ABSTRACT
Objective: To investigate the effect of multi-stent assisted coil embolization for blood blister-like aneurysms (BBA) and the impact on vascular endothelial function. Methods: Multi-stent assisted coil embolization was performed on 31 patients with internal carotid artery BBA. The effect of embolization was evaluated with Raymand classification on the day after operation. And the prognosis was evaluated using modified Rankin scale (mRS) 28 days and 3 months postoperatively during follow-up. The levels of plasma endothelin-1 (ET-1), von Willebrand factor (vWF) and serum nitric oxide (NO) in peripheral blood of patients were compared before and 1 week after operation through statistical methods. Results: The technical success rate of multi-stent assisted coil embolization was 93.55% (29/31). Among 29 patients who underwent successful BBA embolization, Raymand classification results showed that the effective rate of embolization (proportion of grade and Ⅱ) was 100% (29/29) with 22 cases of grade and 7 cases of grade Ⅱ. Twenty-eight days after operation, mRS showed good prognosis (grade 0-2) in 68.97% (20/29) patients, incluing 5 cases of grade 0, 8 cases of grade 1 and 7 cases of grade 2. And the proportion of good prognosis was 75.86% (22/29) 3 months after operation, with 7 cases of grade 0, 12 cases of grade 1 and 3 cases of grade 2. The levels of ET-1 ([518.38±22.91]pg/ml vs [550.32±28.57]pg/ml, t=-4.848, P<0.001), vWF ([1.66±0.20]ng/ml vs [1.86±0.29]ng/ml, t=-3.161, P=0.002) significantly increased, while the serum NO level significantly decreased ([37.40±4.88]nmol/ml vs [33.02±4.24]nmol/ml, t=3.796, P<0.001) 1 week after operation compared with preoperative results in all 31 patients. Conclusion: Multi-stent assisted coil embolization for the treatment of internal carotid artery BBA is effective, but may bring certain adverse impact on postoperative vascular endothelial function.