Résumé
Objective To study the methods and results of endovascular treatment of posterior inferior cerebellar artery (PICA) aneurysms. Methods Twenty-one patients with PICA aneurysms were treated with endovascular treatment. The locations of aneurysm on PICA were evaluated through the DSA. Eight patients received single coil embolization, 5 received liquid Glue embolization, 2 received coil embolization combined with liquid Glue, 2 received coil embolization assisted with stents, and 4 underwent ocelasion of the parent PICA. Outcome was evaluated with the Glasgow outcome scale (COS). Results There were complete (100%) occlusion in 5 patients, near complete (>90% ) occlusion in 2, and incomplete (85%) occlusion in 1 in single coil embolization. Seven patients with Glue embolization (n = 5 ) or combination with coils ( n = 2 ) exhibited complete ( 100% ) occlusion. There were near complete ( >90% ) occlusion in 2 cases with coil assisted with stents. Complete occlusion of the parent PICA was achieved in 3 patients, and near complete occlusion of PICA in one case. One patient suffered from new neurological deficits, and one patient treated with coils and stents died. None of the patients suffered from re-bleeding. These patients received follow-up during a mean period of (22±8) months. Overall long-term outcome was good ( GOS score 4 or 5 ) in 17 patients, poor ( COS score 2 or 3) in 3, and fatal ( GOS score 1 ) in one case. Conclusions According to the location of aneurysms on PICA, aneurysms can be effectively and safely treated with endovaecular embolization.
Résumé
Objective To explore prognostic relative factors of different therapy for patients with intracrani-al aneurysm. Methods In 93 intracranial aneurysm patients, 38 cases were managed through craniotomy, in whom the effects of operation time, intraoperative aneurysmal rupture(IAB), temporary arterial occlusion (TAO)on 30-day and 6-month prognosis were investigated; while other 67 cases experienced endovascular treatment,in whom the simi-lar parameters of the different therapy, types of endovascular treatment, and intracranial aneurysm embolization were evaluated. 30 days and 6 months prognosis were regarded as the dependent variable, and SPSS for Windows 11.5 was adopted for data processing. Chi-Square test was performed. Results IAR exerted significant difference to 30 days and 6 months prognosis in patients undergoing craniotomy and clipping, there were 42 intracranial aneurysm, of which 16 aneurysm ruptured (χ2 = 5. 203,10. 886, P < 0.05 ). For patients undergoing endovascular treatment, the new ma-terial application could improve 6 months prognosis, in whom there were totaly 74 intracranial aneurysm, of which 23 aneurysm were managed by the use of old material for endovascular treatment and 51 aneurysm were managed by the use of new material for endovascular treatment(χ2 = 5. 544 and RR = 2. 364,95% CI 1. 197～4.669 ,P < 0.05 ). Un-successful ratio in the endovascular treatment was reduced simultaneously,from 43.5% (old material group) to 18.0% ( now material group) (χ2 = 5. 542,P < 0.05). Conclusions IAR is the important risk factor, which effects 30 days or 6 months prognosis of patients with intracranial aneurysms managed through craniotomy and clipping. The new material application in the endovascular treatment improves 6 months prognosis, meanwhile unsuccessful ratio in the endovascular treatment is reduced simultaneously.
Résumé
Intracraial aneurysm is the most common cause of subarachnoid hemorrhage.Its incidence varies in different areas,and overall,there is a growing tendency.The incidences and mortalities of ruptured and reruptured intracranial aneurysms remain high,and are influenced by various factors.With the development of diagnostic techniques,the prognosis of intracranial aneurysms is improving increasingly,and the mortality and morbidity have been gradually decreased.