Risk factors of early rebleeding after endovascular embolization of ruptured intracranial aneurysms / 介入放射学杂志

ABSTRACT

Objective To discuss the clinical characteristics and risk factors related to the early rebleeding after endovascular embolization of ruptured intracranial aneurysms, to reduce its occurrence and to provide the theoretical basis for the clinical selection of therapeutic methods. Methods During the period of July 2002-Oct. 2007 in the Department of Neurosurgery of Changhai Hospital, patients with DSA-proved ruptured intracranial aneurysms were treated with pereutaneous endovascular embolization. The clinical data and imaging findings of the patients who had occurred early rebleeding after interventional therapy (study group) were retrospectively analyzed. The patients who had not occurred early rebleeding after interventional therapy during the same period were randomly selected and served as the control group. The number of patients in control group was 7.5 times of that in study group. The suspected risk factors were statistically analyzed by using univariate and multivariate methods, the results were compared between two groups. Results Of 881 patients with raptured intracranial aneurysms treated by endovascular interventional embolization, 17 (1.93%) occurred rebleeding in the early time, among them 12 (1.36%) died. The reality or falsity of the aneurysms, the ruptured times of the aneurysms before treatment, the obvious intracranial vascular spasms seen on DSA during the procedure and the degree of embolization were the four main independent risk factors related to the early rebleeding. The probability equation of the early rebleeding of ruptured intracranial aneurysms afterendovascular embolization was calculated.Conclusion Although the incidence of early rebleeding in patients after endovascular embolization of ruptured intracranial aneurysms is low, the outcome, if it occurs, is poor with high mortality. Preoperative prevention measures directed against the risk factors, embolizing the ruptured intracranial aneurysm as completely as possible and prompt postoperative cerebral angiography are all very important for reducing the incidence of the early rebleeding. And active and effective dealing with the rebleeding can definitely improve the prognosis.