolization. Cerebral embolism embolism process, left hemiplegia. Occlusion, died of lung failure. Conclusion: Endovascular embolization treatment of intracranial aneurysms is a relatively safe, reliable, and effective treatment of wide-necked aneurysms and preoperative cardiopulmonary insufficiency should not line endovascular treatment. The larger the aneurysm, the high rate of recurrence; preoperative repeated subarachnoid hemorrhage possibility of intraoperative aneurysm rupture. The second part of intracranial aneurysms with endovascular treatment with surgical clipping clinical research purposes: compare hospital intracranial aneurysm endovascular treatment and microsurgery surgical clipping of both treatment safety and effectiveness. Method: select the hospital is not only suitable for endovascular treatment can also surgical clipping of intracranial aneurysm patients divided into the intravascular treatment group and microscopic surgical clipping group, based on the patient's wishes, comparing the two groups of patients were discharged efficacy. : Hunt-Hess classification (HH) grade 1, endovascular treatment, 10 patients, with an average length of stay of 9.5 days, GOS score of 5, with no complications; surgical clipping of the 92 cases, the average length of stay of 18.5 days, GOS score 4.91 points, the complication rate of 4.35%. HH 2, endovascular treatment, 16 cases, the average length of stay of 11.17 days, GOS score 4.75 points, the complication rate of 6.25%; surgical clipping of 104 cases, with an average length of stay of 18.85 days, GOS score 4.97 points complications rate of 4.67%. HH 3, endovascular treatment, 16 cases, with an average length of stay of 10.5 days, GOS score of 4.87 points, the complication rate was 12.5%; surgical clipping of the 54 cases, the average length of stay of 20.1 days, GOS score 4.88 points complications rate of 8.16%. Conclusion: Endovascular treatment of intracranial aneurysm patients, its safety and effectiveness and microsurgical clipping similar, but the relatively short duration of hospitalization, a small injury to the patient, has good prospects for development.

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