Clinical experiences of emergency ultra early stage stent-assisted coil embolization in treatment of rupture intracranial aneurysms

doi:10.3969/j.issn.1002-7386.2018.05.014

Abstract：Objective To investigate the safety and clinical efficacy of ultra-early stent-assisted coil embolization in treatment of rupture intracranial wide-necked aneurysms. Methods The clinical data about 26 patients with rupture intracranial wide-necked aneurysms who were treated in our hospital from March 2014 to March 2017 were retrospectively analyzed.All the patients were treated by stent-assisted coil embolization at the early stage of emergency. According to preoperative Hunt-Hess classification,there were 16 cases of gradeⅠ~Ⅱ,8 cases of gradeⅢgrade and 2 cases of gradeⅣ. The immediate embolism effects,perioperative complications,clinical prognosis after 90-day follow up were analyzed.Results Twenty-six patients with wide-necked intracranial aneurysm were completely released (100%),there were 23 cases (88.5%) of Raymond grade Ⅰ embolism,3 cases (11.5%) of Raymond grade lI embolism,moreover, the thrombus was formed inside the stent during embolization in one patient with anterior communicating aneurysm,and the thrombus was disappeared after treated by tirofiban sodium chloride injection. In addition there was 1 case of intraoperative aneurysm rupture,but the patient recovered well after continuous lumbar drainage.After 90-day follow up, excellent and good effects were in 23 patients (mRS score 0-2 points),bad effects in 2 patients (mRS score 3-6 points),and one patient died,with excellent and good rate being 88%. Conclusion The ultra-early stent-assisted embolization in treatment of rupture intracranial aneurysms is safe and effective,which can avoid aneurysm rupture again,improve the aneurysm density embolization rate and reduce the relapse rate,which plays an important role in decreasing the mortality and disability rate of patients.